The promise of new life brings with it anticipation and dreams of a growing family. Happiness is what many of us think of when we await the arrival of a child. However, as many as 13- 20% of new mothers experience post-partum depression. Baby Blues is the name given to a natural transition period of two weeks after giving birth, when 70% of mothers experience high emotions and mood swings and anxiety about parenting an infant. Those who experience depression for periods longer than two weeks may be experiencing Post-Partum Depression (PPD).  The third and most serious of these post-partum ailments is post-partum psychosis; but we will focus on post-partum depression in this article.

PPD’s Major Symptoms

The symptoms of post-partum depression match those of a major depressive episode and may include sadness, loss of interest in usual pursuits, poor sleep, lethargy, weight loss or gain, anxiety, feeling worthless or thoughts of suicide.

Post-Partum Psychosis

A more serious and less common ailment that may develop after childbirth is called Post-Partum Psychosis.  Post-partum psychosis develops suddenly and may include cognitive problems such as delusions, confusion, inability to function, and thoughts of harming herself or baby.  Post- partum psychosis is more serious than Baby Blues or Post-Partum Depression and requires immediate medical and mental health treatment.

Effects of Post-Partum Depression

Post-partum depression is severe enough to have both short and long term effects on mother and baby emotionally, socially and cognitively. Children of mothers suffering from PPD, who were tested from 7 days to  12 years of age, showed evidence of lagging at each developmental stage. Feldman(2009) claims mothers with PPD have “difficulty in supporting a child’s independence, creativity, executive functions, empathy and peer friendships, all functions that emerge during the preschool stage.” The low social interaction between a mother with PPD and her infant reflects the mother’s lack of energy and involvement. Early diagnosis and ongoing evaluation and treatment is necessary to minimize the negative effects to mother, baby and family.

 Types of Mental Health Treatments

The types of psychotherapy used to treat post-partum depression may include Cognitive Behavioral Therapy (CBT), non-directive counseling, hypnosis, art therapy, inter-personal therapy, relaxation exercises and problem solving techniques.  Phone coaching has also been used for the convenience of the new mother.

Successful Treatment Programs


Current successful treatment programs include:

• The Scottish Mellow Babies programs post-partum therapy offered from the beginning of pregnancy as part of birthing classes Based on up to date research, Mellow Parenting designs programmes to address gaps in current service provision which help to address social and health inequalities. The programmes are piloted and evaluated thoroughly until the evidence suggests that they work effectively.

• Hospitals that offer post-partum therapy for all mothers from the beginning of pregnancy during birthing classes. See a list of postpartum locations here.

• Pediatricians and therapists who partner to offer post-partum programs prescribing mothers’ counseling or group therapy sessions synchronized with appointments when the new baby sees a pediatrician.  Postpartum depression: an update

Moving Forward Globally

Post-partum depression treatment is an area that needs further study and the development of best practices. Mothers suffer, infants fall behind developmentally and families are stressed by post- partum depression. It is time to do something about this centuries old, worldwide illness. We urgently need awareness and timely therapy during this vulnerable post-partum time.

Who Will Answer?

Who will advocate for this population? Who will speak to the medical and mental health providers? Will you? Will you inform your doctors and encourage them to offer and promote proactive practices on behalf of the world’s littlest and weakest? Together we can improve lives of mothers, babies and families.

Remember Fuller Life Family Therapy when you need a trained ear to listen.

Resources:

Clay, E.& Seehusen, D. (2004). A review of postpartum depression for the primary care physician. Southern Medical Journal, 97 (2):157-61; quiz 162.

Feldman, R., & Eidelman, A. I. (2009) Biological and environmental initial conditions shape the trajectories of cognitive and social–emotional development across the first years of life. Developmental Science, 12(1), 194–200.

Lewis, Carol; Byers, Allison; Malard, Sarah; and Dawson, Gregory. (2010). Challenges in diagnosing and Treating Post-Partum Blues, Depression and Psychosis. Alabama Counseling Association Journal, 36, 1.

Murray, L., Cooper, P., Wilson, A. and Romaniuk, H. (2003). Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: 2. Impact on the mother-child relationship and child outcome. British Journal of Psychiatry, 182:420-7.

Puckering C. (2010). Mellow Babies: A group intervention for infants and mothers experiencing postnatal depression. Counselling Psychology Review, 25(1), 28-40.

Sit, Dorothy; Rothschild, Anthony; Wisner, Katherine L. (2006). “A Review of Postpartum Psychosis.” Journal of Women’s Health (15409996) 15(4), 352-368.

Laura L. Cardella, LPC Intern Supervised by Amy Fuller PhD, LPC-S