Overview Of Condition
Postpartum Depression Guide
What Causes Postpartum Depression?
Despite much research scientists are still not sure what causes postpartum depression (PPD). However a number of possible causes have been suggested:
Depression is a mental illness which tends to run in families. One study (published in the American Journal of Psychiatry, 2006) found that 42 percent of women with a family history of depression experienced PPD after delivery of their first child, compared to 15 percent of women with no family history. The peak time for symptoms of postpartum depression to occur were between weeks 6 and 8 after childbirth. Additionally, women who experienced episodes of clinical (diagnosed) depression in the past, were at increased risk of it being triggered again by childbirth.
Hormones appear to play a major role, we know for example that hormones directly affect the brain chemicals that control our moods. Women are more prone to mood changes in puberty, during and after pregnancy and during perimenopause when their hormone balance is dramatically changeable. They are particularly vulnerable immediately before and directly after childbirth when estrogen and progesterone hormone levels plummet to practically zero. Cortisol levels, the so-called 'happy hormone', increase towards the end of pregnancy but also crash directly after delivery. Changes in blood volume, blood pressure and metabolism after delivery can also contribute to tiredness and mood swings. This is why nearly 80 percent of new moms experience baby blues. But what turns the baby blues into PPD is not clear. If a woman's brain chemistry is already wired in such a way that she has a tendency toward mood imbalances she is at higher risk of PPD. Antidepressants for postpartum depression are aimed at restoring chemical imbalances. For a more detailed article on this subject, read the effects of depression.
3. Birth Experience
Some women are disappointed that their birth experience did not live up to their expectations. This feeling of being 'let down' can trigger depression. This is particularly true if is was a traumatic birth, for example a premature labor or emergency cesarean section.
4. Not Enough Social Support
Not having family and/or partner support significantly increases the risk of PPD. This is why for example, the rate of PPD is higher in teenage pregnancies. Both practical and emotional support are important. Practical support can mean having help with household chores and hands-on baby care; as well as financial support so you are not stressed about bills. Emotionally it means having someone who is supportive and loving nearby.
5. Images of Motherhood
The expectation on mothers today is almost impossibly high. Popular images from Hollywood suggest that mothers should look naturally radiant, be estatically happy, live in perfect homes, have supportive partners and return to the workplace to continue a dynamic career within days of giving birth. The mothering instinct is supposed to be natural, not something to be learned. Is it any wonder that mothers who find the weeks and months after childbirth difficult have problems asking for help! Instead, many choose to soldier on in silence, leading to an overwhelming sense of inadequacy and isolation. See books on depression for some published personal stories.
The rates of depression are higher in women with eating disorders, especially those suffering from binge-eating and bulimia. Perfectionism is the need to have everything right and not to make mistakes, it is associated with both eating disorders and PPD.
A new mom is more likely to be emotionally stressed and prone to PPD if she has experienced stressful events during her pregnancy. Some events unfortunately are unavoidable, no matter how much we wish they were. For example the death of a loved one or a serious illness. However, other stresses are completely avoidable with a bit of planning. For example, moving house or starting major home renovations during pregnancy is not a good idea. Where possible, wait until a few months after the baby has arrived to make any major changes.
Are you tense? Take our online stress test to assess your chance of developing a stress-related illness.
7. Change in Lifestyle
A baby brings irrevocable changes to your life. You no longer have the luxury of putting your own needs first, now you have this little person who is one hundred percent dependent on you for feeding, entertainment and love. New babies are exhausting, they cry, they sleep and they wake according to their own agenda. Suddenly you are responsible for someone else 24 hours a day. This can place huge strain on relationships as there is the dawning realisation that you have lost the freedom you once took for granted. This sense of loss can trigger depression unless a mother finds ways to adjust to her new life.
Lack of certain nutrients, specifically omega-3 essential fatty acids (n-3 EFA), folic acid, vitamin B-12, iron and vitamin D are associated with increased risk of depression. Pregnant women in America generally consume less than the recommended allowance of these nutrients. Iron deficiency anemia in pregnancy also increases the risk of developing PPD. See also, natural treatment for postpartum depression.
9. Lack Of Exercise
Studies show that aerobic exercise helps protect against the toxic effects of stress, reducing the risk of depression. Lack of physical activity during pregnancy may increase the risk of PPD. Although the American College of Obstetrics and Gynecology recommend at least half an hour of moderate exercise 5 days a week (or more) for pregnant women; most women do not do this. The most common reasons cited are discomfort and fear of causing pregnancy complications.
10. Lack Of Sleep
Studies show that PPD is more common in women who are sleep deprived - specifically those who are awake for more than 2 hours between midnight and 6am and who nap for less than an hour during the day. Read more: prevention of postpartum depression.
Depending on the mother, infant and social situations, breastfeeding can be either stressful, relaxing or both. If she finds it stressful, it can increase her risk of PPD. Factors that increase the risk of stress include insufficient milk supply, infant health problems, lack of sleep and lack of support from family or the workplace. Contrary to popular belief, there is no evidence that breastfeeding reduces the risk of PPD. While there are many benefits of breastfeeding, if it is causing you undue stress, consider switching to bottle feeding.
12. Thyroid Hormones
Low levels of thyroid hormones can cause depression, so your doctor should perform a simple blood test to check for thyroid problems. About 10 percent of new moms develop postpartum thyroiditis, a condition that can result in temporary hypothyroidism (underactive thyroid) and hyperthyroidism (overactive). Symptoms of hypothyroidism include tiredness, depression, memory loss and weight gain. Symptoms of hyperthyroidism include anxiety attacks and insomnia. Ruling out a thyroid problem is important, because antidepressants and therapy would not fix it.
NEXT: Do you have PPD? Take the Postpartum Depression Quiz.