According to studies, it is estimated that the percentage of women who undergo different types of mood disturbances during postpartum phase is about 85%. Most of these women normally encounter short-lived and mild symptoms although on average, 10%-15% develop more considerable symptoms of anxiety and depression. There are three groups of psychiatric illnesses that can manifest during postpartum period (Shields, 2006). They include postpartum depression, postpartum psychosis and postpartum blues. These illnesses may be usefully conceptualized due to their existence along continuum with postpartum psychosis as the most severe and postpartum blues as the least severe type of postpartum psychiatric illness. Postpartum depression (PPD) normally emerges within the first three months after delivery although it may happen at any period after delivery. It is more frequent in women as compared to men. In some women, there are elements of milder depression symptoms at some point in pregnancy.
Kleiman & Raskin (2008) observe that the initial conceptualization of postpartum depression and other psychiatric illness was as a group of illness that was particularly associated with childbirth and pregnancy. Consequently, diagnostically it was considered separate from other forms of psychiatric illnesses. However many recent evidence and study put forward that the illness including its signs and symptoms, can not be practically distinguished from psychiatric disorders which occur at some other times in women’s life.
There are many symptoms that are linked with postpartum depression. During this period, women may encounter considerable anxiety but the most common is generalized anxiety. Cases of hypochondriasis or panic attacks have also been reported among some women. Women can also develop postpartum obsessive-compulsive disorder where they might experience invasive and worrying feelings of harming their babies (Rychnovsky & Brady, 2009). There are a string of other signs and symptoms that can be observed in women suffering from PPD, they include:
- Sleep disturbance.
- Sad or depressed mood.
- Incompetence or worthlessness feelings.
- Suicidal thoughts.
- Change in appetite
- Poor concentration.
- A loss of interest in usual chores.
- Guilt feelings.
It is very hard to detect PPD particularly when the cases are still milder due to many of the symptoms that are used for diagnosing depression like fatigue, lack of sleep and appetite occurring among postpartum women even when they are not experiencing depression (Rychnovsky & Brady, 2009).
Causes of postpartum depression. Many factors can lead to postpartum depression. These causes are broadly divided into three groups: hormonal factors, psychosocial factors and biological/ biologic vulnerability.
Hormonal Factors. Sebastian (2007) suggests that in general, the postpartum period is portrayed by a quick shift in the hormonal environment. In the initial 48 hours after delivery, there is a drastic fall in the concentration levels of estrogen and progesterone. Several investigations have linked these hormonal shirts to development of postpartum affective illness because the process adjusts neurotransmitter systems concerned with mood regulation. Albeit there is a likelihood of there being no constant correlation in levels of serum in progesterone, thyroid, cortisol, , and estrogen hormones and the emergence of postpartum mood disturbances, there are many investigations into the syndrome have hypothesized that specifically in some women, there is sensitivity to changes in hormones that occurs after delivery.
Psychosocial factors. According to many findings that have been consistent, another factor that greatly contributes to postpartum depression is inadequate social support coupled with marital dissatisfaction. Women who encounter these social problems commonly experience PPD as compared to other women. Additionally, if a woman goes through stressful life or actions prior to delivery or during pregnancy they are more likely to suffer from PPD (Sebastian, 2007).
Biologic Factors. All the above mentioned factors may together get involved in causing ppd although the disorders emergency is perhaps a manifestation of a deep rooted susceptibility to affective illness. Women who have earlier on encountered bipolar disorders or major depression are the most vulnerable to postpartum depression. This has an implication that any woman who develops PPD is more likely to encounter repeated incidents of depression that are not related to childbirth or pregnancy (Kleiman & Raskin, 2008).