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'Sad is how I am!' Treating Dysthymia in Children and Adults

Section 29
Postpartum Depression

Question 29 |
Test | Table of Contents

Postpartum depression (PPD) is a condition that describes a range of physical and emotional changes that many mothers can have after having a baby. Roughly ten percent of pregnancies result in postpartum depression, which can occur a few days or even months after delivery.

There are three types of PPD women can have after giving birth:
“Baby blues” happen in many women in the days right after childbirth. A new mother can have sudden mood swings, such as feeling very happy and then feeling very sad. She may cry for no apparent reason and can feel impatient, irritable, restless, anxious, lonely, and sad. The “baby blues” may last only a few hours or as long as 1 to 2 weeks after delivery. The baby blues do not always require treatment from a health care provider. Often, joining a support group of new moms or talking with other moms helps.

Postpartum depression (PPD) can happen a few days or even months after childbirth. PPD can happen after the birth of any child, not just the first child. A woman can have feelings similar to the “baby blues” - sadness, despair, anxiety, irritability - but she feels them much more strongly than she would with the “baby blues.” PPD often keeps a woman from doing the things she needs to do every day. When a woman’s ability to function is affected, this is a sure sign that she needs to see her health care provider right away. If a woman does not get treatment for PPD, symptoms can get worse and last for as long as 1 year. While PPD is a serious condition, it can be treated with medication and counseling.

Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first 3 months after childbirth. Women can lose touch with reality, often having auditory hallucinations, such as hearing things that aren’t actually happening, like a person talking. Women can also have delusions or see things differently from what they are. Visual hallucinations, or seeing things that aren’t there, are less common. Other symptoms include insomnia, feeling agitated and unsettled, angry, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes women are put into the hospital because they are at risk for hurting themselves or someone else.

No one knows for sure what causes postpartum depression. Hormonal changes in a woman’s body may trigger its symptoms. During pregnancy, the amount of two female hormones, estrogen and progesterone, in a woman’s body increase greatly. In the first 24 hours after childbirth, the amount of these hormones rapidly drops and keeps dropping to the amount they were before the woman became pregnant. Researchers think these changes in hormones may lead to depression, just as smaller changes in hormones can affect a woman’s moods before she gets her menstrual period.
Thyroid levels may also drop sharply after giving birth. The thyroid is a small gland in the neck that helps to regulate how your body uses and stores energy from foods eaten. Low thyroid levels can cause symptoms that can feel like depression, such as mood swings, fatigue, agitation, insomnia, and anxiety. A simple thyroid test can tell if this condition is causing a woman’s PPD. If so, thyroid medication can be prescribed by a health care provider.

“Personal Reflection” Journaling Activity #9
The preceding section contained information about Postpartum Depression. Write three case study examples regarding how you might use the content of this section of the Manual in your practice.

Update
The Art of Holding Perinatal
Women in Distress

Kleiman, K., & Waller, H. (2023). The Art of Holding Perinatal Women in Distress. Women's health reports (New Rochelle, N.Y.), 4(1), 111–117.

Peer-Reviewed Journal Article References:
Chesin, M. S., Brodsky, B. S., Beeler, B., Benjamin-Phillips, C. A., Taghavi, I., & Stanley, B. (2018). Perceptions of adjunctive mindfulness-based cognitive therapy to prevent suicidal behavior among high suicide-risk outpatient participants. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 39(6), 451–460.

Geschwind, N., Bosgraaf, E., Bannink, F., & Peeters, F. (2020). Positivity pays off: Clients’ perspectives on positive compared with traditional cognitive behavioral therapy for depression. Psychotherapy, 57(3), 366–378.

Gómez Penedo, J. M., Coyne, A. E., Constantino, M. J., Krieger, T., Hayes, A. M., & grosse Holtforth, M. (2020). Theory-specific patient change processes and mechanisms in different cognitive therapies for depression. Journal of Consulting and Clinical Psychology, 88(8), 774–785.

QUESTION 29
What are the symptoms of Postpartum psychosis? To select and enter your answer go to
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