Signs of Puerperal (postpartum) depression

Description

A severe from of depression or inappropriate happiness occurring in the first few weeks after the baby is born. The term `puerperal' refers to the six week period immediately following childbirth. Clinically the disorder looks like major depression except that it occurs right after delivery. The disorder affects 1 woman in every 500 who have given birth. The symptoms can be severe enough to impair normal functioning and put the mother and the baby's life at risk.

Symptoms

Trouble sleeping or excessive sleeping, a dramatic change in appetite, often with weight gain or loss, fatigue and lack of energy, feelings of worthlessness, self-hate, inappropriate guilt, extreme difficulty concentrating, agitation, restlessness, irritability, inactivity and withdrawal from usual activities, a loss of interest or pleasure in activities that were once enjoyed (such as sex), feelings of hopelessness and helplessness, thoughts of death or suicide.

Tests

A history and physical exam will be performed. The diagnosis is made by taking a history. Tests may be done to rule out other causes of the symptoms.

Treatment

The depression is most effectively treated with medications and counseling. Medications include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin re-uptake inhibitors (SSRIs), and some newer antidepressant drugs. These medications do carry a risk of increased suicidal behavior and patients need to be monitored when the medications are started. The mother and baby's safety should be ensured. Any patient who feels life is not worth living needs to seek medical care immediately. Help is available for patients 24 hours a day at the the National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889).