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Post Natal Depression

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Post Natal Depression
Summary
  • Post Natal Depression may be a traumatic emotional and physical event for a mother after the birth of her baby.
  • Approximately 14% of women experience Post Natal Depression which usually lasts from several weeks to several months.
  • A less severe, 'maternity blues' affects 50 to 70% of all women after childbirth.
Description

Post Natal Depression may be a traumatic emotional and physical event for a mother after the birth of her baby. A sense of loss or disappointment often occurs if the experience of giving birth falls short of the parents' expectations.

Approximately 14%1 of women experience Post Natal Depression which usually lasts from several weeks to several months. The signs of this problem can occur at any time after the baby is born and during the first year of his/her life.

After childbirth, there is a dramatic change in the levels of circulating hormones (progesterone and oestrogen) in the mother2. Mood swings might be traced to the change in hormone and endorphin levels. Endorphins are pain-reducing peptides produced by the body.

It is thought that certain conditions trigger this ailment. After the baby is born, the mother may feel isolated from her friends and normal contacts because of the demands of the infant. The lack of sleep and the constant feeding increase the stress on a new mother3.

The symptoms of this ailment include: a sense of loss of control; low self esteem; inability to do household tasks; inability to think clearly or find the right words; tearfulness for no apparent reason; exhaustion and over concern about lack of sleep; overwhelming feelings of anxiety or a depressed mood; poor appetite or over-eating; loss of sexual interest; fear of being alone; fear of social contact; irritability; apathy; obsessional thoughts or activities; exaggerated fears about health and safety of self, baby or partner; suicidal thoughts, plans or actions.

A less severe, 'maternity blues' affects 50 to 70% of all women after childbirth. It most commonly occurs around the fifth day after birth, and may last for up to two weeks. Many women with 'maternity blues' describe themselves as feeling happy and sad at the same time, or in quick succession4. Women who give birth in hospital are no more prone to postpartum mood disturbances, such as blues and depression, than women who give birth at home5.

Management of Post Natal Depression should focus on the mother overcoming her depression by learning new coping techniques and behaviours; acknowledging the baby's growth and development more positively and re-invigorating the relationship with her husband/partner6.

  • Management

    In no way is this information intended to replace the advice of a medical practitioner. Always consult your Doctor for diagnosis and advice.

    If you are experiencing any physical or emotional problems after the birth of your child, your Doctor should be consulted. Your Doctor may refer you to a counsellor or family care centre for assistance. Discussing issues with your Doctor can be reassuring and extremely helpful in enhancing the experience of parenting.


    Lifestyle

    Diet Hints
    • It is important to have a wholesome and varied diet. A balanced intake of nutrients is necessary for maintaining good physical and mental health.
    • Your diet should be high in fresh vegetables, especially the dark green leafy ones. Lightly cooking (steaming) helps to preserve the nutrient content of the vegetables.
    • Eat raw food as often as possible e.g., salads. Another good idea is to snack on nuts and seeds during the day, as these are high in minerals.
    • Rolled oats are a very good source of fibre and help to keep blood sugar levels stable throughout the day. Fluctuating blood sugar levels can adversely affect a person's mood.
    • Reduce your intake of beverages containing caffeine such as tea, coffee and cola drinks. Caffeine is a chemical stimulant that can induce feelings of anxiety and have an adverse effect on the nervous system if taken in large amounts.
    • Include foods rich in B group vitamins such as pork, ham, liver, wholemeal bread and cereals and yeast extract.
    • Fish is a very good source of lean protein and deep sea, cold water fish such as tuna, mackerel, halibut, salmon etc., are good sources of essential fatty acids needed for maintaining a healthy immune and nervous system.
    • Eat several small meals and snacks through the day to keep energy levels up and drink plenty of fresh water.
    • Restrict your intake of alcohol as heavy drinking can trigger mood swings and alcohol is passed onto your baby through your breast milk.
    • Drink freshly made juices from in season fruits and vegetables. Fresh juice is high in nutrients and fluids. It is a good idea to dilute fresh juices with water to restrict your intake of concentrated fruit sugar (fructose).
    • The diet should be high in calcium and magnesium. These minerals play a large role in maintaining the normal functioning of the nervous system and can be depleted during pregnancy. Good sources of calcium include; dairy products, sardines, egg yolk, broccoli, green vegetables, nuts, seeds, peas, beans and lentils. Good sources of magnesium include: nuts and seeds, soybeans, parsnips, wholegrain cereals, brewers' yeast kelp, seafood, green leaves, wheat germ and sprouted grains.


