Postpartum “blues” are defined as temporary low mood and moderate depressive symptoms that are self-limited and exceedingly frequent during the perinatal period. This activity outlines the diagnostic criteria for postpartum blues and emphasizes the role of the interprofessional team in its assessment and management.
In this article we are going to discuss regarding major Objectives:
- Determine the cause of postpartum blues.
- Examine the postpartum blues diagnostic criteria.
- Outline the various therapy options for postpartum blues.
- Summarise some interprofessional practises that can help patients suffering from postpartum blues achieve better outcomes.
Introduction:
Approximately 85% of women have some form of mood disruption during the postpartum period. Most women experience moderate and transient symptoms of sadness or anxiety; however, 10 to 15% of women experience more severe symptoms of depression or anxiety.
Non-psychotic psychiatric diseases are one of the most common morbidities of pregnancy and the perinatal period. Depressive illnesses (postpartum blues, postpartum depression), anxiety, post-traumatic stress disorder (PTSD), and personality problems are examples of these conditions. Postpartum “blues” are classified as temporary and self-limiting low mood and moderate depression symptoms. Sadness, sobbing, tiredness, impatience, anxiety, decreased sleep, decreased focus, and labile mood are all symptoms of depression. These symptoms normally appear two to three days after labour, peak during the next few days, and disappear on their own within two weeks.
While these symptoms are unexpected and frequently disconcerting, they do not impair a woman’s capacity to perform. There is no special therapy necessary; nevertheless, it should be emphasised that the blues can sometimes signal the onset of a more serious mood illness, particularly in women with a history of depression. If depressive symptoms last more than two weeks, the patient should be assessed to rule out a more serious mood condition.
There are three types of postpartum psychiatric illness:
(1) Postpartum blues
(2) Postpartum depression
(3) Postpartum psychosis.
It may be helpful to think of these disorders as occurring on a scale, with postpartum blues being the mildest and postpartum psychosis being the most serious form of postpartum psychiatric illness.
Postpartum blues:
During the first week after giving birth, many women experience mild dysphoria. Depressed mood, sobbing bouts, impatience, anxiety, mood lability, confusion, and sleep and eating problems are all common symptoms. Despite the negative connotation of the term “blues,” women are more likely than males to suffer symptoms such as sobbing, bewilderment, worry, and mood lability. Symptoms usually appear within a few days of delivery and can last anywhere from a few hours to several days. To diagnose the blues, various criteria have been utilised. For a diagnosis of the blues to be made, at least four of the seven symptoms have to be present and clearly observable to the patient or others (evaluated in the context of a diagnostic interview).
Postpartum depression:
PPD is most common in the first two to three months following delivery, but it can occur at any time. Some women experience lesser depressive symptoms during pregnancy. Clinically, postpartum depression is different from depression that occurs at other periods in a woman’s life. Postpartum depression symptoms include:
- Sad or depressed mood
- Tearfulness
- Disinterest in routine activities
- Guilt feelings
- Feelings of inadequacy or worthlessness
- Fatigue
- Sleep deprivation
- Appetite Modification
- Inability to concentrate
- Suicidal ideation
Postpartum psychosis:
The most severe form of postpartum psychiatric disease is postpartum psychosis. It is a rare occurrence that occurs in 1 to 2 out of every 1000 women following childbirth. Its appearance is frequently spectacular, with symptoms appearing as early as 48 to 72 hours after delivery. The majority of women with puerperal psychosis experience symptoms within the first two weeks after giving birth.
Postpartum psychosis appears to be a bipolar disorder episode in the majority of instances; the symptoms of puerperal psychosis most closely mimic those of a quickly growing manic (or mixed) episode. Restlessness, irritability, and sleeplessness are the first symptoms. Women with this disease have irregular or disorganised behaviour, as well as a fast-fluctuating melancholy or happy mood.
Delusional beliefs are common and frequently revolve around the infant. Auditory hallucinations instructing the woman to kill herself or her child are also possible. In this community, the risk of infanticide and suicide is high.
References:
- Postpartum Mental Disorders | GLOWM [WWW Document], n.d. URL http://www.glowm.com/section-view/heading/Postpartum Mental Disorders/item/419 (accessed 12.7.23).
- Postpartum depression – Symptoms and causes [WWW Document], n.d. . Mayo Clinic. URL https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617 (accessed 12.7.23).
- Postpartum depression [WWW Document], n.d. URL https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-depression (accessed 12.7.23).
- Postpartum Depression: Causes, Symptoms & Treatment [WWW Document], n.d. . Cleveland Clinic. URL https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression (accessed 12.7.23).
- Rai, S., Pathak, A., Sharma, I., 2015. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry 57, S216–S221. https://doi.org/10.4103/0019-5545.161481