Postpartum Depression

What is postpartum depression?

Postpartum depression, or PPD, is a form of clinical depression that one in ten women experience after childbirth. Contributing factors of PPD are a plummet in estrogen and progesterone after birth, the emotional stress on families combined with a lack of sleep. PPD is not simply just Baby Blues, which subsides after a few days or weeks. Rather, postpartum depression can persist for months after the birth of a child. This form of depression shares many of the same symptoms as general depression, namely: sadness, anxiety, fatigue, changes in eating and appetite, guilt, mood swings, and a general lack of interest in life. In addition, PPD also includes symptoms such as: thoughts of doing harm to the baby, difficulty bonding with the baby, and feeling that you cannot care for the baby. This form of depression doesn’t just affect you; it can have damaging long-term effects on your relationship with your spouse as well as your baby. Children who have mothers in the throes of PPD are more likely to have behavioral and cognitive problems later in life, so it is important to treat this disease.

Who is at risk?

If you have had PPD after other pregnancies, experienced depression during your pregnancy, had a history of depression, or if this pregnancy was unplanned or unwanted, you may be at risk for postpartum depression. The recent loss of a loved one or a job, or conflicts with your partner are also be contributing factors. It has also been shown that a lack of support from your spouse, family or community can contribute.

Is PPD Preventable?

Having an honest, open relationship with your doctor is important during pregnancy. Disclose concerns you may have with your doctor, and inform him of any history with depression. If you have had postpartum depression with other pregnancies, your doctor may prescribe antidepressants immediately after delivery to prevent another bout of PPD. Eating a balanced diet rich with omega 3 fatty acids and keeping hydrated (especially breastfeeding mothers) has also been shown to help postpartum depression. Exercise as soon as your doctor says it’s safe- the endorphins released during exercise can counteract the effects of postpartum depression.

What is the treatment for postpartum depression?

In some cases, counseling may be enough to help you through your PPD, but your doctor may prescribe antidepressants. There has also been research concerning hormone replacement therapy. Be aware that any medication will be passed through your milk if you’re breastfeeding. If you’re looking for alternative treatments, studies show that acupuncture and massage therapy may lessen the effects of postpartum depression. An important aspect of overcoming postpartum depression is to take care of yourself. Get as much sleep as you can with the new baby. Take at least fifteen minutes every day to do something that you enjoy or helps you relax. Remember that your baby will be happier if you’re happy.

Dysthymic disorder

Dysthymia is a mild but chronic form of depression. Dysthymia symptoms usually last for at least two years, and often much longer than that, especially when the condition starts in childhood. Although the symptoms are less severe than major depression, they can affect your life seriously because they last so long. With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity and have a low self-esteem. In general, dysthymia prevents you from living life to its fullest, and your overall quality of life may be low.

Dysthymia symptoms typically come and go over a period of years, and their intensity can change over time, as well. In general, you may find it hard to be upbeat even on happy occasions — you may be characterized as having a gloomy personality.

Symptoms of dysthymic disorder are very similar to those of major depression: loss of interest in daily activities, feeling sad or low, poor appetite, overeating, hopelessness, sleep problems, lack of energy, fatigue, low self-esteem, trouble concentrating, self-criticism, excessive anger, decreased productivity, feelings of guilt and avoidance of social activity. People who have dysthymic disorder will often report that they don’t recall ever not feeling depressed, but they may be relatively functional in managing their life, although the symptoms are severe enough to cause distress and interference with important life role responsibilities.

Like major depression, these symptoms don’t go away on their own and may even get worse if left untreated; commonly, untreated dysthymic disorder can evolve into major depression. Dysthymia and depression is known as double depression.

Some complications of dysthymia can include:

• Reduced quality of life
• Major depression
• Suicidal behavior
• Substance abuse
• Relationship difficulties
• Family conflicts
• Social isolation
• School and work problems
• Decreased productivity

What causes dysthymic disorder?

Like major depression, the causes of dysthymic disorder aren’t known, although it is felt to have causes similar to that of major depression; i.e., biochemical, genetic and environmental.

Risk factors for dysthymic disorder

It isn’t exactly clear how many people suffer from dysthymia; however, it is felt to be more common than major depression. The reason for this is that dysthymia tends to start earlier in life, often in childhood or during the teen years, and lasts longer than depression.

