Advancements Within Postpartum Depression

Macy Scott
Apr 27, 2019 · 9 min read

Depression comes in many different forms, and it can happen to anyone of any age. Depression can also come from many different reasons. It could be because of a death of a loved one, feeling like you aren’t good enough, and my main focus in this essay is the feeling you get after giving birth to your child. That specific type of depression is called postpartum depression. Today we will be discussing what postpartum depression is, what causes it, and some risks and preventions, then, we will discuss what some symptoms are and how it can be treated, and finally, what the process was to developing a drug for this depression. Depression is a very serious topic, especially when it deals with mothers and their children so having The Food and Drug Administration (FDA) approve a drug specifically for this depression will help every mother going through it every single day.

Postpartum depression is depression suffered by a mother following birth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue. Normally after, giving childbirth the mother may find that they feel empty or they might feel sad because they don’t have a baby inside them anymore. According to the Office on Women’s Health, they say that if that feeling goes past two weeks, you may be having signs of postpartum depression. Postpartum depression is a serious mental illness that involves the brain and affects your behavior and physical health (Office on Women’s Health, 2018).

This video also helps explain what what postpartum depression is and the causes. And just more information you need to know to learn about postpartum depression. It helps you visualize better than just reading from a paper.

Postpartum depression can take away from your day-to-day activities, and can even put your family at stake. One in every nine women can get this depression. The main cause of postpartum depression is having hormonal changes that may trigger this depression. The hormone estrogen and progesterone are at its highest during pregnancy, so when you give birth you hormone levels may fluctuate. Estrogen is any of a group of steroid hormones, which promote the development and maintenance of female characteristics of the body. Such hormones are also produced artificially for use in oral contraceptives or to treat menopausal and menstrual disorders (Merriam-Webster’s collegiate dictionary, 1999). Progesterone is a steroid hormone released by the corpus luteum that stimulates the uterus to prepare for pregnancy (Merriam-Webster’s collegiate dictionary, 1999). In the first 24 hours they go back to pre-pregnancy levels. Researchers say this is one of the main causes in leading up to this depression. Other causes may be being tired after labor, being overwhelmed with the new baby, doubts about being a good mother, grief about wanting to feel and look the way they did before pregnancy. There are many different reasons for becoming depressed. Having a new baby is a lot of pressure, and some mothers struggle with it. Sometimes they want to be the perfect mother, or they just get upset that they won’t be the same after their child is born.

You can see from this picture that this mother is suffering from postpartum depression. She is taking care of her child, but your face looks like she is upset. Even though she is taking care of her child, she still looks upset about the situation.

Each person is different for why they have postpartum depression. That is why creating a new drug for this specific depression may help mothers all over the world be the best mother for their newborn that they can be. Not only do mothers suffer from this depression, fathers may reach this point as well. For both mothers and fathers the risks are about the same. If you are younger your risk to get postpartum depression increases. If your family has personal or family history of depression or bipolar disorders, if you don’t have support from your friends and family, have relationship or money issues, were depressed during pregnancy, or had problems from a previous birth, your risk will increase for receiving postpartum depression (Office on Women’s Health, 2018).

In this graph, it shows you the mothers that are more susceptible to postpartum depression. As I stated above before this graph, younger mothers are at a higher risk and if you have had recent stressful events in the last six months.

During your pregnancy, your doctor can monitor you closely for signs of depression. Support groups, counseling or other therapies may be recommended during pregnancy. Antidepressants may be described as well. After your baby is born you may have to go through a screening or checkup to see if you have any signs (Postpartum depression by Mayo Clinic Staff, 2018). Antepartum and postpartum screening, an early diagnosis, and a tailored approach to depression are essential for better results and prognosis related to both mother and child (Stanescu, D. Balalau , Ples, Paunica, C. Balalau, 2018).

There are three different types of postpartum depression, that all of different symptoms for each. There is first something called baby blues. This only lasts about a few days to a week after giving birth. Some symptoms of this would be mood swings, anxiety, sadness, irritability, crying, or feeling overwhelmed. This one is the least serious type of depression. Next there actually comes the title of postpartum depression. These symptoms are more serious than the baby blues and if they aren’t treated right away they may last longer than what they should. The symptoms include depressed mood or severe mood swings, excessive crying, difficulty bonding with your baby, staying away from friends and family, loss of appetite or you may eat too much, you may either not get enough sleep or you may get too much. There are many symptoms involving postpartum depression. Some more may be fatigue or loss of energy, anger, fear of being a terrible mother, hopelessness, restlessness, sever anxiety and panic attacks, thoughts of harming yourself or your newborn, or recurrent thoughts of death or suicide. Those symptoms can be very frightening to the mothers that are experiencing them. With even a small chance of mothers harming their children, there needed to be some kind of treatment that helped out mothers start feeling better sooner after childbirth.

This chart is the different stages of postpartum depression, starting with not being impacted by this disorder and all the way to postpartum anxiety.

One more type involving birth is called postpartum psychosis. This usually happens during the first week after you give birth. These symptoms are more severe than regular postpartum depression and the baby blues. This condition is very rare, but if not treated, it could have life-threatening problems come their way. This condition is definitely the hardest one to combat because the symptoms are so troubling. Some symptoms include confusion and disorientation, obsessive thoughts about your baby, hallucinations and delusions, sleep disturbances, excessive energy and agitation, paranoia, and attempts to harm yourself or your baby. This condition happens right away after giving birth. If the mother starts feeling depressed once she has given birth and it has lasted a few days, you should go see a doctor.

