Postpartum Depression

Postpartum depression, often occurring within the first year after childbirth, is a complex condition triggered by rapid hormonal changes post-delivery. This leads mothers to experience feelings of sadness, sleep disturbances, irritability, disinterest in self and surroundings, fatigue, weight loss, and, in severe cases, suicidal thoughts.

Symptoms of postpartum depression to look out for:

• Persistent feelings of sadness
• Sleep disturbances
• Irritability
• Lack of interest in oneself and the environment
• Fatigue
• Weight loss
• Suicidal thoughts

Causes of Postpartum Depression:

• Loss of self-worth during pregnancy, such as being unprepared for pregnancy, early-age pregnancy, first-time pregnancy, or a history of previous miscarriages, coupled with inadequate psychological and physical support from family and society.
• In the postpartum phase, mothers undergo physical changes, including postpartum pain, administration of sleeping pills or painkillers, sleep deprivation, and alterations in hormone levels like oestrogen and progesterone, as well as neurotransmitters like serotonin and norepinephrine, leading to reduced alertness and increased vulnerability to mood swings.
• Societal adjustments, including adapting to changes in self-image, physical recovery post-childbirth, adjusting to the maternal role, managing breastfeeding, and dealing personal and societal expectations in childcare, significantly impact a mother’s mental well-being.

Treating postpartum depression requires a thorough assessment of multiple factors, considering the risks for both the mother and the infant, as well as the potential risk of medication exposure through breastfeeding. If symptoms are not severe, non-pharmacological interventions, such as various forms of psychotherapy, are usually preferred. However, when medication is deemed necessary, the psychiatrist will carefully select a medication with a lower risk of passing into breast milk and will aim to minimise the use of medication whenever feasible.

Ariyaporn Tangcheewinsirikul, M.D.