Certain factors seem to increase the risk of developing dysthymia and include:

• Having biological relatives with depression
• Having biological relatives with dysthymia
• Being female
• Stressful life events
• Having a chronic medical condition

When to seek medical attention

The first step in getting over any type of depression is recognizing the symptoms and realizing that not everyone spends their life feeling like this. The second step is to see your doctor and talk with him or her about getting specialized medical attention to treat the disorder.

If your primary care physician feels your symptoms are mild or haven’t been present for a long period of time, he or she may treat you with anti-depressants; if that isn’t felt to be effective, you may be sent to a specialist for further care. As only MDs can prescribe medication, you may be sent to a psychiatrist, rather than a psychologist or licensed clinical social worker (LCSW), or your physician may choose to continue prescribing your medications while sending you for psychotherapy.

Be prepared to tell your physician how long you have had symptoms, how your daily life is affected, if you have had other treatment and what that treatment has been, if you are taking medication or have tried medication and what those medications are, what you have tried on your own to treat, whether you are taking illicit drugs (be honest about this – it’s important), and whether any of your relatives suffer from any kind of depressive disorder or addictions.

Major Depression

This is the most serious form of depression in terms of number of symptoms and severity of symptoms. It is a medical illness that involves the mind and the body and affects how a person thinks and behaves. Although suicidal thoughts or gestures are part of major depression, a person does not have to be suicidal to be clinically depressed; you may not be able to go about your usual daily activities, and depression may make you feel as if life just isn’t worth living anymore. Although some people experience only one episode of depression, most have repeated episodes of depression symptoms throughout their life.

Symptoms of major depression

• Loss of interest in normal daily activities
• Feeling sad or down
• Feeling hopeless
• Crying spells for no apparent reason
• Problems sleeping
• Trouble focusing or concentrating
• Difficulty making decisions
• Unintentional weight gain or loss
• Irritability
• Restlessness
• Being easily annoyed
• Feeling fatigued or weak
• Feeling worthless
• Loss of interest in sex
• Thoughts of suicide or suicidal behavior
• Unexplained physical problems, such as back pain or headaches

The severity of symptoms differ from person to person. In some people, the symptoms are obvious to those around us, even if we don’t recognize them in ourselves. Sometimes, a depressed person may just feel miserable or unhappy without knowing why.

What causes major depression?

It isn’t known exactly what causes depression, but it is felt to be a combination of factors.

Biochemical: It is felt that naturally occurring chemical uptake to the brain (called neurotransmitters) may be interrupted or faulty. These affect mood and thought and are felt to play a part in depression. Hormonal imbalance can also be a factor.

Genetic: Some studies show that depression is more common in family groups and therefore is hereditary to some degree.

Environment: Life events can trigger depression. Loss of a loved one, financial problems, periods of high stress and marital issues are some of the major environmental factors in depression.

Risk factors for depression

Although the exact causes or triggers for depression aren’t known, there are certain factors and life events that seem to increase the risk of developing depression. Being aware of these triggers can help you identify your own depression.

• Having other biological relatives with depression
• Having family members who have taken their own life
• Stressful life events, such as the death of a loved one
• Having a depressed mood as a youngster
• Illness, such as cancer, heart disease, Alzheimer’s or HIV/AIDS
• Long-term use of certain medications, such as some drugs used to control high blood pressure, sleeping pills or, occasionally, birth control pills
• Certain personality traits, such as having low self-esteem and being overly dependent, self-critical or pessimistic
• Alcohol, nicotine and drug abuse
• Having recently given birth
• Being in a lower socioeconomic group

Seeking medical advice

Many people don’t recognize their own depression and therefore don’t seek help. If you recognize yourself in any of the above, you are taking a step in the right direction. Once you recognize the symptoms, you can then also recognize that you don’t have to live like this.

It’s perfectly normal to occasionally “feel blue,” sad or upset or unhappy with situations in your life. With depression, however, these feelings linger for a long period of time. Your friends and family may tell you to “get over it,” but you find yourself unable to do that. These feelings are more intense than just “feeling blue,” and interfere with your life, work and enjoyment of daily living.

If you are feeling suicidal or having thoughts that life just isn’t worth living, seek medical attention immediately. If you are having suicidal feelings right now, call the National Suicide Hotline at 1-800-273-TALK (1-800-273-8255). This is a free service.

