Mental health is a vital part of each mother's overall health as as well as their child's health and development. This is especially important as untreated perinatal mental health challenges are among the leading causes of the U.S. maternal mortality crisis.
I was privileged to serve and oversee Maternal and Child Health at Bellevue Hospital as a first-line manager in my journey. We coordinated services for maternal child health, collaborated with registered nurses, neonatologists, OB/GYN residents, pediatricians, registered dieticians, and NYU social work graduate interns. Postpartum depression can be assessed by a child's low birth weight, previous usage of substance abuse and ability to take care of herself and the baby. The Weekly Maternal Childhealth Round and rotating 24/7 on call were awesome!
The Importance of Protecting a New Mother's Mental Health.Postpartum depression (PD) is a mental health condition where you feel sad, hopeless, or anxious for more than 2 weeks after childbirth. It is the number one health problem after childbirth, affecting 10% to 20% of all
women. Postpartum Psychosis (PPP) usually affects 1 or 2 women out of every 1000. Perinatal mental health is preventable.
Common symptoms of PPD are:
- Irritability
- Guilt
- Having a hard time feeling connected to your baby
- Having a hard time feeling connected to your friends and family
- Crying a lot
- Feeling tired
- Sleeping less or more than usual
- Eating less or more than usual
- Feeling nervous about your ability to care for your baby
- Having trouble thinking clearly
- Having thoughts about hurting yourself or your baby (Gupta, 2021).
PPD can also happen in men, birth mothers, adoptive parents, and grandparents.
Postpartum psychosis (PPP) is a rare mental health condition that causes psychosis.
People with psychosis have an altered experience of reality. This interferes with their ability to function normally in everyday life. (Gupta, 2021).
PPP usually starts suddenly in the first couple of weeks after childbirth.
Symptoms include:
- Paranoia
- Dramatic mood changes
- Hallucinations
- Delusions
- Suicidal and/or homicidal thoughts (Gupta, 2021)
What causes postpartum depression and postpartum psychosis?
We don't know for sure what causes PPD and PPP. It's likely a combination of:
- Family history (genetics)
- Personal medical history
- Personal mental health history
- The emotional, social, and hormonal changes that are part of childbirth (Gupta, 2021)
The two most used instruments are the patient health questionnaire (PHQ -9) and the Edinburgh Postnatal Depression Screen. (EPDS). The 10 questions that are self-administered and Translated into numerous languages. A score of 10 is considered positive and clinicians need to review self-harm behaviors. (Simas et al, 2023).
Can postpartum depression lead to postpartum psychosis?
PPD and PPP are different conditions, though they can occur together.
PPD is treated with therapy (counseling) and/or medication. It can usually be treated on an outpatient basis. This means you stay at home and see a provider as needed. (Gupta, 2021). On August 24, 2023, there was a new FDA-approved postpartum depression medication, Zuranolone. (Simas et al, 2023).
Postpartum Psychosis is considered a medical emergency
If you or someone you know are having PPP symptoms, contact a healthcare provider immediately (STAT). If it is a life-threatening situation, call 911 or the person experiencing PPP should be taken to the nearest emergency room.
Tips for Postpartum Depression
- Psychotherapy is the first line of treatment for mild depression.
- Pharmacotherapy is considered for moderate to severe symptoms.
Get support. Resources:
- If you need more postpartum mental health resources, call the Postpartum Support International HelpLine at 1-800-944-4773.
- If you are pregnant or a new mother and you are in crisis,
the National Maternal Mental Health Hotline provides free,
confidential support 24/7 in English and Spanish. Call or
text the hotline at 833-TLC-MAMA ( 833-852-6262). - National Women's Health Information Center
https://www.womenshealth.gov/mental-health/mental-health-conditions
/postpartum-depression - Medline Plus
http://www.nlm.nih.gov/medlineplus/postpartumdepression.html
References:
Gupta, S. (2021) What's the Difference Between Postpartum Depression and Postpartum Psychosis? GoodRx Health
Simas, M. , Wheelan, A. & Byatt, A. (2023). Women's Health: Postpartum Depression New Screenings and Recommendations. JAMA Insights