Introduction

Postpartum Depression is a severe type of depression occurring during the first year after delivery in women. It is a curable disorder; it may occur within six months to a year postpartum.

Postpartum Depression or Postnatal Depression may cause a woman to become weary, experience sleep disorders, be dejected and detached, lose self-confidence, and have low self-esteem. Slight mood changes are commonplace after delivery, but when symptoms become pronounced, help will be necessary. This disorder may prove to be serious health hazard for both mother and the child.

The severity of the depression can vary from mild to severe and seems to be the general tendency after the initial pregnancy.

The discrepancy involving postpartum depression and the ‘baby blues’ is that postpartum depression generally impacts a woman’s health and affects her normal functioning for a considerable length of time. Postpartum depression needs counseling, support and medications. Changes in hormonal balances during delivery are thought to be the causes for 'baby blues'.

Causes of Postpartum Depression

Biological Causes: Female ovarian chemical substances like estrogen and progesterone play an important role during pregnancy and after delivery. During pregnancy, the levels of these substances increase by ten times. After child birth, they decrease drastically, reaching normal levels in three days. Research shows that there is an association between rapid decrease of these substances and postpartum depression.

Also, a decrease in levels of serum concentrations of steroids, namely cortisol and aldosterone, take place during the postpartum phase. It is assumed that there may be a connection between these decreasing levels and incidence of mood swings of women during postpartum phase.

Another area of attention these days is the association between prolactin levels and depression. The levels of Prolactin are at minimum at the time of child birth and tend to go up rapidly within a week after delivery.

Insulin is also supposed to play an important role in causing postpartum depression. A fall in insulin levels in mothers after delivery causes brain serotonin levels to fall. This serotonin fall is associated with person’s mood changes.

A research illustrated the relationship between levels of certain chemical substances called HPA (Hypothalamic-Pituitary-Adrenal) of mothers during the postpartum period and other women who are not in postpartum phase and but who suffer from chronic depression. The study showed that the HPA axis was decontrolled in the depressed group, but regulated in the non-depressed group at 6 and 12 weeks postpartum.

Variations in the levels of the neurotransmitters in the brain, namely serotonin and norepinephrine, occur shortly after a woman delivers, and these variations are assumed to be extremely significant causative factors to postpartum depression. Deficiencies of dietary elements like the vitamins, minerals, and amino acids that constitute these neurotransmitters can seriously inhibit the capacity of the brain and nervous system to produce them. Both mental and physical well-being will be affected if the dietary elements that that are needed to produce vital chemical substances, neurotransmitters, and other necessary chemicals are not available in the body in substantial amounts.

Thyroid is also assumed to play a role in postpartum depression. It is observed that thyroid levels may fall after delivery. Decreased levels are indicated in gloominess, apathy, lack of energy, bad temper, loss of focus and weight increase. These are all symptoms common to depression.

Psychological Causes: Women with past history of mental health issues before delivery are more prone to get depressed after delivery. The threat of severe depression after miscarriage is high for childless women within first few months after the miscarriage. . It occurs in such women also who were not happy about being pregnant at all. Childbearing and delivery are major events in a woman’s life. Coming to terms with these realities is a huge mental task which may cause stressful situations. These, in turn, will cause depression in woman.

Other causes:

Mental diseases prior to pregnancy

Family history of post-partum depression

Prevalence of mental disorder in earlier pregnancies and deliveries

Marital discord, job loss, or poor family support

History of miscarriages or stillbirths

Worry about changes in physical appearance after delivery like weight gain etc.

Stress due to cesarean delivery and recovery

Overwhelming motherhood responsibilities

Sense of weariness due to disturbed sleeping patterns

Poor dietary intake after delivery