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Postpartum Depression Is Common and Often Untreated

It's often undiagnosed and can take a high toll.

illustration showing a baby's hand grasping an adult's finger
It is normal to feel anxious, restless, irritated and tearful for the first weeks after giving birth. When these feeling don't resolve, it is called postpartum depression. The symptoms can include anxiety, panic and mania. Postpartum depression will usually occur within four to twelve weeks after pregnancy, although it can take up to a year to develop.

A new study has found that although one-in-seven women will experience postpartum depression, it often goes unrecognized and untreated.

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“In the US, the vast majority of postpartum women with depression are not identified or treated even though they are at higher risk for psychiatric disorders,” said lead author Katherine L. Wisner, MD, Northwestern University Feinberg School of Medicine, Chicago, Illinois. This is a huge public health problem for both mothers and their babies.

Many women who have major depression during the postpartum period have had at least one episode of depression before giving birth. This study found that 26% of women with postpartum depression had at least one episode of major depression before pregnancy, 33% during pregnancy and 40% postpartum.

Two-thirds of women with postpartum depression had a comorbid psychiatric disorder. In more than 80% of these cases, the women also had an anxiety disorder.

“Clinicians need to know that the most common clinical presentation in the post-birth period is more complex than a single episode of depression,” said Dr. Wisner. “The depression is recurrent and superimposed on an anxiety disorder.

Of the women who screened positive for major depression, 22% had bipolar disorder. Few of the women with bipolar disorder had been diagnosed with it previously. 

“That’s a very high rate of bipolar disorder that has never been reported in a population screened for postpartum depression,” said Dr. Wisner. “It is significant because antidepressant drug treatment alone can worsen the course of bipolar disorder.”

If a woman is going to have a manic episode, postpartum is the most likely time in her life that it will occur.

As for the seriousness of postpartum depression, suicide is the second most common cause of mortality in postpartum women.

Click here for more on Medpage Today.

Click here for more from Science Daily.

Click here for more on Medscape. 

Click here for the abstract from the Journal of the American Medical Assocation

Click here for the PUBMED fact sheet about postpartum depression. 

The illustration is by Daerick Gross Sr. from my book on sex, the "Guide To Getting It On."

Paul Joannides, Psy.D., is a research psychoanalyst, author of Guide To Getting It On, and a speaker on college campuses. more...

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