Postpartum Depression A Mothers’ Mental Health Toolkit Project Learning Video with Dr. Joanne MacDonald Reproductive Mental Health Service IWK Health Centre Halifax NS

Postpartum Depression

Depression that begins for the mother within the first 12 months after a baby is born is called Postpartum Depression. This comes from the word partuition which is a medical term for the process of delivering the baby. 1 in 10 women will experience Postpartum Depression. This mental health problem is then one of the most common complications of childbirth % will have no previous history of diagnosed illness.

Postpartum Depression Family and friends may not expect PPD

Postpartum Depression Signs? Inability to rest when baby rests Mind working very slowly or very quickly Low motivation Poor concentration, planning Lack of ability to enjoy usual activities or people Low self-concept, unusual hopelessness Overwhelmed easily compared to past coping Unexplainable changes in sleep or appetite

Postpartum Depression True or False? 1. PPD is more common with teen mothers 2. Family history of PPD increases risk 3. The depression will lift in time 4. It is better to cope without treatment for the sake of the baby/child 5. There is little family or friends can do

Postpartum Depression 1. Teen mothers have the same rate of Major Depression as older mothers in formal studies. But they may have more difficulties with adjustment if supports are few, and increased social disadvantage because of deficits in education or income. 2. Family history of PPD with mother, aunts, sisters or cousins, does increase a woman’s risk. 3. Up to 20 % of untreated postpartum depression becomes chronic depression that affects function and quality of life. 4. Untreated depression in a mother is strongly associated with delays in development and attachment for the baby. 5. High levels of social support seems to protect from PPD and improve recovery.

Postpartum Depression Social Determinants of Health influence availability and accessibility of health care

Postpartum Depression Fast Fact: Postpartum depression can be a mixture of mood disturbance – with sad, blue or low mood, unusual irritability and tension and/or increased anxiety in the body and in thinking. It can be dismissed as adjustment and not recognized as a treatable illness.

Postpartum Depression Why does depression risk increase after a baby is born? Sleep deprivation is a general trigger for mood regulation problems Major changes in role, relationships and expectations contribute to depression risk in any person Usual coping strategies may not be as easy to do, such as daily exercise routine Some women have brain chemistry that is triggered by the hormones that change in pregnancy and after birth. This is the factor that is shared by family members at risk.

Postpartum Depression Strategies to Prevent PPD include: Reducing stresses where possible Help with tasks other than baby care Rest periods from baby care Building in extra sleep whenever possible Active treatment of depression in pregnancy Cognitive-behavioral & emotional regulation strategies and therapies

Postpartum Depression Treatment Options: Mindfulness & Relaxation Techniques Physical Exercise including Practices that increase relaxation and focus Interpersonal and Cognitive-Behavioral Psychotherapy Antidepressant Medications ( safety for each woman and her baby if breastfeeding needs to be evaluated; many medications are safely and effectively used) Antianxiety Medications Sleep Medications Nutritional Enhancement, including Supplements such as Omega-3-Fatty Acids

Postpartum Depression Who can help? Friends & Family

Postpartum Depression Who can help? Partner

Postpartum Depression Who can help? Primary care doctor or nurse

Postpartum Depression Who can help? Mothers supporting other mothers

Postpartum Depression Who can help? Community Support Workers

Postpartum Depression Who can help? Mental Health Professionals

Postpartum Depression What can help? Self-care Self-directed recovery strategies Peer support and connection Key Resources: mentalhealth.htm

Postpartum Depression What’s the outcome? Full pre-baby recovery is typical with treatment Full physical and emotional recovery can come slowly though over weeks to months Self-care strategies and stress reduction may need to become lifelong habits

Postpartum Depression What is a woman’s risk for depression after her next pregnancy if she has had one episode of Postpartum Depression?

Postpartum Depression Risk first time is 10% One episode risk increases to 20 % But chance of remaining well is still 80% Self-care, stress reduction, quick assessment and treatment of new depression reduces risk and effects of illness

Postpartum Depression Take Home Point: Community service providers can be critical as sources of support, recognition of a woman’s struggle, knowledge of local resources and leadership in reducing stigma in mental health care for mothers. Postpartum Depression can be a serious but treatable illness with a good outcome with care.