Overview Of Condition
Postpartum Depression Guide
|How Is Postpartum Depression Diagnosed?
Despite the relatively high incidence rate of postpartum depression (PND), the condition can be difficult to detect. This is partly because there is no definitive medical test for depression and partly because new moms are often reluctant to report depressive symptoms to their doctor. Why do they delay?
1. Women expect a period of change and adjustment after having a baby. As a result first time moms may not recognize that what they are experiencing is not ‘normal’.
2. Society places pressure on women to be ‘great mothers’. As a result, if the mother realizes something is wrong she is loath to admit it out of shame.
3. Many women with PPD think they are going ‘crazy’ and worry that if they admit these thoughts that they will be locked up or that someone will take their baby away.
Yet, studies show that the longer PND remains untreated the longer it is likely to last. Not only that, but you run the risk of suffering from chronic bouts of depression for the rest of your life. Mothers with PND are twice as likely to have future episodes over a 5 year period. Another issue in delaying diagnosis is the speed at which symptoms occur. When symptoms are severe and start almost immediately after childbirth, women are more likely to seek help early. However, in many cases symptoms are insidious and creep up gradually over a number of months. In such instances, treatment is often delayed, if it is ever sought.
If you think you may be experiencing symptoms of postpartum depression (even if you gave birth six months or longer ago), contact your primary care doctor or Ob/gyn. They will be able to carry out an initial screening before recommending you to a competent professional for further assessment.
There is significant evidence that formal depression screening is very useful in detecting PPD. Two frequently used screening tools are the Edinburgh Postnatal Depression Scale (see postpartum depression quiz) and the Patient Health Questionnaire, which have extensively been tried and tested. A high score on these tests indicates the presence of PND but it still is not a clinical diagnosis. The doctor will also look for signs of sadness, guilt, worthlessness and change in eating habits - or any such changes that occur every day for at least 2 weeks. He should also carry out a blood test to rule out other causes for mood swings such as anemia or a temporary thyroid disorder. Based on this complete clinical assessment your doctor may refer you to a mental health
professional for a diagnosis.
If you are referred to a psychiatric professional you will need to go through another round of evaluation. At the end of the evaluation a diagnosis is usually given. Different therapists have their own methods of evaluation. They will probably use your results from the Edinburgh scale as a starting point and then ask more specific questions about:
• Your hormone history, for example, how bad your menstrual mood swings are.
• If there is a family history of mood disorders.
• What you are eating and drinking.
• The major stresses in your life.
• The quality and quantity of your sleep. Feeling tired because your baby is a few weeks old and is not sleeping is normal. However feeling exhausted when your baby is 4 months old and sleeping soundly is more likely to be a sign of depression.
So You Have PPD? Your Initial Reaction
Women react in different ways to the diagnosis that they have PPD. The most common reactions are:
Denial: You may say something like ‘I just have the baby blues, this phase will pass once my hormones sort themselves out’. Or you may think, depression is something that happens to other people and not to you.
Shame: You may feel shame or embarrassment because having PPD must mean you are 'mad' or 'crazy'.
Weak and inadequate: ‘What's wrong with me, other mothers can handle having a baby so why can't I?’ The assumption here is that the condition is unique to you, whereas in fact 1 in 10 new moms develop PPD. PPD is not a character flaw, it is an illness that needs treatment to correct.
Self Pity: ‘Why me?’ Feeling a little self pity is not a bad thing, particularly if it lets you accept your diagnosis and move onto the treatment stage.
Guilt: ‘Did I cause this? I've never been confident; maybe I shouldn't have become a mother’. Again a reminder - PPD is an illness; there is nothing you can do to cause it. (Read about the causes of postpartum depression).
Although it may not feel like it, a diagnosis is a major step in the right direction. Once you have worked through the initial emotional implications you can put your postpartum treatment plan in place. It's time to get your life back on track. The next step is to find a therapist you like and that you feel you can work with. This may be the person who performed the professional diagnosis, or someone else. Seeing a therapist or counselor will help you recover more quickly and completely than if you try to work through issues on your own. Untreated PPD can turn into chronic depression, that is, relapses of depression for the rest of your life. Getting the right support and being treated quickly is therefore critical for your mental health and well being.