Knowing the Warning Signs
Depression is a common illness that affects millions of Americans each year, and there is no exception for new and expecting mothers. According to the U.S. Department of Health and Human Services, nearly 13% of moms-to-be and new moms experience some form of depression before or after their baby’s arrival. This is significant because if untreated or undiagnosed, depression can affect mother-infant bonding and infant behavior. Because there aren’t any requirements to screen women for depression during and after pregnancy, many who experience symptoms do not get the help they need. Therefore, if you work with women it’s important that you know about depression, and its key warning signs, to accurately access and educate them before and after pregnancy.
What Is Maternal Depression?
Similar to depression, maternal depression is a serious yet treatable illness that involves the brain. However, unlike general depression, maternal depression is gender specific and only affects new mothers and moms-to-be. Maternal depression can affect a woman’s ability to function as a mother, disabling her from completing day-to-day tasks such as caring for her new infant. Maternal depression can range from mild to severe and depending on its severity the women you serve may or may not need treatment. The four most common types of maternal depression are: prenatal depression, the “baby blues”, postpartum depression and postpartum psychosis.
Typically most women will experience some form of anxiety, irritability, fatigue and/or sadness during their pregnancy. However, symptoms that linger for more than a month may be a sign of prenatal depression. Prenatal depression affects approximately 10% to 20% of pregnant women each year. Depending on its severity, treatment for prenatal depression may include counseling or medication, such as anti-depressants.
The Baby Blues
The "baby blues" is the mildest form of maternal depression and the most common among women post-pregnancy. According to the American Pregnancy Association, approximately 50% to 75% of all new mothers experience some feelings of moodiness, sadness and anxiousness after their baby’s arrival. However, symptoms for the “baby blues” usually go away within a couple of days or weeks and do not require treatment.
If symptoms continue to persist, it may be a sign of postpartum depression, a more serious form of maternal depression. Approximately 10% to 15% of new mothers experience postpartum depression each year. Unlike the “baby blues”, postpartum depression requires medical attention and could worsen if left untreated. Treatment for postpartum depression may include counseling or medication, such as anti-depressants. Some warnings signs to look for and to share with your clients are:
- Feelings of worthlessness, sadness, hopelessness
- Excessive worrying about the baby or not concerned about the baby at all
- Restlessness, anger or irritability
- Sleeping too much or not sleeping enough
- Increased eating or not eating
- Loss of interest or pleasure in activities once enjoyed
- Excessive crying
- Loss of energy
- Endless thoughts of hurting themselves and/ or the baby
Postpartum psychosis is the most severe, yet rarest, form of maternal depression. Symptoms of postpartum psychosis include confusion, hallucinations and severe mood swings. It’s important that you ask the women you see if they have a history of bipolar disorder or any other type of mental illness. Such illnesses are key contributors to postpartum psychosis. Postpartum psychosis is treatable but may require a combination of both counseling and medication. In some cases hospitalization may be necessary.
Who Is Affected and Why Does It Happen?
Studies have shown that hormonal changes during pregnancy and childbirth play a significant role in the development of maternal depression. However, hormonal changes are usually not the sole culprit. Typically there is a combination of factors that cause maternal depression. In addition to hormonal changes, some women who have maternal depression also have a family history of mental illness or are under a lot of stress.
Because there is no specific cause, depression can affect women of all ages and races. A seemingly healthy woman can develop depression simply from the stress of day-to-day activities such as the preparation before the baby comes. However, because some women are at a greater risk, it’s important for you to talk about any past history of mental illness or depression in their family.
How You Can Help
Be sure to discuss with the new moms (or moms-to-be) that you see the potential dangers of maternal depression. Make sure they are aware of the key warning signs and when it is necessary to seek medical attention. Also make sure you ask questions about their medical history (if appropriate) and if they are experiencing any of the symptoms mentioned above. Because of its severity, depression should be discussed with not only the woman but a close family member who is able to bring them in for medical attention if symptoms arise and/or persist. Early detection is key for the health and well-being of the mother and most importantly the infant.