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Postpartum Depression: Symptom or Disease?

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Postpartum Depression: Symptom or Disease?

Is postpartum depression a symptom or disease? This is a question that does not have a black and white answer, and it is a question that is as important for the society in which we live as it is for healthcare practitioners, families, friends and mothers. Why? Because in societies where women have the most support, i.e. paid leave and automatic postnatal health and household chore support, the incidence of PPD (Postpartum Depression) is significantly lower.

PPD and PPA (Postpartum Anxiety) are experienced by many women after child birth and yet it’s been little more than a decade that we have been talking about the problem. We give a lot of credit to Marie Osmond, who 12 years ago went on the Oprah show and talked about her experience with PPD and shed some light on the issue. Up until that point, PPD and PPA did not have a face. It was not something discussed in polite company. The myth of “happy motherhood and perfect baby” was the picture most of us carried around. And that picture made it even more difficult for mothers to come forward and get the help that they needed.

When asking the question of PPD as a symptom or disease, several things come to mind:

1. Exhaustion or Depression:  No other normal physiologic body process is as demanding as pregnancy and birth. Many women go home with a new baby and have other small children and a husband to care for as well. New babies have intense needs day and night. They require nursing and feeding , lots of body contact and soothing. That means that mother probably won’t be sleeping through the night. Sleep deprivation contributes to negative mental states. Caring for a family and an infant can render mother exhausted. If a new mother has had a C-section, she is also recovering from surgery. Treatment for exhaustion is as important as treatment for depression, and it should be noted that exhaustion can mimic many of the symptoms of depression.

2. Nutritional Depletion: A baby’s body is made up entirely of nutrients that are donated by its mother’s body. The placenta is also made from nutrients donated by mother’s body. The placenta pulls nutrients from a mother’s bloodstream and gives it to the developing fetus. Nature has it wired that if one is going to do without; it will be the mother for the sake of new life. Some women lose a great deal of blood during childbirth and since blood is made from nutrients, this further depletes a mother’s nutritional reserves.

The research is clear that certain nutritional deficiencies, for example the DHA and EPA (as from fish oils) can cause depression and moods swings. So can a lack of certain B vitamins. All postpartum women can benefit from taking a good multiple vitamin and mineral, fish oils and supplementing calcium and magnesium.  Many health care professionals now recommend that mothers stay on their prenatal vitamins for several months after the baby is born.

3.Community: In the past when extended families lived together or close by, a new mother would be able to have her needs met while she rested for a number of weeks to regain her strength. Women relatives and close neighbors would prepare her family’s meals and they would also help soothe her tender emotions while her body recovered. These days many women no longer have that kind of support. In the 1950s a woman who had just given birth stayed in the maternity ward for an average of 2 weeks, resting and bonding with her newborn. Now she is out of the hospital in 48 hours.

Today there are thousands of web sites started by women who have suffered and survived postpartum depression wanting to help other new mothers who are suffering. These are communities where women share their fears and stories and share what methods and treatments worked for them.  Mothers who experience PPD and PPA need to know that they are not alone. These sites provide valuable support, community and information to both mother and her family.

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58 comments

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12:51PM PDT on May 28, 2010

In other cultures women get to relax with their new baby for up to a year, while family take care of everything.
Here its just get up and go, not good for the mum or baby.

11:46PM PDT on May 23, 2010

Very informative article. Thank you.

8:28AM PDT on May 2, 2010

Here is part of the truth! Authorities, (people and associations with money) do not love patients. They are lovers of the Great God. What is his name? Money!
People die? It is sad! But how to do that this situation will bring great profit?
Tris! Sad! Sad! This is our world. What to do? I do not know!

8:24PM PDT on May 1, 2010

One of the causes of PPD is probably the whole sterile unnatural way most babies are birthed in modern hospitals. It would be interesting to see a study comparing Moms who had natural childbirth with a midwife to OB GyN delievered births to see if there is the difference in the amount PPD. There is a bonding process that it is suppossed to happen immediately after the birth. The baby put on the mothers chest where it can hear the mother's heartbeat, not cutting the cord too quickly so the baby gradually acculmates to breathing on its own, soft lights etc. Instead the modern hospital use glaring lights, lots of noise, separating Mom and baby, whacking the baby to start it breathing etc.

9:16PM PDT on Apr 30, 2010

This is Western socity. It takes a village to raise a child. Women cannot do it alone. In this society people used to believe that if the child is mentally disabled it is because of the woman and it was her fault and she made him or her this way. It was all the blaming on the woman. New mothers need help from family members and neighbors and friends and not just from the hospital.

8:36AM PDT on Apr 27, 2010

Sad...doctors should be more helpful...oops, forgot myself for a minute.

7:03AM PDT on Apr 25, 2010

Very good article, and thanks for sharing!

9:20PM PDT on Apr 24, 2010

My mother suffered postpartum depression many years ago. She received no help until it was too late. She never fully recovered.

6:05AM PDT on Apr 24, 2010

Janice,
My heart goes out to your friends, their grandchild and son-in-law. This is utterly tragic and makes me want to ask so many questions. Why did their daughter suffer a broken pelvis during the birth, that must have been an absolutely horrendous experience? Did she also have PTSD as a result of the birth? Why was she still needing medication for the pain of it 18 months later? If a doctor was prescribing medication, was he also recommending therapy/professional support? Was anyone helping her parents help her? Here is a woman, a new mother, who must have had a traumatic birth experience, in pain and whose partner is away on active duty. It's not rocket science. We simply can't handle everything life throws at us, especially not when it's all thrown at once.

9:42PM PDT on Apr 22, 2010

Janice,

That is such a very sad story. Unfortunately it is more common than we would all like to think. You are right that we need better screening and more informed doctors, families and friends. There is a new law called the Melanie Blocker-Stokes Act (named after a woman with PPD that comitted suicide by jumping off a bridge)that hopefully will significantly improve medical acreening for PPD/PPA.

Thank you.

Dr. Dean Raffelock

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