Postpartum depression (PPD) is a type of major depressive disorder that occurs in women after childbirth. It is marked by a significant depressive episode that begins either during pregnancy or within four weeks after delivery. PPD is not considered a separate disease but rather a major depressive episode with peripartum onset according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Postpartum depression can significantly affect a woman's ability to care for herself and her newborn. A study by Dow University of Health Sciences and the University of Missouri-Kansas City (UMKC), published in the National Institutes of Health, highlights 9 symptoms that cause considerable distress and hinder a woman's daily functioning. These are:
Change in weight or appetite: Visible changes in appetite, leading to significant weight loss or gain (a change of more than 5 percent of body weight in a month), not related to dieting or intentional weight changes.
Depressed mood: A persistent feeling of sadness or emptiness that is noticeable most of the day, nearly every day. This mood change can be subjective (felt internally) or observed by others.
Feelings of worthlessness or guilt: Excessive or inappropriate feelings of worthlessness or guilt, which may be delusional and not merely self-reproach or guilt about being sick.
Impaired concentration or indecisiveness: Difficulty in thinking, concentrating, or making decisions, experienced nearly every day, which can affect daily functioning.
Insomnia or hypersomnia: Significant changes in sleep patterns, including difficulty falling asleep (insomnia) or excessive sleeping (hypersomnia), almost every day.
Loss of energy or fatigue: Persistent tiredness and a lack of energy, making even simple tasks feel overwhelming, present nearly every day.
Loss of interest or pleasure (Anhedonia): A significant decrease in interest or pleasure in almost all activities that were once enjoyed, most of the day, nearly every day.
Psychomotor retardation or agitation: Noticeable slowing down of physical movements, speech, and thought processes (psychomotor retardation), or excessive physical activity and restlessness (psychomotor agitation), observed by others.
Suicidal thoughts or attempts: Frequent thoughts about death, suicidal ideation, planning or attempts to commit suicide, which indicate severe distress and risk.
Detection and diagnosis:
The above mentioned symptoms can cause distress and impair daily functioning. Postpartum depression is diagnosed when at least five depressive symptoms persist for at least 2 weeks. The nine symptoms occur nearly every day, signaling a change from the usual routine. Alongside, for a PPD diagnosis, they must not stem from substance use, medical conditions, or psychotic disorders, and there should be no history of manic episodes.
Diagnosis requires either depression or anhedonia along with the five symptoms. Proper medical assessment and treatment are essential for managing postpartum.
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