This video is explaining how to recognize if you have postpartum depression. If you start feeling those symptoms right away it may not be as bad as you think. Once you continue to have these symptoms is when you should consult with a doctor.

There are two main treatments for postpartum depression. The first one is counseling or talk therapy. Talking to a trained professional like a counselor, therapist, or psychologist may help patients get over postpartum depression faster. There are two types of counseling that are effective in treating this (Postpartum Depression Facts, The National Institution of Mental Health Information Resource Center). There is something called cognitive behavioral approach, which is a treatment approach that incorporates basic principles of learning to change the way people think (Feldman, 2017, p. 472). Antidepressants are also very common in treating postpartum depression (Postpartum Depression Facts, The National Institute of Mental Health Information Resource Center). Acupuncture is also something that may help with depression. The result of an experiment with acupuncture resulted in this kind of treatment reducing the Hamilton Depression Rating Scale, but with regards to the Edinburgh Postnatal Depression Scale, it suggested that no beneficial effects of acupuncture for postpartum women (Li, Yin, Lao, Xu, 2019). The Food and Drug Administration has approved a drug for postpartum depression. This drug will become very popular in many mothers, and the hope for it to succeed for each mother.

The Food and Drug Administration (FDA) finalized a drug that is available to mothers that suffer from postpartum depression. The Food and Drug Administration is an organization held in the United States. They protect the public health by assuring safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The FDA also is in charge of the safety and security of out nation’s food supply, cosmetics, dietary supplements, products that have to do with radiation, and for regulating tobacco products (FDA, 2019). This drug is known as Zulresso (brexanolone) injection for IV use. “Postpartum depression is a serious condition that, when severe, can be life-threatening. Women may experience thoughts about harming themselves or harming their child. Postpartum depression can also interfere with the maternal-infant bond. This approval marks the first time a drug has been specifically approved to treat postpartum depression, providing an important new treatment option,” said Tiffany Farchione, M.D., acting director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research (FDA, 2019). There is a program called Zulresso REMS Program. That program says that this injection is only available to patients through a restricted distribution program at certified health care facilities where the health care provider may monitor the patient to make sure everything goes smoothly. Zulresso is given as a continuous IV infusion throughout a 60-hour period. One of the side effects of this drug is a sudden loss of consciousness, so patients must be monitored at all times during this injection is occurring. While receiving this treatment, the patient is required to be accompanied by their child. While figuring out if this drug would be approved, the FDA did two clinical studies. The participants received a 60-hour continuous intravenous infusion of Zulresso or placebo (a harmless pill, medicine, or procedure prescribed more for the psychological benefit to the patient than for any physiological effect) and then were followed for the following four weeks (Merriam-Webster’s collegiate dictionary, 1999 & FDA, 2019). One of the clinical studies had patients with severe postpartum depression, and the other study have patients with moderate postpartum depression. There were some side effects that occurred after the procedure. Most common effects reported by patients were sleepiness, dry mouth, loss of consciousness, and flushing. The FDA believes that health care providers should discontinue Zulresso if the patient experiences suicidal thoughts or behaviors. The approval of the drug Zulresso was granted to Sage Therapeutics, Inc (FDA, 2019).

Postpartum is something that happens to many mothers for a long period of time. Thanks to the FDA for approving something that is very helpful to many mothers. Today we discussed what postpartum depression is, what causes it, and some risks and preventions, then, we discussed what some symptoms were and how it can be treated, and finally, what the process was to developing a drug for this depression. Depression is a very serious topic especially when it deals with mothers and their children so having The Food and Drug Administration (FDA) approve a drug specifically for this depression will help every mother going through it every single day. Postpartum is something that will go on forever, and finally having a treatment that will be successful and keep the mother and baby safer is something everyone should be thankful for. Postpartum depression is a serious topic that everyone should know about.

References

Dictionary by Merriam-Webster: Americas most-trusted … (n.d.). Retrieved from https://www.merriam-webster.com/

Feldman, Robert, S. (2017). Essentials of Understanding Psychology (12th ed.). New York, NY: McGraw-Hill Education, Chapter 13: Treatment of Psychological Disorders

LI, W. et al. Effectiveness of Acupuncture Used for the Management of Postpartum Depression: A Systematic Review and Meta-Analysis. BioMed Research International, Retrieved from http://web.a.ebscohost.com.proxy.southeast.edu/ehost/detail/detail?vid=4&sid=821c18e3-ad29-4dfd-ab72-e2035b429c9a%40sdc-v-sessmgr03&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=135459991&db=aph

M. (2018, September 01). Postpartum depression. Retrieved from https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

NIH Radio: NIMH Investigators Talk about New Evidence that Suggests Exercise and Positive Environment can Help Hedge Against Stress Related Depression. (2010).PsycEXTRA Dataset. doi:10.1037/e542862012–001 Retrieved from https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml

Office of the Commissioner. (n.d.). Press Announcements — FDA approves first treatment for post-partum depression. Retrieved from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm633919.htm

Postpartum depression. (2018, October 18). Retrieved from https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

STANESCU, A. D. et al. Postpartum depression: Prevention and multimodal therapy. Journal of Mind & Medical Sciences, Retrieved from http://web.a.ebscohost.com.proxy.southeast.edu/ehost/detail/detail?vid=6&sid=74efe31a-78a6-4470-baca-64cd570ed3ed%40sessionmgr4008&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=132452294&db=aph

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