Understanding Postpartum Depression -- Diagnosis and Treatment
How Do I Know If I Have Postpartum Depression?
Despite the fact that postpartum depression has been evident for centuries, many experts believe it is not being properly diagnosed. As knowledge about postpartum depression grows, more health care providers are looking for risk factors in their patients as early as their first prenatal care visit. If a woman is at risk, her health care provider can evaluate her moods throughout the pregnancy. After a woman gives birth, she and those close to her should watch for signs and symptoms of depression. Her health care provider should look for such signs at her six-week postpartum visit, as well.
If you experience the symptoms of postpartum depression, your health care provider will first determine your immediate risk for harming yourself or your baby. Your health care provider will also ask about symptoms to determine whether you are suffering from postpartum depression or another condition. Your thyroid levels also may be checked to make sure it is functioning normally. Hypothyroidism can cause the same symptoms as postpartum depression.
What Are the Treatments for Postpartum Depression?
Postpartum depression (PPD) sometimes goes away on its own within three months of giving birth. But if it interferes with your normal functioning at any time, or if "the blues" lasts longer than two weeks, you should seek treatment. About 90% of women who have postpartum depression can be treated successfully with medication or a combination of medication and psychotherapy. Participation in a support group may also be helpful. In cases of severe postpartum depression or postpartum psychosis, hospitalization may be necessary. Infrequently, electroconvulsive (ECT) therapy may be used to treat particularly severe depressions with hallucinations (false perceptions) or delusions (false beliefs).
It is best to seek treatment as soon as possible. If it's detected late or not at all, the condition may worsen. Also, experts have found that children can be affected by a parent's untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.
While you are recovering from postpartum depression, you will probably see an improvement from month to month. Be aware that your symptoms may flare up before a menstrual period because of fluctuations in your hormones.
Medications for Postpartum Depression
The first step in treatment is to resolve immediate problems such as sleep and appetite changes. Antidepressants are usually quite effective for this. You and your doctor will need to make a careful decision about the use and choice of antidepressants if you are breastfeeding. Some antidepressants are secreted in small amounts in breast milk. Other medications, such as lithium, are more controversial in breastfeeding because of concerns that they may cause infant toxicity, although there is debate if lithium poses a real risk. Talk to your health care provider to determine if the benefits of antidepressant therapy outweigh the risk. If you take an antidepressant, you will probably be advised to take it for six months to a year to avoid a relapse and then either taper it off or continue it longer depending on your symptoms and history.