Postpartum Depression

Excerpt

Postpartum depression (PPD) is a mood disorder that affects individuals within 1 year after childbirth. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), postpartum depression is now included in the term perinatal depression. A major depressive episode that begins during pregnancy or within 4 weeks after delivery is classified as peripartum depression. This term encompasses both prenatal and postpartum depression. The DSM-5 does not recognize PPD as a separate entity. Instead, PPD is included within the broader diagnosis of peripartum depression. Unlike the "baby blues," which typically resolve within a few weeks, PPD is more severe and can last for months if untreated.

Depression symptoms, including persistent sadness, lack of interest, low self-esteem, sleep disturbances, loss of appetite, anxiety, irritability with a hostile attitude towards infants, self-blame, and feelings of humiliation characterize PPD. People with PPD may also experience changes in sleeping and eating patterns, difficulty bonding with their baby, and feelings of hopelessness or worthlessness. Recognizing and addressing PPD is crucial for the health and well-being of the patient and their baby. If left untreated, PPD can interfere with the ability to care for the child and may contribute to long-term developmental issues in the child (eg, emotional and behavioral problems). PPD can also strain family relationships and increase the risk of suicide.

Screening for PPD should be a routine part of postpartum care, utilizing tools such as the Edinburgh Postnatal Depression Scale (EPDS) to identify those at risk. Treatment typically involves a combination of psychotherapy, support groups, and medication, including antidepressants, which can safely be used during lactation. Up to 50% of PPD cases remain undiagnosed due to patient reluctance to disclose symptoms, partly because of the stigma around PPD, which includes fears of abandonment and lack of support upon disclosure. Raising awareness about PPD, reducing stigma, and ensuring access to mental health resources are essential steps in supporting new parents and promoting healthy family dynamics.