Postnatal depression

Postnatal depression (also called Postpartum depression or PPD) is a form of clinical depression which can affect parents following childbirth. While mood swings and weepiness are common in new mothers and often referred to as the 'baby blues', PPD is a much more serious disorder which can affect your ability to care for yourself and your newborn child. Over half of all new mothers experience the 'baby blues' but they usually last only a few days and don't tend to lead to PPD. Around one in 10 women gets PPD but it can also affect men to a lesser extent and symptoms can last from a few weeks to several months.

Symptoms of PPD can occur anytime within the first year following childbirth and include;

Sadness
Guilt
Low Self-Esteem
Exhaustion
Panic attacks and anxiety
Becoming easily frustrated
Impaired speech or writing
Sleep and eating distrubances
A lack of interest in your baby
Negative feelings towards your baby

The exact causes of PPD are as yet unknown but research is ongoing and a number of theories have been proposed. Biological changes are common throughout pregnancy and there may be a link between these changes and PPD. Hormonal changes such as a sharp drop in oestrogen and progesterone occur suddenly after childbirth. Although it's not clear how these affect mood or emotions, research suggests that women who are more sensitive to these changes can go on to develop PPD. Similarly changes in the immune system and blood pressure have also been shown to contribute.

In addition to the chemical changes, other physical changes also occur following pregnancy and coupled with the emotional stress involved this is seen as a common cause of PPD. Lifestyle adjustments are particularly difficult for new mothers and the stress of caring for the baby and physical changes like loss of baby-weight can all contribute or trigger PPD.

Research has also found that women with less resources and social support are at a greater risk of developing PPD. Mothers used to working may feel isolated at home and those who have less support, especially those lacking the help of their immediate family are more likely to develop PPD. Other at-risk groups include those of African descent and lesbian or bisexual mothers, who may face discrimination as well as the usual stresses of childbirth.

A number of risk factors have also been identified that are likely to lead to PPD,

A history of depression
Low self esteem
Prenatal depression
Poor marital relationship
Single parent
Unplanned pregnancy
Cigarette Smoking
Formula rather than breast feeding

There has been some sucess with preemptive treatment of PPD and women can be screened by their doctor to find their risk for developing the disorder. Nutrition can be a factor in preventing PPD, a loss of omega 3 fatty acids from the mother's brain occurs during pregnancy in order to support the brain of the fetus. This can be combated by increasing the omega 3 acids in the mothers diet and foods such as fish and eggs are high in these. Protein also has an important role to play and it's recomended that nursing mothers eat protein-rich foods such as meat and cheese. Similarly vitamins and proper nutrition can also lessen the risk of PPD as can avoiding dehydration which can cause feelings of fatigue.

PPD is usually treated in the same way as normal depression, using a combination of therapy and medication. Individual or group therapy is often very effective in treating PPD. Interpersonal therapy focusing on relationship issues has also been shown to be good at treating the disorder. Marital issues which may contribute to PPD can often be helped by attending counseling sessions particularly if you're feeling unsupported at home.

Common medications prescribed for PPD include antidepressants or serotonin-specific reuptake inhibitors (SSRI's). These can help reduce the length of the symptoms and their severity. Many new mothers choose to only use therapy however as there are risks of passing the medication to the baby through breastfeeding. Other physical treatments include maintaining a healthy diet and consistent sleep patterns. In some cases however, the symptoms of PPD will disappear of their own accord.