The birth of a child can be one of life’s greatest joys, but for 10 to 20 percent of all mothers, it can trigger an unexpected – and potentially serious – condition known as postpartum depression (PPD). The emotional state can range from a mild case of “baby blues” after childbirth to severe and long-lasting depression, or even postpartum psychosis.
To meet the need, Parkland launched a new Postpartum Depression Program funded by the state’s 1115 waiver that integrates behavioral health services into outpatient obstetrics settings to provide increased access to mental health services.
The causes of PPD are not well understood, but hormonal changes are believed to play a strong role. After childbirth, a dramatic drop in the hormones estrogen and progesterone may contribute to PPD. Changes in metabolism, sleep deprivation and lifestyle influences such as a demanding baby, other children, financial pressures and lack of support from one’s partner or loved ones also play a role.
Symptoms may include sadness, anxiety, episodes of crying, mood swings, feelings of shame or guilt, insomnia, changes in eating patterns and withdrawal from friends and family. In severe cases, there is a risk of maternal suicide and infant harm or death.
Children of mothers with postpartum depression can become withdrawn, irritable or inconsolable; display insecure attachment and behavioral problems; experience problems in cognitive, social and emotional development; and have a higher risk of anxiety disorders and major depression in childhood.
Treatment for PPD can include individual or group counseling, medications, referral to a Parkland psychiatrist and hospitalization for extreme cases. PPD counselors coordinate care with the Parkland Psychiatry Clinic and provide phone follow-up and referrals to other resources, such as domestic violence counseling, parenting skills training or substance abuse counseling.
At Parkland, all women are screened for symptoms of PPD at their routine postpartum two-week check-up using the Edinburgh postpartum Depression Scale (EPDS), a questionnaire widely used to identify women with PPD. Further assessments can include substance abuse screening, a psychiatric/social history and discussion of symptoms, with same-day referral to a Parkland psychiatrist if necessary. If you feel you have postpartum depress, we can help at one of our Women’s Health Centers near you.