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Thursday, March 13, 2014

Post Partum Depression: Gynos think it exists but there is no formal psychiatric diagnosis

Women can be stressed and tired without being depressed after having a baby, but baby blues, postpartum depression, and postpartum psychosis are three diagnoses that may need serious attention from your health care provider. And now a NYT article notes that these feeling actually begin in pregnancy, not just post partum. And not just for women who have had poor outcomes in pregnancy such as miscarriage or stillbirth. Oddly the current formal categories of psychiatric diagnosis do not recognize postpartum depression as being anything other than depression.
The "baby blues" usually begins right after delivery, may be the worst in the first days at home with baby, and are often described as feeling a bit on edge, irritable or sad, and essentially go away without treatment. Postpartum depression is significant, you worry too much about the baby, have trouble concentrating and enjoying motherhood and may even get so difficult moms with this much depression think of killing themselves so they will not harm the baby. It is essentially clinical depression that will respond to the treatments we use for depression during pregnancy, and many of the medications are safe during breastfeeding as well. It is unfortunately very common, some studies say 1/5 women can experience postpartum depression.Actual postpartum psychosis is very rare and very serious. It can be difficult to diagnose. Poor sleep, mood swings and temporary improvement make it harder to diagnose. Thinking can become so disordered if not treated these patients may harm their infant. Essentially recovering post delivery means taking care of your inner self as well as your physical self, and it's definitely a topic to gab with your gyno about.

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