Practical tips to help Women with Postpartum Depression, before starting any medications
In this article we will discuss the complex mental illness known as postpartum depression (or postnatal depression) that can affect 15% of women around the world. Recent studies show that PPD can affect men as well. PPD is a poorly understood disorder with a great deal of stigma in the community.
Using a few practical tips to help new mothers cope with their transitions into motherhood, it is possible to manage their symptoms at home, without the need for any medications until advised by a healthcare professional.
What are the Signs of Postpartum Depression?
Postpartum Depression (PPD) is a complex neuro-hormonal disorder that affects new mothers, occurring 1 week to 1 month after the delivery of their newborn. It is often characterised by mild to moderate changes in mood, irritability, anxiety and sadness.
Follow up consultations with the mother’s obstetrician or midwife, may help to diagnose (or atleast suspect) an episode of PPD and get her the necessary help.
Although most cases are mild and dissipate over time, provided she receives the necessary support from family and friends, early diagnosis and management is crucial to prevent worsening of symptoms which may lead to Postpartum Psychosis and/or harm to her newborn.
A diagnosis of a mental health disorder like postpartum depressions does not need to be an adverse personal event, by seeking professional help or even a second expert medical opinion, the whole family may get the help they need at the right time.
Can Postpartum Depression Affect Men?
Although it is rare for men to experience PPD, recent research points to higher awareness of the complex emotional and psychosocial changes that new fathers have to undergo during this sensitive moment in their lives.
Between 1% to 26% of new fathers may experience alterations in their moods, sleep cycles, appetite and other drastic changes coinciding with their partners stress levels.
ObGyn and Family Medicine specialists should be aware of the interlinked emotional changes that may affect the fathers as well. A thorough and open conversation should be discussed in certain high risk populations.
What are the Risks of Untreated Postpartum Depression?
Untreated PPD falls under the same risks of any untreated mental illness. Ignorance of early warning signs of a more severe emotional disturbance (unlike usual postpartum blues) may be hazardous to the mother and her baby. Due to social stigma, avoidance of seeking early help or ignorance by the healthcare community can be detrimental to managing PPD at its early stages.
There are widely known examples of untreated PPD in high risk women (low socioeconomic status, history of abuse, substance use, family history of mental illness etc) who intentionally harm their baby and are now facing incarceration.
Many mothers contemplate or even successfully commit self harm and/or suicide as a consequence of not treating PPD early.
What Helps Postpartum Depression?
PPD can be considered a subcategory of Depression, but according to the ICD-10 criteria there are some variations in diagnosis. Treatment for most mental illnesses can be divided into conservative and medication-based treatments based on severity, underlying situations and the clinical decision of certified mental health professionals.
PPD has the potential to be managed conservatively at home, provided there is ample community and family support for the new mother. Treatment options for PPD are similar to managing mild to moderate cases of depression.
The patient and her family is strong encouraged to seek professional mental health guidance before proceeding with any form of treatment
The main treatment options for PPD are:
Cognitive Behavioural Therapy (CBT)
Often the primary step in confirming a diagnosis of a case of PPD. A certified psychiatrist can help the afflicted mother to acknowledge her feelings of inadequacy, self-doubt, anxiety and other negative emotions.
Using guided group therapy or just personalised one-to-one psychological counselling, the mental health specialist can provide guidance on non-pharmacological methods in managing milder forms of PPD.
Family-oriented CBT is regarded as the cornerstone of therapy for the new mother. In many Eastern cultures, there has been anthropological evidence of better outcomes when the female elders of the family and the community come together to assist the young family with their infant care responsibilities.
Serotonin-specific Reuptake inhibitors (SSRI) may be prescribed as first-line pharmacotherapy, to manage imbalances in neurotransmitters responsible for mood eg. serotonin levels.
Due to a latency period when any signs of mood improvements may be observed. The mother may need to be carefully assessed with continuous CBT and under direct supervision by the treating physician.
Many psychiatrists are considering specific hormone therapy such as with progesterone analogues eg. Brexanolone
Considering the reported side effects of many psycho-active medications, especially the risks of their spread to the mother’s breast milk. Women should exercise caution and seek appropriate expert second opinions before deciding on the best course of action.
Electroconvulsive Therapy (ECT)
Rare cases of severe refractory PPD i.e. resistant to behavioral therapy and/or standard medications, may require institutional management. Electroconvulsive therapy (ECT) is an option reserved for difficult to manage cases (where symptoms are worsening to the point of progressing towards postpartum psychosis) so as to prevent harm to the mother and her baby.
Tertiary-level referral may be needed to assess the requirement of electroconvulsive therapy for postpartum depression.
What are the Natural Methods to Help Postpartum Depression?
For mild cases of PPD and on the advice of the mother’s obgyn doctor, some women may try natural methods to manage their mood symptoms. Such lifestyle strategies can be a more comfortable and holistic approach to a personal sensitive matter, such that the mother does not have to miss out on the intimate bonding moments with her newborn.
The following lifestyle methods can be used to reduce some of the symptoms and allow for natural healing of the unfortunate mood swings in PPD:
1) Ask for help with household chores from your own mother or mother-in-law, and even the father.
2) Try to sleep when your baby falls asleep to
3) Gentle exercise such as power-walking or yoga can help with mood swings and overcoming the residual pain from childbirth
4) Making time to do things for yourself eg. reading a book, blogging, painting, gardening
5) Eating regular, healthy meals
6) Joining a support group for women with PPD (either online or in your community)
What should you do if your Wife/Sister has Postpartum Depression?
Childbirth and motherhood are beautifully interlinked moments in a woman’s (and a man’s) life. It is important to realise that people experience such moments in their own way under their own personal adverse situations as the case may be. The importance of a community-based approach to postpartum depression is an important first step to accepting the concept of PPD (to remove any stigma) and the opportunities in getting the right professional help when needed.
Most women contend with hiding their emotional and physical pains, but they do not have to. Even before the global lockdown, women have always faced barriers to seeking professional medical support.
Telemedicine is an ideal solution for women, their mothers and other female support groups to come together in a safe and private environment to talk openly about their concerns. In many cases even cognitive behavioural therapy can be best provided with telemedicine consults so that the mother does not have to leave her home and neglect her infant at her time of need.
Why Choose VIOS?
The hardworking people behind VIOS are all children of strong mothers too. We have taken great strides to create a hassle-free private virtual care solution for women around the world. Maternal Telemedicine care would not be complete without a platform that understands the importance of providing expert second opinions before beginning any complex management and giving guided lifestyle counselling.
In many cases, sometimes you just need to speak with another experienced mother-figure to help you in these tough times.
At VIOS we believe that you should be free to choose your provider based on their skills and the personalised needs that would help you in the best way possible. With easy direct pay options; you can choose your preferred specialist, a suitable appointment that is convenient for you and have an open honest discussion for as long as you need.
View this infographic to see how easily you can have a discrete online appointment with an obgyn specialist