    Vitamins/Minerals/Herbs
    • Chamomile is a soothing herb and oats is a herb that has a restorative effect on nervous debility, exhaustion and depression.
    • Vitamin A, vitamin C and vitamin E are antioxidants which help 'mop up' damaging molecules in the body (free radicals) and the B group vitamins are needed for energy.
    • Magnesium and calcium are required for proper functioning of the nervous system.
    • Iron is suggested if you are anaemic (iron deficient) and this can be confirmed by a simple blood test 7
  • Pharmacist Advice

    Ask your Pharmacist for advice.

    1. Follow the Diet Hints.
    2. Talk to your husband/partner or trusted family and friends8.
    3. Let a trusted person look after the baby, even for a short time, to allow you to rest and have some time to yourself. A new baby can be very demanding.
    4. Breastfeeding has a stabilising effect on a woman's hormones that may help to reduce the severity of Post Natal Depression.
    5. Ask your Pharmacist about any antidepressant medication you may be taking. Some medications are unsuitable for breastfeeding mothers9.
    6. If the diet is inadequate, consider some supplements.
  • Notes

    Organisations & Support Groups

    Queensland
    Post Natal Disorders Support Group.
    Tel: 0417 632 844.
    Address: PO Box 25 Greenslopes 4120.
    Services available: phone support, book and video library, support group meetings, seminars and home visits.

    ACT
    Post Natal Depression Support Group ACT.
    Tel: (02) 62375108 or (02) 2888337.
    Address: PO Box 1705 Tuggeranong 2901.

    Victoria
    Post and Ante Natal Depression Asspciation (PaNDa).
    Tel: (03) 9882 5396.
    Address: 1st Floor, Canterbury Family Centre. 19 Canterbury Rd. Camberwell 3124.


    References

    1. Dennerstein L, et al. Postpartum depression-risk factors. J Psychosom Obstet Gynaecol (suppl) 1989; 10:53-65.
    2. Chang J, et al. Impact of placental hormone withdrawal on postpartum depression. Chung-Hua-Fu-Chan-Ko-Tsa-Chih. 1995 Jun; 30(6): 342-4.
    3. Chen CH. Etiology of postpartum depression--a review. Kao-Hsiung-I-Hsueh-Ko-Hsueh-Tsa-Chih. 1995 Jan; 11(1): 1-7.
    4. Byrne G. & Rapheal B. Postpartum Depression. Current Therapeutics, August 1995.
    5. Pop-VJ; Wijnen-HA; van-Montfort-M; Essed-GG; de-Geus-CA; van-Son-MM; Komproe-IH. Blues and depression during early puerperium: home versus hospital deliveries. Br-J-Obstet-Gynaecol. 1995 Sep; 102(9): 701-6.
    6. Trad-PV. Using maternal representational patterns to evaluate postpartum depression. Am-J-Psychother. 1995 Winter; 49(1): 128-48. 
    7. Viola-H; Wasowski-C; Levi-de-Stein-M; Wolfman-C; Silveira-R; Dajas-F; Medina-JH; Paladini-AC. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta-Med. 1995 Jun; 61(3): 213-6.
    8. Treatment of postpartum depression with interpersonal psychotherapy [letter; comment] Arch-Gen-Psychiatry. 1995 Jan; 52(1): 75-6.
    9. Byrne G. & Rapheal B. Postpartum Depression. Current Therapeutics, August 1995.
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