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Postpartum Depression

Samantha Castro

California State University of Fullerton

ENG 360-01

Dr. Leslie Bruce

December 9, 2020
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Postpartum Depression
A major mental illness that occurs in women and men after the birth of a child, which can
drastically affect their psychological and physical capacity negatively.

Postpartum Depression Versus “Baby Blues”

A typical person that experiences a significant amount of stress and anxiety can become more

prone to some degree of depression. Similar situations are seen in a newborn’s mother and father

who experience new and overwhelming responsibilities while learning to adjust and live up to

their brand-new status. It is not uncommon to experience “baby blues” given the drastic physical

and emotional changes in a short time. “Baby blues” symptoms include a tendency to cry, feeling

moody, sad, and overwhelmed shortly after giving birth. Symptoms are similar to postpartum

depression (PPD); however, “baby blues” are much shorter in duration and are considerably less

intense. The symptoms of PPD are listed below in Figure 1 (Office of Women’s Health, 2019).

Figure 1. Venn Diagram of “Baby Blues” Symptoms and Postpartum Depression Symptoms. Samantha
Castro. (https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression)
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The main difference is that “baby blues” typically resolves on its own, whereas dangerous

repercussions may occur if medical professionals do not treat PPD. Parents may not be able to

care for their newborn appropriately and are more susceptible to suicide attempts. Children of

parents with PPD can also experience problems that may include delays in speech, difficulty in

learning, behavior problems, and difficulty in school and social situations; ultimately, affecting

the future of their health and wellbeing (Office of Women’s Health, 2019).

Causes

In addition to the overwhelming physical changes like sleep deprivation and recovery from labor,

social pressures of being an outstanding parent, and environmental changes, extreme hormonal

changes may also contribute to PPD. After conception, estrogen and progesterone levels increase

until childbirth significantly, then within 24-hours of delivery, pre-pregnancy hormone levels are

attained, illustrated in Figure 2. PPD symptoms are similar to symptoms experienced during a

menstrual cycle but on a much longer and grander scale. A third hormone suspected of inducing

PPD is the thyroid hormone, which regulates the body’s metabolism and energy usage that drops

after birth, leading to depression symptoms.

Figure 2. Postpartum Depression – (Hormonal) Causes. Barends Psychology Practice.

https://barendspsychology.com/different-types-of-depression/mental-disorders-postpartum-depression/
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Diagnosis

A medical professional officially diagnoses PPD in individuals following treatment; however,

diagnosis is not possible if they do not report their symptoms. After childbirth, women are

advised to seek a medical professional if their symptoms last for longer than two weeks,

symptoms intensify or worsen, can no longer care for yourself or the baby, or have thoughts of

harming yourself and the baby. Unfortunately, many individuals may choose not to report for

several reasons, which are further discussed in the “barriers to seeking help” section below.

Another means to detect PPD is through the Pregnancy Risk Assessment Monitoring System

(PRAMS), which is set into motion by collaborating with the Centers for Disease Control and

Prevention (2020) and state health departments. The collaboration investigates ongoing problems

in reproductive health. Participants are chosen at random nationwide and are evaluated based on

their personal views and experiences before, during, and shortly after pregnancy.

Population at Risk

Between 10% - 13% of women are affected by PPD and depend on the method used to report

incidence – self-reported or PRAMS (Office on Women’s Health, 2019; CDC, 2020). Women

are more at risk if they have a personal or family history of mental disorders, have problems

during and after pregnancy, have little to no social support, previous adverse life events, or have

had a history of substance abuse. The number one predictor is experiencing depression during

pregnancy, in which they are seven times more likely to develop PPD (Stewart & Vigod, 2016).

Some studies even showed that educational attainment, or lack of, has a more significant

influence than race or ethnicity (Di Florio, 2017).

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Fathers may also develop paternal PPD, typically up to one year after childbirth. Given current

studies, the prevalence of paternal PPD ranges from 1% - 46% worldwide and about 13% in

North America alone. Studies indicate that paternal PPD is positively correlated with maternal

depression (Cameron et al., 2016). However, this concept is new; therefore, specific causes and

mechanisms are unknown and are still under investigation.

Treatment

The most effective method in treating PPD is to provide interventions after childbirth rather than

during pregnancy (Stewart & Vigod, 2016). The Office on Women’s Health (2019) states that at-

home treatment involves self-care routines such as getting enough rest, eating well, getting

enough physical activity, and getting support from friends, family, and support groups. If PPD

symptoms were due to a deficiency in thyroid hormone, medication is prescribed to increase

levels. However, the most common prescriptions are antidepressants. Most treatments involve a

medical professional such as talk therapy with a licensed therapist or psychologist (Office of

Women’s Health, 2019). Other forms include more risky medicines, such as drugs that require

administration by medical professionals that may not be safe for women who are breastfeeding

or women who are pregnant.

