Postpartum Depression
Postpartum depression and other perinatal mental health conditions often share symptoms, making accurate diagnosis especially challenging—and critically important. At Amen Clinics, we go beyond traditional mental health care with advanced brain imaging to uncover the root causes and guide targeted, effective treatment during this vital stage of life.
What IS POSTPARTUM DEPRESSION?
Many new moms experience the “baby blues” after giving birth, but it’s when feelings of sadness, hopelessness, or exhaustion get in the way of daily functioning and parenting that it may be postpartum depression. The condition, which is more common than you think, can also emerge during pregnancy, which is known as antepartum depression. Depression isn’t the only mental health condition that can affect women (and sometimes men) during pregnancy or after birth. Perinatal (meaning around birth) mental health disorders include a range of conditions, such as antepartum (during pregnancy) or postpartum depression, perinatal anxiety, perinatal obsessive-compulsive disorder (OCD), birth trauma and posttraumatic stress disorder (PTSD), perinatal bipolar disorder, and perinatal psychosis or schizophrenia. See below for a list of symptoms associated with postpartum depression.
How Common Is It?
Estimates vary widely, but about 25% of women may experience depression or another perinatal mental health disorder within the first year of giving birth. The first year of a baby’s life is the time when women are more likely to develop depression than any other stage of life. Experts suggest that perinatal mental health conditions are often underrecognized and undertreated, so the numbers may be even higher. Less than half (about 40%) of mothers who are experiencing perinatal or postpartum symptoms seek help.
Women aren’t the only ones who suffer. Research shows that 10% of new fathers show signs of paternal postpartum depression. That number jumps to 26% during the first 3-6 months of the baby’s arrival, and it’s even higher for fathers when their partner is experiencing perinatal mental health problems.
What is the Cause?
There is not one single cause of these conditions, and there are numerous risk factors. Dramatic hormonal changes during pregnancy and after birth may contribute to mental health problems. In addition, financial stresses, troubled relationships, and lack of support may play a role. Having a history of mental illness or a family history of such conditions makes you more vulnerable to problems during pregnancy and after birth.
WHAT IF IT GOES UNTREATED?
When left untreated, postpartum depression and other perinatal mental health conditions can interfere with all-important bonding with your infant, including
- Trouble breastfeeding
- Lack of emotion towards the baby
- Not taking the baby to preventive healthy checkups
- Not using infant car safety seats
- Not baby-proofing their homes (using safety latches and electrical outlet covers)
- Lack of ability to connect with the baby, such as playing, reading, singing, touching, or smiling.
Symptoms of Postpartum Depression and Perinatal Mental Health Disorders
Perinatal mental health disorders can manifest in a variety of ways. The following list includes symptoms of a range of different types of perinatal and postpartum conditions. If you are suffering from any of these symptoms, it could be a sign of a disorder that needs investigating. Please note that these symptoms are in no way a sign of weakness or an indicator that you are not fit to be a parent.
- Sadness, emptiness, or hopelessness
- Feeling overwhelmed
- Crying spells for no apparent reasons
- Anger, rage, or irritability
- Oversleeping or the inability to sleep (even when your baby is sleeping)
- Loss of interest in usually pleasurable activities
- Trouble concentrating
- Persistent physical aches and pains
- Exhaustion
- Changes in appetite (undereating or overeating)
- Isolating yourself from family and friends
- Difficulty bonding with your baby
- Strong doubts about being able to care for your baby
- Fear of being alone with your baby
- Thoughts about harming yourself
- Thoughts about harming your baby
- Severe mood swings
- Feeling anxious, nervous, or on edge
- Having trouble relaxing
- Restlessness
- Feeling as if something bad is going to happen (such as to your baby)
- Flashbacks or nightmares
- Avoidance of people, places, or things related to birth trauma
- Confusion
- Hallucinations
- Delusions
- Disturbing thoughts
- Disorganized speech
- Disorganized behavior
What are the Consequences?
Postpartum depression can have adverse effects on your child, including developmental delays. It also negatively impacts your child’s cognitive skills, emotional stability, and ability to handle stress later in life. Postpartum depression and perinatal mental health conditions also raise an infant’s risk of depression and anxiety later in life.
Sadly, postpartum depression also increases the risk of maternal suicide. One study showed that suicide accounted for 1 of every 19 deaths in women during pregnancy or postpartum. This grim statistic along with the potential long-term impacts on children show why it is so important to seek treatment for symptoms of perinatal mental health disorders.
Why Choose Amen Clinics FOR TREATING POSTPARTUM DEPRESSION AND OTHER PERINATAL MENTAL HEALTH CONDITIONS?
When it comes to treatment for postpartum depression and perinatal mental health disorders, one size does NOT fit all. Treatment that works for one pregnant woman or new mother (or father) won’t work for everybody, and it could even make you worse! At Amen Clinics, we perform brain SPECT imaging as part of a comprehensive evaluation, along with hormone testing and other lab work to more accurately diagnose and more effectively treat perinatal mental health conditions. Our treatment plans can include natural supplements, nutrition, exercise, and helpful forms of therapy to help you heal so you can be the best parent possible to your new baby.
POSTPARTUM DEPRESSION BRAINS WORK DIFFERENTLY
Brain-imaging studies using SPECT technology show that postpartum depression and perinatal mental health disorders aren’t simple or single disorders. Each condition is associated with multiple changes within the brain. The only way to know the root cause of your symptoms is to look at the brain. See below for more on postpartum depression and perinatal mental health disorders and the brain.
SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates blood flow and activity in the brain. Basically, it shows three things: healthy activity, too little activity, or too much activity. A healthy “active” scan shows the most active parts of the brain with blue representing the average activity and red (or sometimes red and white) representing the most active parts of the brain. In the healthy scan on the top right, the most active area is in the cerebellum, at the back/bottom part of the brain. In the brain scan below it of a woman with postpartum depression, there is excessive activity in the deep limbic system—the brain’s emotional center.
Healthy Brain Scan
Postpartum Depression
Brain Scan
Postpartum Depression and Perinatal Mental Health Disorders and the Brain
Postpartum and perinatal mental health issues are not single or simple disorders. Brain SPECT imaging shows that they are all associated with different brain patterns and the following conditions.
Depression: When postpartum or antepartum depression arises, the mother’s brain’s limbic system shows abnormally high activity (this phenomenon has been detected in animals as well as humans).
Anxiety: Perinatal anxiety is often associated with heightened activity in a number of areas of the brain, including the basal ganglia, amygdala and hippocampus, insular cortex, and parts of the prefrontal cortex.
OCD: Obsessive-compulsive tendencies that emerge during pregnancy or after giving birth are generally related to increased activity in an area of the brain called the anterior cingulate gyrus. This region is known as the brain’s gear shifter and when activity is too high, it causes you to get stuck on worries and negative thoughts.
PTSD: Experiencing a traumatic birth—whether it was real or perceived trauma—can reset the brain to a perpetually more active state that leads to PTSD. It is estimated that PTSD affects about 9% of women postpartum. In the brain, PTSD is associated with increased activity in the limbic system, basal ganglia, and anterior cingulate gyrus.
Bipolar Disorder: Perinatal bipolar disorder, characterized by extreme mood swings, can often be mistaken for other conditions, such as depression or even ADHD. Brain imaging allows for the detection of certain brain patterns associated with bipolar disorder for a more accurate diagnosis.
Psychosis/Schizophrenia: Perinatal psychosis or schizophrenia is often related to neurotransmitter abnormalities that cause decreased prefrontal cortex activity.