Anna Elzabeth Tom, Correspondent, India Pharma Outlook
Not every postpartum mood disorder is the same. There mainly three types of post-partum mood disorders based on their varying severity.
About 50 to 85 percent of new moms experience baby blues in the first few weeks following delivery. It’s normal and is not a severe mental illness. The mother may feel anxiety, sadness ad irritability, and it usually peaks on the fourth or fifth day post-delivery and should usually subside within two weeks.
On the other hand, postpartum depression is persistent and doesn’t subside after two weeks. One in every seven new mother has been shown to develop PDD. It can extend for months and will affect the daily functionality of the mother. The mother develops anxiety, a change in appetite and sleep, hypochondriasis, and even suicidal tendencies.
“You can expect a little baby blues in some women for certain, but with postpartum depression, when a patient has persistent sadness, a loss of interest in pleasure, and anhedonia, and it is really affecting her quality of life…” says Deb York, MSN, PMHNP-BC, APRN, CCRA, Adjunct Faculty Instructor, Walden University.
Postpartum obsessive-compulsive disorder has also been reported, where women start having intrusive thoughts of killing their infants. The most severe postpartum mental disorder is Postpartum Psychosis. It’s usually rare, and only one or two in 1000 new mothers experience this. This is a psychiatric emergency, and the mother experiences hallucinations, insomnia, bipolar episodes, irritability and delusions. Women with Postpartum Psychosis are at high risk of suicide and infanticide.
Recent studies revealed a shocking truth that we should not ignore. Recent studies show that the prevalence of PPD in the world is around 10 to 30%. Nearly 50 to 80% of all postpartum women suffer from a mild form of baby blues, which generally lasts for two weeks.
A recent systematic review revealed that in India, the overall prevalence of PPD is 22%. The southern regions showed greater prevalence (26%) and the lowest in northern regions (15%). That means in a country of 1.4 billion people, where a million babies are born every year, one in four new mothers is silently struggling. And yet, 50% of these cases remain undiagnosed and untreated in India. This is not just numbers; this shows a failure.
But why has this stayed in the shadows for so long? One of the reasons is that for decades, postpartum care has primarily focused on the infant's health and weight while the mother sat quietly suffering in silence. The mother was expected to be happy and grateful if the infant was healthy. A woman complaining of anxiety would have been overlooked or labeled hysterical. And as a result, generations of new mothers suffered alone.
For decades, postpartum depression was treated just like any other common depression, and the go to solution was antidepressants. Selective Serotonin Reuptake Inhibitors (SSRI) such as sertraline (Zoloft) and fluoxetine (Prozac), serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine and desvenlafaxine and tricyclic antidepressants thus became the default remedy.
They helped some women, but they were not designed for Postpartum Depression. They were designed for treating general depression syndrome and not specifically the neurological and hormonal events that occurs post childbirth. And they take four to six weeks to start showing improvement and for a new born mother alone dealing with an infant and depression it feel like an eternity.
These antidepressants also carry along with it a plethora of side effects like nausea, insomnia and sexual dysfunction. In extreme conditions, it can also lead to antidepressants discontinuation syndrome, seizures and serotonin syndrome. For a new mother who is dealing with physical, emotional and lifestyle changes these side effects can be very horrifying.
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