Understanding, Recognizing, and Treating Perinatal Depression

Perinatal depression is quite common. Let us explore the diagnosis, self-help strategies, and available treatments for this pressing concern

Concept for Perinatal Depression or Postpartum Depression
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One in seven women grapples with pregnancy-related depression, a condition that, despite the label postpartum depression (PPD), frequently takes root before childbirth. So, embracing the term perinatal depression, I shed light on this pervasive issue.

“Baby blues” describes the fleeting weepiness and sadness following childbirth—common but not perilous.

Perinatal depression often surfaces weeks after delivery, persisting without intervention. Recognized as a severe medical disorder, its repercussions extend beyond the individual to encompass the well-being of both mother and baby. This article navigates the identification, self-help strategies, and available medical treatments for this pressing concern.

Decoding Perinatal Depression

Depression seldom walks alone; it brings companions. Up to two-thirds of individuals battling perinatal depression also contend with anxiety disorders, panic disorder, social phobia, and obsessive-compulsive disorder. This unaddressed mental health burden demands attention.

Perinatal depression isn’t just an individual woe; untreated, it casts a shadow on the new mother, the infant, and the entire family.

Recognizing Warning Signs of PPD

Identifying potential signs of postpartum depression is crucial:

  • Excessive sadness
  • Feeling hopeless
  • Struggling to bond with your baby
  • Avoiding social connections
  • Frequent crying
  • Disturbing thoughts of self-harm or harm to your baby
  • Neglecting household and childcare tasks
  • Sleep disturbances, either excessive or insufficient
  • Anxiety, panic attacks, or mood swings

Recognize these signals as a call to action, and seek immediate consultation with your doctor. Prompt intervention ensures a return to your joyful self, capable of relishing and cherishing your newfound motherhood.

Empowering Yourself Against Perinatal Depression

Perinatal depression demands immediate attention, and seeking help from a healthcare professional is crucial. However, you can take proactive steps to support your well-being:

1. Cultivate Joy

Engage in activities that brought you happiness before pregnancy.

2. Meet Friends and Loved Ones

Regularly spend time with friends and family who can assist with baby care, allowing you moments for rest or preferred activities.

3. Venture Out Daily

Break the 24/7 baby care routine by going for walks, running errands, or meeting a friend.

4. Nurture Bonding

Make intentional efforts to be emotionally present with your baby, as their joy can significantly counteract depressive thoughts.

5. Exercise Mindfully

Initiate an exercise program with guidance from your doctor to enhance both physical and mental wellbeing.

6. Join Supportive Communities

Explore local or online postpartum depression support groups, recommended by your doctor. Connecting with others in similar situations can be incredibly beneficial.

Treatment Paths for PPD

When tackling postpartum depression (PPD), the initial recourse is often psychotherapy, a beneficial choice, particularly for milder cases. Remarkably, even in severe instances, your doctor may recommend this approach. It’s generally advised to steer clear of medications while breastfeeding.

Engaging in therapy sessions with proficient mental health experts, either in-person or through remote video conferencing, proves instrumental in conquering PPD without resorting to medication. Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) emerge as two widely employed psychotherapeutic methods.

However, for those with a history of requiring depression medications or experiencing moderate to severe depression, psychotherapy alone might not suffice. In such cases, your doctor may initiate medication as a primary step, especially if access to psychotherapy is limited. The treatment path chosen hinges on individual circumstances, ensuring a tailored approach to address the complexities of postpartum depression.

Medicines for Perinatal Depression

Perinatal depression can be treated with various medications. Common choices include SSRIs like Zoloft and Lexapro and SNRIs like venlafaxine and duloxetine. While there are other options like TCAs, MAOIs, and hormones, SSRIs are usually preferred.

Newer medications, Brexanolone (Zulresso) and Zuranolone (Zurzuvae), act faster but come with considerations. Brexanolone is given through a 60-hour infusion, providing almost immediate relief but requires a hospital stay and costs $34,000. Zuranolone, taken orally, is rapidly effective but is expensive at $16,000 for a 14-day course. While these offer quicker relief, concerns include cost, potential addiction, and safety during breastfeeding. Zuranolone was approved in late 2023 and will be available in early 2024.

Navigating Risks of Treatment

Contemplating the safety of mental health medications while breastfeeding raises valid concerns. Fortunately, most depression medications, when present in breast milk, pose minimal risk to babies. It’s crucial to acknowledge that untreated postpartum depression can potentially harm both mother and baby more than the medicines employed for treatment.

Another noteworthy consideration is that one in five individuals initially diagnosed with perinatal depression may have bipolar disorder. Ruling out bipolar disorder is essential as depression medications can trigger mania and other complications. Moreover, the risk of suicide is heightened.

Risks of Untreated Depression

During pregnancy, untreated depression is linked to serious complications, including pre-eclampsia, premature birth, and low birth weight. Similarly, untreated PPD poses dangers, with suicide being a frequent cause of death in the year after childbirth, and potential harm to babies.

Beyond these outcomes, untreated PPD adversely affects a baby’s development, extending into childhood and adolescence.

PPD’s impact ripples through family dynamics and relationships. If you suspect PPD, seeking help promptly is crucial. There’s no shame in addressing this common medical condition, and timely treatment not only saves lives and relationships but also enhances overall quality of life.

Summing up

Perinatal depression, or postpartum depression, impacts one in seven women, often starting before childbirth. Untreated, it poses serious consequences for mothers and families. Recognizing symptoms, seeking prompt help, and exploring treatments like psychotherapy are vital. Untreated depression during pregnancy and postpartum underscores the need for timely intervention. Seeking support and dispelling stigma contribute to a positive postpartum experience, saving lives and improving overall quality of life.

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