If you don’t want to or are unable to for some reason, you have other choices for reaching out for help:

• Contact a family member or friend
• Contact a doctor, mental health provider or other health care professional
• Contact a minister, spiritual leader or someone in your faith community
• Go to your local hospital emergency room
• Call a crisis center or hot line

Helping a loved one

You may be visiting HandlingDepression.com because you feel someone you love is suffering from depression and you wonder what you could be doing for them.

Have an open and honest discussion with them. As stated above, many times people don’t realize they’re depressed. For them, depression is “normal,” and they don’t recognize the severity of their condition. They believe that everyone feels the way they do. You may not be able to force someone to get professional help, but you can be supportive and offer encouragement.

Sometimes, someone who is depressed just needs someone to demonstrate to them that their presence in the world does matter, that there are people who care about them enough to help them make the first step in the right direction. It can be very helpful to them if you get a referral for them to get professional help, assist them in making the appointment and getting to it. Even these simple tasks can be daunting to someone who is severely depressed. Often, they require assistance in getting the help they desperately need because they are incapable of taking care of the things the rest of us take for granted.

If your loved one is suicidal, do not attempt to help them on your own. That is not to say don’t help them – just don’t try to handle it without professional help. Take them to the emergency room or call for emergency help.

SAD

Seasonal Affective Disorder (SAD)

It’s very common for people to develop cabin fever during the winter months, eat more and put on weight and sleep more when the temperature drops and darkness falls earlier and lasts longer. These are normal and common reactions to changing seasons.

However, people with Seasonal Affective Disorder (SAD) experience a more serious reaction. The short days and long nights trigger feelings of lethargy, fatigue and depression. These shouldn’t be dismissed as simply a case of “winter blues” or “cabin fever.” SAD is a type of depression that can be crippling.

SAD typically becomes apparent in young adulthood and is uncommon in people less than 20 years of age. Some studies have shown that although it’s more common in women, it’s symptoms may be more severe in men. Some evidence also suggests that seasonal affective disorder is more common in people who live at higher latitudes or farther from the equator, or that there is a component of susceptibility in family groups.

The specific causes of seasonal affective disorder are unknown. Some researches suspect that it’s related to the circadian rhythm and that the reduced levels of sunlight may disrupt the circadian rhythm. The circadian rhythm is a process that regulates the body’s internal clock, letting you know when to sleep and when to wake. Disruption of the process may trigger depression, more in some individuals than others and more in some areas of the country or world than others.

Some researchers also suspect that SAD may be related to melatonin, a sleep-related hormone that has been linked to depression, as the body’s production of melatonin is increased during the long nights of winter. Others suggest that serotonin, a natural chemical in the brain that affects mood, may be a factor, as reduced sunlight can cause a drop in serotonin levels, which may lead to depression.

Treatment for SAD can be very effective. The first step to recovery is recognizing the symptoms.

Signs and symptoms

SAD cycles with the seasons, typically appearing in the fall or early winter and going away in the spring, as the days get longer and warmer. However, some people have the opposite pattern, developing seasonal affective disorder in the warmer months. In either case, problems may start out mild and become more severe as the season progresses.

In some cases, people may experience reverse seasonal affective disorder. Instead of symptoms of depression, they have symptoms of mania or hypomania (a less intense mania) during the summer.

Symptoms of winter-onset SAD include:

• Depression
• Hopelessness
• Anxiety
• Loss of energy
• Social withdrawal
• Oversleeping
• Loss of interest in activities you once enjoyed
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Difficulty concentrating and processing information

Spring and summer (summer depression) SAD symptoms can include:

• Anxiety
• Insomnia
• IIrritability
• Agitation
• Weight loss
• Poor appetite
• Increased sex drive

Reverse SAD (mania or hypomania) include:

• Persistently elevated mood
• Increased social activity
• Hyperactivity
• Enthusiasm out of proportion to the situation

When to seek medical advice

If you feel down for days at a time or can’t seem to get motivated, or if you persist in having some or all of the symptoms of seasonal affective disorder, make an appointment and go see your doctor.

Subscribe to updates at this site for upcoming information on other types of depression and helpful tips on how to handle depression and what you can do to minimize the symptoms.