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Women's Health : Services : Postpartum Mood Disorders

New mothers are often told that “this is the happiest time of your life”.  In reality, it can be one of the most stressful times of your life.  And for one in ten women, they may experience overwhelming psychological changes, which replace the feelings of joy and affect the maternal bonding with the infant.  These women may experience high anxiety levels, despondency, insomnia, frequent crying and fear of harming the baby.  For women suffering from these changes, they may feel “out of control” and may be afraid to care for their baby. Many women have feelings of guilt and disappointment and are ashamed to admit what they are feeling.  They are suffering from postpartum depression.

There are five postpartum mood disorders.  The most common are the “baby blues” which are experienced by 50-80% of all new mothers.  The “baby blues” occur within the first week postpartum and usually persists for up to 3 weeks.  Common symptoms are mood instability, sadness, lack of concentration, and dependency.  Many of these symptoms are due to hormonal changes, as well as, the physical and emotional stress of childbirth.

Perinatal Mood Disorders 

In 15-20% of mothers, postpartum depression or anxiety may develop.  It may develop anytime in the first year after delivery.

In 15-20% of mothers, postpartum depression or anxiety may develop.  It may develop anytime in the first year after delivery.  Some of the common symptoms are excessive worry or anxiety, irritability, feeling overwhelmed, sleep problems, lack of feelings towards the baby, and change in appetite.  Risk factors include a personal history of depression/anxiety, social isolation, or history of thyroid dysfunction.  Postpartum depression can be treated with antidepressants as well as therapy.

In 3-5 % of new mothers, they may develop obsessive symptoms.  They may have repetitive and persistant thoughts, they may even have thoughts of harming the baby.  Treatment includes medication and therapy.

Panic disorder may develop in 10 % of postpartum women.  They may experience severe anxiety, shortness of breath, chest pain, or palpitations.  A very small number of women may develop postpartum psychosis.  This may occur in the first 2-3 days postpartum.  Symptoms include delusional thinking, visual or auditory hallucinations, and delirium.  Women experiencing postpartum psychosis in general need to be hospitalized for further treatment.

At MUSC Women’s Health Services, we understand that many patients keep their symptoms to themselves.  They also may be unaware that the feelings they are having are due to postpartum depression.  The Women’s Health Services at MUSC strive to educate and screen patients for symptoms of postpartum depression during pregnancy and at the postpartum visit.   This team is sensitive to the emotional as well as the physical needs of pregnancy.  The team is comprised of a physician, and a clinical nurse specialist with a specialty in high risk obstetrics and psychiatric mental health nursing.  Women can be immediately accessed into support and treatment utilizing a variety of internal and community resources.

Practitioners involved:
Angela Raney, RN, Director of Women’s Health Services at MUSC

MUSC Online Health Library Resources:
 What is depression? 
 Overview of Mood Disorders

Other Online Resources:
The Ruth Rhoden Craven Foundation, Inc. for Postpartum Depression Awareness- Mt Pleasant, SC
Major Depression During Conception and Pregnancy: A Guide for Patients and Families- Expert Knowledge Systems LLC
The Ruth Rhoden Craven Foundation, Inc. for Postpartum Depression Awareness 
Postpartum Depression- National Library of Medicine
Postpartum Depression- National Women's Health Information Center
Postpartum Depression- Nemours Foundation

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