Heartland Human Services

Postpartum Depression: What The Community Should Know


By Diana Moon, MS, LCP, Therapist

Defining PPD

Postpartum depression (PPD) is a prevalent women’s health issue in today’s world. According to Albright (1993) at least 12% of women suffer from a form of postpartum depression.  Recent research attempts to define the difference between Baby Blues, Postpartum depression and Postpartum Psychosis.  Baby blues is said to affect approximately 70% of new mothers and is understood to be temporary and is defined by mild symptomology, including the following: irritability, mood swings, sadness, and trouble sleeping (Byers, Dawson, Lewis & Malard, 2010).  Postpartum depression is more severe than the Baby Blues and is characterized in the Diagnostic and Statistical Manual (DSM IV) as any major depressive, manic, or mixed episode which occurs postpartum.
According to the DSM IV, a diagnosis of PPD can be determined when at least five of the following nine symptoms are present for at least four weeks after childbirth: persistent depressed mood, lessened interest in performing tasks, considerable weight loss or gain, oversleeping or lack of sleep, restlessness or lack of energy, excessive feelings of remorse, difficulty concentrating, and preoccupation with death.  Postpartum psychosis is defined by an extreme form of postpartum depression; one who experiences postpartum psychosis may experience the following symptoms: hallucinations, delusions, disorientation, confusion, paranoia and attempts to harm self or baby.  According to Byers, Dawson, Lewis & Malard (2010), symptoms of postpartum psychosis may be experienced by one in 500 mothers after childbirth. 

Presumed Risk Factors

-Biological causes, lack of social support, relationship with partner (Journal of Counseling and Development)
-Possible risk factors for PPD: experienced physical abuse or trauma, financial stress, partner related stress (Byers, Dawson, Lewis & Malard, 2010)
-Mothers who identify themselves with being a minority, having a low socioeconomic status and/or have previous experience with depression (Rich-Edwards, Kleinman, Abrams, Harlow, McLaughlin, Joffe et al., 2006)
-A possible genetic predisposition for depression, biological and hormonal factors, marital problems, low self-esteem, lack of social support system (MedicineNet.com)
-Being from a rural community and having 2 or more young children (Dennis, McKay, Ross, Villegas, 2011)
-Adolescent mothers experiencing social isolation, maternal competence, and weight concerns (Birkeland, Phares, Thompson, 2005)
-Bledsoe & Grote (2007) research suggested that women who were optimistic during pregnancy and focused on positive experiences in life were less likely than women who were pessimistic during pregnancy and focused on hardships such as financial, spousal and physical stress related struggles to experience severe PPD symptoms.

Presumed Treatment

Various forms of psychotherapy, cognitive-behavior therapy (CBT), and non-directive counseling approaches have been suggested by Cooper & Murray (1997) to be common treatment practices for patients who suffer from PPD.  Other alternative therapy modalities that may be used to treat PPD include but are not limited to the following: antidepressants, hypnosis, electroconvulsive therapy, art therapy and exercise (Byers, Dawson, Lewis & Malard, 2010).  From a mental health professional’s standpoint, a combination of psychotherapy and medication may be the most effective treatment for patients experiencing postpartum depression, however medication and/or alternative treatment may be necessary in the treatment of a consumer experiencing postpartum psychosis.  Taking medications and engaging in therapy is a consumer’s choice, therefore treatment routes can be multifaceted.
Presumed Preventative Measures

-Postpartum education at the beginning of pregnancy, for example initiating in individual therapy or group therapy to educate mom about postpartum risk factors and symptoms may be one preventative measure (Byers, Dawson, Lewis & Malard, 2010). The etiology of PPD is still up for debate, it is suggested by many professionals and much research that more research needs to be done on PPD in order to define and address more effective preventative measures for the illness.

How Loved Ones/Community Can React

-Educate yourself/community about the causes and treatment for PPD.
-Check in on new mothers and offer moral support and a helping hand, if able. The following can be helpful to someone experiencing PPD: a break from baby for a few hours, help with laundry, caregiving for other children in the home, cooking meals, anything you can think of to help lift some of the stressful daily demands life places on an individual can be of help.
-Know your limits as a caring family member/friend/community member and seek help.  Know when professional help from a doctor or therapist may be needed in order for those affected to get better.  Someone suffering from PPD does not always have the insight needed to assess the danger and seriousness of the illness therefore it may be necessary for an outsider to seek help.
-Take threats seriously.  If a mother is reporting to be suicidal or is reporting an inability to love or care for her child and indicates she could be a harm to baby at some point, seek immediate attention at your local ER.