*Among women, the leading cause of disease-related
disability is depression (Gaynes et. al, 2005).
*Perinatal Mood and Anxiety Disorders have been
identified in women of every culture, age, income level and race. (The term “Perinatal” generally refers to
the period of pregnancy and the first year after a baby is born.)
*Research shows that Perinatal Mood and Anxiety
Disorders can appear days or even months after
childbirth, and does not usually resolve without
treatment. (Kendell, 1987).
*Although the term “Postpartum Depression” is often
used, there is actually a spectrum of disorders that canaffect mothers during
pregnancy and postpartum. These include:
Depression/ Anxiety in
Pregnancy: It is estimated that 15-20% (Bennett et. al, 2004) of
pregnant
women will experience moderate to severe symptoms of
depression and/or anxiety.
Postpartum Depression: Approximately 15%
(Marcus, 2009) of women experience major or
minor depression following childbirth. Symptoms differ
for everyone, and may include: feelingsof anger, fear and/or guilt, lack of interest in the baby, appetite and sleep disturbance, difficulty
concentrating/ making decisions, and possible thoughts of harming the baby or oneself.
Postpartum Panic Disorder: This is a form of anxiety that occurs in up to 11% of new mothers.
Symptoms include: feeling very nervous, recurring
panic attacks (shortness of breath, chest pain,heart palpitations), many worries or fears (Wisner, Peindl & Hanusa, 1996).
Postpartum
Obsessive-Compulsive Disorder: This
is the most misunderstood and misdiagnosed
of the perinatal disorders. It is estimated that as
many as 3-5% of new mothers will
experiencethe following symptoms: Obsessions (persistent thoughts or mental images related to the baby),
Compulsions (doing things over and over to reduce the fears and obsessions), a sense of horror
about the obsessions. These mothers know their thoughts are bizarre and are very unlikely to ever
act on them (Brandes et al, 2004).
Postpartum Posttraumatic
Stress Disorder: An estimated 1-6% (Beck, 2004) of women
experience PTSD following childbirth. Symptoms
typically include: Traumatic childbirthexperience with a re-experiencing of the trauma (dreams, thoughts, etc.), avoidance of stimuli
associated with the event (thoughts, feelings, people, places, details of event, etc.), and persistent
increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response).
Postpartum Psychosis: occurs in approximately 1 to 2 of every 1,000 deliveries (Sit, et al, 2006).
The onset is usually sudden, most within the first 4
weeks, with symptoms including: delusions(strange beliefs) and/or hallucinations, feeling very irritated, hyperactive, decreased need for sleep,
and significant mood changes with poor decision-making. There is a 5% infanticide/suicide rate
associated with Psychosis and thus immediate treatment is imperative.
*Without appropriate intervention, maternal depression
can have long term and adverse implications for both the mother and the child.
*A mother’s mood / anxiety symptoms have a direct
impact on her partner as well. Her partner may feel overwhelmed, confused, angry, and afraid she will
never be well. This may place a strain on the couple’s relationship. About 10% of new dads have mood or
anxiety problems, as well.
*Screening and early intervention can protect the
well-being of the mother, baby and entire family.
*Scientific evidence is available on the effectiveness
of a variety of treatment options.
*Mothers need to know: “You are not alone. You are not to blame.
With help, you will be well.”
Beck, C. 2004. Post-Traumatic Stress Disorder Due to Childbirth, The Aftermath. Nursing Research 53(4):216-224.
Bennett, HA, et al., Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004 Apr;103(4):698-709. Review.
Brandes, M., Soares, C.N., & Cohen, L.S. (2004). Postpartum onset obsessive compulsive disorder: Diagnosis and management.
Archives in Women’s Mental Health, 7, 99-110.
Gaynes, et al., (2005). Agency for Healthcare Research and Quality (AHRQ), in collaboration with the Safe Motherhood Group (SMG).
Kendell, R.E., Chalmers, J.C., and Platz, C. (1987). Epidemiology of puerperal psychoses. British Journal of Psychiatry, 150, 662-673.
Marcus, S., Depression during pregnancy: rates, risks and consequences--Motherisk Update 2008, Can J Clin Pharmacol. 2009 Winter;6(1)
Sit, D., et al ., A review of postpartum psychosis, Journal of Women’s Health, 2006 May:15(4):352-68.
Wisner, K.L., Peindl, K. S., & Hanusa, B.H. (1996). Effects of childbearing on the natural history of panic disorder with comorbid mood
disorder. Journal of Affective Disorders, 41, 173-180.
©2009, Postpartum Support International
