Cause of Post Partum Depression

Although many experts in the field believe Post Partum Depression (PPD) is caused solely by a hormonal imbalance, a significant number believe that this is by no means the complete story. This split in opinion has provoked numerous studies, undertaken in an effort to gain a fuller understanding of all the variables.

Post Partum Depression is far more serious than the so called ‘baby blues’ which on average lasts a few day to a week.  It can typically develop anytime, up to three months after delivery and affect between 10 to 15% of all the women who give birth.  If feelings of depression go beyond two weeks the matter should be brought to the attention of the physician.

According to those in the medical profession, it rarely resolves itself without medical intervention and even with treatment, symptoms can last for several months. PPD is a serious condition which can impact heavily on the mother’s relationship with her child, giving rise to negative bonding issues and affect her ability to properly care for her newborn and for herself.

Typical symptoms include regular bouts of tearfulness, angry outbursts, irritability, feelings of despair and hopelessness, suicidal thoughts and fears surrounding the safety of the baby and herself. Also common are feelings of inadequacy, lack of confidence when caring for the infant, irrational obsessions are all symptoms of the disease.

Apart from hormonal imbalance, environmental factors such the lack of an adequate social network, loss of personal freedom, negative childbirth experience, underlying negative childhood experiences and a poor relationship with the child’s father, have been cited as playing a significant role and seen as possible causes relating to the onset of the disease. From a psychological perspective, when women feel loved and secure within the relationship with their partner, symptoms of PPD are significantly reduced. 

A newborn bring with it an increase in the day-to-day household chores and with that comes fatigue, which is believed to be another important factor in the diagnosis of PPD. One study undertaken in 2005, using a sample of 42 women found that fatigue and the lack of sleep impacted heavily on the mother’s mood.  This is yet another factor which makes it difficult for her to cope with the needs of her baby or take proper care of herself, leading to the feelings of low esteem and depression.

Culture and social background has been cited as yet another cause.  Another scientific study was undertaken using a sample of 99 socially disadvantaged women who were assessed as being at risk of PPD. The women were separated into two groups, one group received standard antenatal care only, whilst the other group was given the standard antenatal care, plus the intervention of on-going interpersonal psychotherapy during their pregnancy. 

Three months after delivery, diagnostic interviews were held to assess the two groups for any major depressive disorders. The assessment found that amongst the women who received only the standard antenatal care, 20% were found to be suffering from deep post natal depression, whilst amongst the group who received both the standard care and psychotherapy, only 4% suffered any form of depressive illness.  The results of this study give weight to the importance of psychotherapy for disadvantaged women both during and after delivery.

Counselling, medication and hormone therapy have all been found useful in the treatment of PPD.  Counselling undertaken by a trained health care professional such as a psychiatrist or psychologist who can help to uncover any underlying psychological problems and unresolved feelings and helping the mother to arrive at solutions and develop strategies to cope with her problems.

Anti-depressant medication has a proven track record of successfully treating PPD when taken over a period of several months. If the mother is breast feeding, her physician would normally prescribe an anti-depressant that is unlikely to have any ill-effects on the infant. Even after all the symptoms have disappeared, the physician usually continues to prescribe the medication for some time thereafter to avoid the possibility of a relapse.

Immediately after childbirth there is usually a marked drop in the levels of Oestrogen (hormone) in the body. This drop is believed to be one of the causes of PPD. In such cases hormone replacement therapy is used to normalize the levels circulating in the blood. This treatment has an unproven track record, however it has been found to be helpful in treating the symptoms of PPD in a sufficient number for women and is now regarded as a credible form of treatment in the case of some women.

Post Partum Depression is not a common condition with only a relatively small number of women falling victim to the disease annual. However, it is a very dangerous psychiatric disease which leads to 5% suicides and 4% infanticide each year in the US, therefore it demands to be taken seriously and treated as early as possible.