Peripartum Onset Depression (previously postnatal depression)
Women are at increased risk of depression during pregnancy and in the first year after the baby is born. As 50% of postpartum depressive episodes actually begin before the baby’s birth, this prompted the name change (peripartum onset depression) to encompass it more broadly. The signs and symptoms are the same as those for depression.
Signs and symptoms
The symptoms of major depression, using the DSM-5 (2013), must include the experience of five of the following symptoms for two weeks or more, and it must have a significant impact on a persons life. One of these symptoms must be either depressed mood, or a loss of interest or pleasure in things.
- Low (depressed mood) for the majority of the day, on most days
- Loss of interest or enjoyment in things
- Difficulty or changes in sleeping. This might be sleeping a lot (hypersomnia), or having difficulty in being able to sleep (insomnia)
- Feeling keyed up, uneasy, might find it difficult to sit still, or quite the opposite, like limbs are heavy and difficult to move
- Tired and having no energy
- Feeling they are pointless, or feeling responsible and guilt ridden for things that are not their fault
- Significant loss of weight that is not due to dieting, or there can be a significant gain in weight
- Difficulty in thinking or focusing, or being undecided and unable to make decisions easily
- Thoughts or plans of suicide
Prevalence and who is more likely to experience peripartum onset depression
Many women experience the baby blues, this is common and is related to hormonal changes. This is very different to depression which is more severe and longer lasting. It is estimated that around 10% of women will experience depression during pregnancy and 16% will experience depression in the first 3 months after delivery.
As with depression at other times, treatment can involve both psychological and medical treatment. Psychological interventions, in particular cognitive behavioural therapy, which also involves the partner, is used. Many approaches also look at issues around bonding with the baby including time at a mother-baby unit. Medication in severe cases can also be useful and is done in conjunction with a general practitioner or medical specialist.