Four characteristics may offer a way to predict if a woman will experience postpartum depression—and if her symptoms will worsen over the first year after giving birth.
Identifying the factors early on could allow earlier treatment and improve chances of a full recovery, say researchers.
The four characteristics are:
- Number of children
- Ability to function in general life, at work, and in relationships
- Education level, which can determine access to resources
- Depression severity at four to eight weeks postpartum
“By the time a mother comes in for her six-week postpartum visit, we have the potential to predict the severity of her depression over the next 12 months,” says Sheehan Fisher, assistant professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and lead author of the paper in Depression & Anxiety.
“This would be a game-changer for mothers and their clinicians because we could encourage early intervention so moms have better odds of success with their treatment over time.”
A mother with postpartum depression can fall into one of three depression trajectories: gradual remission (over time she starts to get better); partial improvement (at 12 months postpartum, she is headed in a positive direction but continues to have symptoms); and chronic severe (her symptoms start at the same level as the partial improvement trajectory but worsen over time).
“It’s not just a question of ‘Is the mother feeling depressed?’ but rather, ‘Which way is she headed in her depression?'” Fisher says. “If her depression symptoms are going to get worse over time, she needs to be proactive about treatment.”
Fisher hopes the findings will lead to improved step care for mothers in all three depression trajectories, meaning health providers can tailor the level of care to each woman.
Postpartum symptoms and treatments
Mothers with postpartum depression typically experience difficulty sleeping, feelings of worthlessness or excessive guilt, coping with negative emotions, have an inability to focus or concentrate on things, and generally feel a lot of emotional distress, Fisher says.
Postpartum depression affects not only the mother but also can negatively affect her child’s functioning and health. It can affect the child’s emotional development and ability to regulate their own emotions and confer a higher risk for anxiety and depression.
The longer a woman’s depression goes untreated, the more difficult it is for her to get back on track, Fisher says. It can also take a while to find the right medication and get access to the right provider.
“It only complicates things if the mother doesn’t start her treatment until later on,” Fisher says.
Treatment for women in the chronic severe group differs based on the individual but could include psychotherapy and/or medication, Fisher says. Clinicians might enlist the help of the father or other family members or might seek high-level care like an intensive outpatient course of treatment for the mother.
The longitudinal study looked at data collected between 2006 and 2011 of women delivering at an academic medical center in Pittsburgh, Pennsylvania. Women with a postpartum depressive disorder participated and completed symptom severity assessments at 4-8 weeks (intake), 3 months, 6 months, and 12 months postpartum. Clinicians interviewed the women about the severity of their depressive symptoms, medical and psychiatric history, functioning, obstetric experience, and infant status.
The scientists determined a woman’s score based on the four characteristics and, using a computational algorithm that predicts her depression trajectory, provided the odds of which group the woman would fall in. The study predictions were 72.8 percent accurate.
The National Institute of Mental Health of the National Institutes of Health funded the work.
Source: Northwestern University
- Da Capo Lifelong Books
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- Identify the symptoms of PPD and distinguish it from "baby blues"
- Deal with panic attacks, obsessive-compulsive urges, and stress overload
- Break the cycle of shame and negative thoughts
- Mobilize support from your husband or partner, family, and friends
- Seek and evaluate treatment options
- Cope with the disappointment and loss of self-esteem
Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek their Help
This book provides a comprehensive look at effective therapy for postpartum depression. Using a blend of professional objectivity, evidence-based research, and personal, straight-forward suggestions gathered from years of experience, this book brings the reader into the private world of therapy with the postpartum woman. Based on Psychodynamic and Cognitive-Behavioral theories, and on D.W. Winnicott's "good-enough mother" and the "holding environment" in particular, the book is written by a therapist who has specialized in the treatment of postpartum depression for over 20 years. Therapy and the Postpartum Woman will serve as a companion tool for clinicians and the women they treat.
- Mary Jo Codey
Studio: For Dummies
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Postpartum Depression For Dummies can help you begin the process of determining what’s going on with you and give you a better idea of where you fall so that you can get yourself into proper treatment right away. The book covers all aspects of PPD, from its history and its origins to its effects on women and their families to the wide variety of treatments available—including conventional Western medicine, psychological therapy, alternative medical treatments, and self-care measures. Postpartum Depression For Dummies reveals:
- Why some doctors may be hush-hush about PPD
- How to distinguish between pregnancy hormone changes, "baby blues," and PPD
- The difficulties of getting a proper diagnosis
- The role and importance of a therapist
- The benefits of medication for depression
- Alternative treatments with a successful track record
- How to find the right balance of psychological, medical, and alternative treatment
- Ways you can help foster recovery
- The nutrition you need to care for yourself properly
- How to help your partner help you
Postpartum Depression For Dummies also provides the additional resources you need—web sites, organizations, and further reading—to help avoid the unnecessary suffering caused by undiagnosed and untreated PPD and survive and thrive as a new mom.