According to the American Psychiatric Association (2020), in exceptionally severe cases or in

cases that an individual has tried every other treatment but has not responded well to any, the

treating physician may employ electroconvulsive therapy (ECT). Also known as electroshock

therapy with informed consent allows trained medical professionals to continuously monitor a
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procedure involving a quick electrical stimulation to the patient’s brain under general anesthesia.

The patient undergoes an induced and controlled seizure that provides temporary relief of

symptoms that usually requires multiple sessions. This procedure is typically used in conjunction

with other treatments, such as talk therapy and antidepressants.

Barriers to Seeking Help

No means of transportation, lack of insurance, financial problems, and childcare problems are

some obstacles when seeking help with PPD; however, one of the most significant barriers to

overcome is the associated stigma (Stewart & Vigod, 2016). Despite the commonality of PPD

and “baby blues” in many people, individuals tend to feel too embarrassed or ashamed about

feeling negative about a new child’s birth when the traditional reaction is to be joyful and

optimistic (Office on Women’s Health, 2019). Studies have shown a relationship between

perceived stigma, the individual’s feeling of personal shame, and overall self-efficacy or

confidence in oneself. Stigma can originate internally; in other words, the person is making it up

all in their head. On the other hand, they could have experienced stigma after receiving adverse

reactions from other people.

It is essential to understand that experiencing “baby blues” or PPD does not make you a bad

parent or a terrible person. On the contrary, having the courage to speak up and get help shows

more strength than weakness. Efforts to diminish the stigma associated with PPD must persevere

in hopes of revealing more individuals in need of support (Mickelson et al., 2016).

Resources: If experiencing symptoms, always seek help from friends and family, a physician, a
nurse, or a midwife. Furthermore, be sure to seek local or state government-funded aid
programs.
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References

American Psychiatric Association. (2020). What is electroconvulsive therapy (ECT)?

https://www.psychiatry.org/patients-families/ect

Barends Psychology Practice. (.n.d). Postpartum depression. Barends Psychology.

https://barendspsychology.com/different-types-of-depression/mental-disorders-
postpartum-depression/

Cameron, E. E., Sedov, I. D., & Tomfohr-Madsen, L. M. (2016). Prevalence of paternal

depression in pregnancy and the postpartum: An updated meta-analysis. Journal of
Affective Disorders, 206, 189-203. https://doi.org/10.1016/j.jad.2016.07.044

Centers for Disease Control and Prevention. (2020). Depression among women.

Di Florio, A., Putnam, K., Altemus, M., Apter, G., Bergink, V., Bilszta, J., Brock, R., Buist, A.,
Deligiannidis, K. M., Devouche, E., Epperson, C. N., Guille, C., Kim, D., Lichtenstein,
P., Magnusson, P. K., Martinez, P., Munk-Olsen, T., Newport, J., Payne, J., Penninx, B.
W., … Meltzer-Brody, S. (2017). The impact of education, country, race and ethnicity on
the self-report of postpartum depression using the Edinburgh Postnatal Depression
Scale. Psychological medicine, 47(5), 787–799.
https://doi.org/10.1017/S0033291716002087

Mickelson, K.D., Biehle, S.N., Chong, A., & Gordon, A. (2016) Perceived stigma of postpartum
depression symptoms in low-risk first-time parents: gender differences in a dual-pathway
model. Sex Roles, 76(5-6), 306-318. https://doi-org.lib-
proxy.fullerton.edu/10.1007/s11199-016-0603-4

Office on Women’s Health. (2019). Postpartum depression.

https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-
depression

Stewart, D.E., & Vigod, S. (2016). Postpartum depression. The New England Journal of
Medicine, 375, 2177-86. https://www-nejm-org.lib-
proxy.fullerton.edu/doi/10.1056/NEJMcp1607649
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Postwrite

I used partitioning to break down the definition of postpartum depression into categories

of postpartum depression versus “baby blues,” causes, diagnosis, population at risk, treatment,

and barriers to seeking help. In the first section, postpartum depression versus “baby blues,” I

began with an analogy of an average person dealing with significant stresses making them more

prone to a degree of depression to the experiences a new mother and father experience. I also

included a Venn diagram (graphics) to make a clear distinction to compare and contrast the

symptoms of with using examples. Additionally, I gave examples of the problems that may

occur if PPD is not treated. In the “causes” section, I used analogy to describe the similarities of

the symptoms of PPD and the menstrual cycle but on a much larger scale. I also included a

graph to show the dramatic hormonal changes. In the “barriers to seeking help” section, I used

the negation strategy to show that seeking help for symptoms of PPD should not be viewed

negatively but should be regarded as courageous in overcoming a complicated obstacle.