Postpartum Depression

Pregnancy causes hormonal changes in a woman. When a woman gets pregnant, hormones kick in to do what they need to do to support the healthy growth of a baby. At least six hormones are involved each of them carrying different functions. Dramatic hormonal changes occur after a baby is born which causes anywhere from mild depression or what is commonly known as the “baby blues” to a more serious psychotic episode which is rare. This is what is called postpartum disorder.  Postpartum disorder describes the range of emotional, physical, and behavioral challenges that a mother faces after a baby is born.  Postpartum psychosis which is the most serious of the postpartum disorders occurs in approximately 1-2 out of every 1,000 deliveries. The clinical onset is rapid, with symptoms occurring as early as the first 48 to 72 hours postpartum, although the majority of episodes develop within the first two weeks after delivery.  Postpartum psychosis is a psychiatric emergency.

There was a shocking event that happened in 2001 in Houston Texas. Andrea Yates got into depression after she gave birth to her fourth son.  In June 1999, she attempted suicide and was put on antidepressants. In July 1999 she suffered a nervous breakdown and attempted suicide two times.  She was diagnosed with postpartum psychosis and hospitalized. Her first psychiatrist had urged the couple not to have any more children but they went against that advice. Seven weeks after being discharged from the hospital, they conceived their fifth and final child. On June 20 2001, her husband went to work leaving Andrea alone against the doctor’s advice. His mother would be over at their home within an hour after he left. Andrea drowned all her five children within that one hour window. She was convicted of killing her children and sentenced to life in prison however her conviction was overturned in 2006 and she was found not guilty by reason of insanity. She is in a Texas mental hospital where she remains today. I still remember not understanding how she would have killed her own children until I went through postpartum depression and I thank God I never went into psychosis. I will share my story a little bit later. Right now, let me talk about postpartum depression. What it is, what are the symptoms and how it can be avoided and also treated.

Postpartum depression is depression suffered by a mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue. Postpartum depression can occur any time within the first year after childbirth—usually within four weeks after delivery but sometimes several months later.

What are the symptoms?

Many patients suffer from symptoms six months after onset and, when untreated, up to 25 percent of patients are depressed one year later. They include

  • Depressed mood for most of the day and nearly every day
  • Loss of interest in activities previously considered pleasurable
  • Hopelessness and despair
  • Thoughts of suicide and/or infanticide
  • Fear of harming the baby
  • Lack of concern or over-concern for the baby
  • Feelings of guilt, inadequacy, and worthlessness
  • Poor focus and impaired memory
  • Bizarre thoughts
  • Hallucinations
  • Nightmares
  • Panic attacks
  • Agitation or lethargy

The events that predispose a woman to postpartum depression include:

  • Previous postpartum depression
  • Depression unrelated to pregnancy
  • Stressful marital, family, vocational, or financial conditions
  • Unwanted pregnancy or ambivalence about the pregnancy

What are the causes?

The exact cause of postpartum depression is not known however, there are psychosocial and cultural factors.

Psychosocial and emotional factors can act as stressors and impact a woman’s self-esteem. Mothers require high levels of support. Prolonged postpartum depression is linked to lack of social support. Mothers need comfort and support during pregnancy and after delivery. They also need help with household chores and childcare. Sleeplessness and fatigue are common complaints after a baby is born. Giving birth is taxing to a woman’s strength, and it can takes her several weeks to recover. A woman who undergoes cesarean delivery which is a major surgery requires more recovery time. If you combine all this with the energy spent caring for a baby around the clock as well as tending to other responsibilities, mothers are not able to have adequate rest increases the chances of depression caused by fatigue. Weight gain during pregnancy can also affect self-esteem and increase the risk of depression. Feelings of loss, such as loss of freedom and control are common and can add to depression.

Cultural Aspects

Cross-cultural studies show that the incidences of postpartum depression (but not psychosis) is much lower in non-western cultures. The mother in this cultures seems to be provided with a level of emotional and physical support that is largely absent in western society. Only 18 percent of new mothers  in the United States receive more than two weeks assistance with housework and 20 percent report help with child care beyond the first week. Before I talk about the treatment options that are out there, let me give you my story.

When we got our second baby, I was well for the first month. My  mother had travelled to be with us therefore she helped a lot. Three families also visited during that time. After one month my mother had to leave and life became very hard. Our daughter was not going to daycare and our son used to wake me up every two hours at night. I was not sleeping during the day and I was barely sleeping well at night. I remember at least two to three times, as I help our son to wind him after he had nursed, he slid off my hands because I fell asleep. Thank God he did not fall off the bed. I was usually so tired. I do not remember much of what happened during this period which was one and a half to two months but I will tell you that I was in a totally different place. I remember shouting at the kids a lot. Like I was out of my mind. I was always angry. I assume I used to give our children a bath but I cannot tell you when I did it. I also cannot remember when I took a shower. My husband had to work and when he came home he was very tired and helped where he could. But the bulk of the work was mine. I remember times when I would look at my children and feel like I just want to walk out of the house and leave them there. At the time I had two close friends and both of them were pregnant so they could not help much. One of the says she used to call me but I do not remember but I do believe her. My mother told me she would call me to but I do not remember having any conversation with her. One day, we finally found a daycare that was reasonable for our daughter so life became easier. After going through what I went through, I told my  husband I did not want any other children. I love kids but after my ordeal, I did not want any more children. My husband is really wonderful and he was fine with the decision.

There are treatment options like antidepressant medication, psychotherapy, and participation in a support group, or a combination of treatments. I believe that a lack of support is the number one problem of in this issue of postpartum. Mothers really need support.

One of the issues I really want to deal with after going through postpartum is to come to a place of helping mothers and making sure they have the proper support they need. I will be the first to tell you that if God was not on my side and if God did not hold me through that time, I would have lost my mind. When God promises never to leave us nor forsake us, He sure is with us every step of the way. I just want to encourage you. Whatever you are going through, whether it is postpartum depression or any other kind of issue that is causing pain and major discomfort in your life, the number one thing you should do is give it over to Jesus. Give him that burden. Trust in him to get you through; to hold your hand and guide you when you can walk and to carry you when you cannot walk. If you do not know Jesus, choose to give your life over to him. There is a peace we who are born again experience even through difficult situations. You cannot experience that peace without Jesus in your life. If you want to give your life to Jesus, please repeat these words after me:

Dear God, I am a sinner and come before you to ask for forgiveness of my sin. Because of your love for me, you sent your son Jesus to die on the cross that I may have eternal life. I surrender my life to you. I confess with my mouth Jesus Christ is Lord of my life. From today onwards, I will never be the same again in Jesus name. Amen.

If you just gave your life to Christ, welcome to the Kingdom of God. This is the greatest experience you will ever have on earth. Make sure you get into a good bible teaching church.

 

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