Transcript IMPACT of UNTREATED POSTPARTUM DEPRESSION

IMPACT of UNTREATED
POSTPARTUM DEPRESSION
Dr Violet Okech- Helu
Department of Mental Health, KNH
Email:[email protected]
Postpartum Depression: The Facts
• Depression is one of the commonest, treatable
yet undiagnosed mental health disorders with a
HUGE impact on bio-psycho-social functioning.
• Approximately 10% of mothers experience
postpartum depression.
• Numbers could be higher due to underdiagnosis.
• Left untreated can severely affect the
mother,baby,father, siblings and wider society.
Baby blues or Postpartum depression?
• Many women experience
the "baby blues" after
childbirth.
• Symptoms
• Mood swings
• Crying easily,
• Poor concentration
• Irritability
• Sadness
• Resolve within 1-2 weeks
• Due to hormonal changes
& physiological changes
• Postpartum Depression
• More severe symptoms
Last longer than 2 weeks
• Interfere with Mom’s
ability to care for:
• Baby
• Herself
• Family
• Daily tasks
• In postpartum psychosis
hallucinations may pose
harm to the baby or Mom
Postpartum depression(PPD)
• Loss of appetite
• Insomnia
• Intense irritability and
anger
• Overwhelming fatigue
• Loss of interest in sex
• Lack of joy in life
• Feelings of shame, guilt
or inadequacy
• Severe mood swings
• Difficulty bonding with
your baby
• Withdrawal from family
and friends
• Thoughts of harming
yourself or your baby
• NB:PPD is not a sign of
weakness nor mom’s
fault. It’s a disease.
Postpartum psychosis
• Symptoms
• Confusion and
disorientation
• Hallucinations and
delusions
• Paranoia
• Attempts to harm
yourself or your baby
• An EMERGENCY!
Mom’s should seek help if..
• Symptoms last more than
two weeks
• Are getting worse
• Difficulty in baby care
• Difficulty in completing
everyday tasks
• Have thoughts of harming
self or your baby
Risks for postpartum depression
• Previous depression,
either during pregnancy
or at other times
• Previous postpartum
depression
• Recent stressful events..
complicated pregnancy
illness, job loss.
• Bipolar mood disorder
• Unplanned or
unwanted pregnancy
• Financial difficulties
• Young, unwed mother
• Problems with spouse
or baby’s dad/family
• Weak social support
system
• Please Screen for these
risks actively…
Edinburgh Postnatal Depression Scale
• The Edinburgh Postnatal Depression Scale (EDPS) was
developed in 1987 to help doctors determine whether
a mother may be suffering from postpartum
depression.
• The scale has since been validated and confirmed to
be both reliable and sensitive in detecting depression.
• During the postpartum period, 10 to 15% of women
develop significant symptoms of depression or anxiety.
• Unfortunately, many moms are never treated, and
although they may be coping, their enjoyment of life
and family dynamics may be seriously affected.
Edinburgh Postnatal Depression Scale
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In the past 7 days:
1. I have been able to laugh and see the funny side of things a. As much as I always could
b. Not quite so much now
c. Definitely not so much now
d. Not at all
2. I have looked forward with enjoyment to things a. As much as I ever did
b. Rather less than I used to
c. Definitely less than I used to
d. Hardly at all
3. I have blamed myself unnecessarily when things went wrong a. Yes, most of the time
b. Yes, some of the time
c. Not very often
d. No, never
4. I have been anxious or worried for no good reason a. No, not at all
b. Hardly ever
c. Yes, sometimes
d. Yes, very often
Edinburgh Postnatal Depression Scale
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5. I have felt scared or panicky for no good reason a. Yes, quite a lot
b. Yes, sometimes
c. No, not much
d. No, not at all
6. Things have been getting on top of me a. Yes, most of the time I haven’t been able to cope at all
b. Yes, sometimes I haven’t been coping as well as usual
c. No, most of the time I have coped quite well
d. No, I have been coping as well as ever
7. I have been so unhappy that I have had difficulty sleeping a. Yes, most of the time
b. Yes, some of the time
c. Not very often
d. No, not at all
8. I have felt sad or miserable a. Yes, most of the time
b. Yes, some of the time
c. Not very often
d. No, not at all
9. I have been so unhappy that I have been crying a. Yes, most of the time
b. Yes, quite often
c. Only occasionally
d. No, never
10. The thought of harming myself has occurred to me a. Yes, quite often
b. Sometimes
c. Hardly ever
d. Never
Impact on baby
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Difficulty in attachment and breastfeeding
Difficulty in regulating emotion
Reduced cognitive ability
Poor social skills and the ability to from successful
relationships
• Increased fussiness and irritability
• Increased risk of mental illness in later lifeelevated cortisol, reduced dopamine and
serotonin
Impact on baby
• Difficulty in matching facial expression to
emotion
• Reduced ability to show empathy-conduct
disorder, later development of psychopathic
behaviour?...
• Increased impulsivity
• Increased social withdrawal
• Decreased access to healthcare options,
immunization etc..
Impact on mother/father/family
• Decreased use of postpartum care for Mum and
child
• Reduced chances or time for breastfeeding
• Inconsistent parenting leading to reduced ability
of children to listen to and obey instructions
• Increased likelihood of marital conflict over sex
and family roles
• Maternal withdrawal or over-intrusiveness
• Possible harm to baby in psychotic episodes
Managing Postpartum depression
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Early detection
Medication
Psychotherapy-personal and couple
Destigmatization of PPD
Increasing social support
Mom “me” time/selfcare
Promoting adherence to treatment