Five Things Health Care Providers Should Know About Postpartum Depression

U.S. Army photo by Meghan Portillo
By Janelle Fundersburg
October 9, 2017

October is Depression Awareness Month. This is the first of a two-part series focused on a type of depression that many patients don’t disclose to their doctors, limiting their access to care. The birth of a baby is considered to be one of the happiest moments of a woman’s life. With the expectation of such great emotion, many women are embarrassed or ashamed to discuss feelings of uncertainty with their providers. Postpartum depression (PPD) can be an invisible disorder for new moms who feel this way. To help bridge the gap, here are five things health care providers should know about PPD from a patient’s perspective:

  1. Promote a safe environment to discuss mental health to help new moms feel more comfortable.

    Screening for PPD can be a little uncomfortable for a new mom who does not expect to have any feelings other than joyfulness for her new baby. Many women may not know the signs of PPD or may try to deal with it on their own. Making them aware that their concerns are common by posting PPD information in the clinic and/or providing a PPD checklist can help release some of the embarrassment they may have. The Centers for Disease Control (CDC) created a checklist, which can help start the conversation.

  2. Explain the difference between “baby blues” and postpartum depression.

    Hormones are rapidly changing immediately after childbirth causing a new mom to feel like she is on an emotional roller coaster. Crying spells, irritability, mood swings, and a general feeling of being overwhelmed are considered normal emotions after pregnancy. But when does the emotional rollercoaster end? The “baby blues” isn’t an actual diagnosis but is a term used to describe the down feeling new moms experience. It usually occurs within a few days after childbirth and may last up to two weeks. Explaining that some of the symptoms of “baby blues” can overlap with PPD will help new moms monitor their symptoms and report back if the symptoms are constant and last longer than two weeks.

  3. Help moms understand there is no one cause for postpartum depression.

    PPD is not linked to a single cause, but may result from a combination of physical and emotional factors. Many women may be depressed during pregnancy and not know since hormonal changes during pregnancy can mimic symptoms similar to depression. According to the National Institute of Mental Health, some women are at a greater risk for developing PPD due to risk factors such as:

    • Symptoms of depression during or after a previous pregnancy

    • Previous experience with depression or bipolar disorder at another time in her life

    • A family member who has been diagnosed with depression or other mental illness

    • A stressful life event during pregnancy or shortly after giving birth, such as job loss, death of a loved one, domestic violence, or personal illness

    • Medical complications during childbirth, including premature delivery or having a baby with medical problems

    • Mixed feelings about the pregnancy, whether it was planned or unplanned

    • A lack of strong emotional support from her spouse, partner, family, or friends

    • Alcohol or other drug misuse problems

  4. Asking relevant questions during the first prenatal visit might prompt a woman to reveal previous mental health treatment and/or help to monitor potential depressive symptoms.

  5. Encourage questions.

    During the initial PPD screening, a new mom may have questions that she’s afraid to ask since her symptoms do not fit perfectly into the screening questionnaire. Reiterating that there are common risk factors and symptoms but no woman is the same may encourage her to ask questions. Also, providing reassurance that revealing unconventional situations or concerns such as single parent households will not exempt her from treatment may encourage her to ask questions.

  6. Educate on the importance of effective treatment.

    Symptoms of PPD can appear anytime within the first year after childbirth, but what happens if a new mom is not treated within that year? Is it still considered PPD? According to the National Institute of Mental Health, without treatment, PPD can last for months or years and can interfere with the mom’s ability to connect with and care for her baby. Furthermore, some women receive ineffective treatment since what works for one, does not work for all. The first step of treatment is talking with a provider. Encourage new moms to schedule follow-up appointments to ensure they receive effective treatment.

Stay tuned for next week’s blog which will discuss treatment options for PPD offered in the Military Health System.

Ms. Janelle Fundersburg is an operations assistant in the Primary Care Behavioral Health directorate at Deployment Health Clinical Center. She’s currently enrolled at the University of Maryland University College majoring in social sciences.

The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.

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