Postpartum Depression
A Mothers’ Mental Health Toolkit Project Learning
with Dr. Joanne MacDonald
Reproductive Mental Health Service
IWK Health Centre
Halifax NS
Postpartum Depression
Postpartum Depression
Depression that begins for the mother within the first 12
months after a baby is born is called Postpartum
This comes from the word partuition which is a medical
term for the process of delivering the baby.
1 in 10 women will experience Postpartum Depression.
This mental health problem is then one of the most
common complications of childbirth.
60 + % will have no previous history of diagnosed illness.
Postpartum Depression
Family and friends may not expect PPD
Postpartum Depression
Inability to rest when baby rests
Mind working very slowly or very quickly
Low motivation
Poor concentration, planning
Lack of ability to enjoy usual activities or people
Low self-concept, unusual hopelessness
Overwhelmed easily compared to past coping
Unexplainable changes in sleep or appetite
Postpartum Depression
True or False?
1. PPD is more common with teen
2. Family history of PPD increases risk
3. The depression will lift in time
4. It is better to cope without treatment
for the sake of the baby/child
5. There is little family or friends can do
Postpartum Depression
Teen mothers have the same rate of Major Depression as older
mothers in formal studies. But they may have more difficulties
with adjustment if supports are few, and increased social
disadvantage because of deficits in education or income.
Family history of PPD with mother, aunts, sisters or cousins, does
increase a woman’s risk.
Up to 20 % of untreated postpartum depression becomes
chronic depression that affects function and quality of life.
Untreated depression in a mother is strongly associated with
delays in development and attachment for the baby.
High levels of social support seems to protect from PPD and
improve recovery.
Postpartum Depression
Social Determinants of Health influence
availability and accessibility of health care
Postpartum Depression
Fast Fact:
Postpartum depression can be a mixture of
mood disturbance – with sad, blue or low
mood, unusual irritability and tension
and/or increased anxiety in the body and
in thinking. It can be dismissed as
adjustment and not recognized as a
treatable illness.
Postpartum Depression
Why does depression risk increase after a
baby is born?
Sleep deprivation is a general trigger for mood regulation
Major changes in role, relationships and expectations
contribute to depression risk in any person
Usual coping strategies may not be as easy to do, such as
daily exercise routine
Some women have brain chemistry that is triggered by the
hormones that change in pregnancy and after birth. This
is the factor that is shared by family members at risk.
Postpartum Depression
Strategies to Prevent PPD include:
Reducing stresses where possible
Help with tasks other than baby care
Rest periods from baby care
Building in extra sleep whenever possible
Active treatment of depression in pregnancy
Cognitive-behavioral & emotional regulation
strategies and therapies
Postpartum Depression
Treatment Options:
Mindfulness & Relaxation Techniques
Physical Exercise including Practices that increase
relaxation and focus
Interpersonal and Cognitive-Behavioral Psychotherapy
Antidepressant Medications ( safety for each woman and
her baby if breastfeeding needs to be evaluated; many
medications are safely and effectively used)
Antianxiety Medications
Sleep Medications
Nutritional Enhancement, including Supplements such as
Omega-3-Fatty Acids
Postpartum Depression
Who can help?
Friends & Family
Postpartum Depression
Who can help?
Postpartum Depression
Who can help?
Primary care doctor or nurse
Postpartum Depression
Who can help?
Mothers supporting other mothers
Postpartum Depression
Who can help?
Community Support Workers
Postpartum Depression
Who can help?
Mental Health Professionals
Postpartum Depression
What can help?
Self-directed recovery strategies
Peer support and connection
Key Resources:
Postpartum Depression
What’s the outcome?
Full pre-baby recovery is typical with
Full physical and emotional recovery can
come slowly though over weeks to
Self-care strategies and stress reduction
may need to become lifelong habits
Postpartum Depression
What is a woman’s risk for depression after
her next pregnancy if she has had one
episode of Postpartum Depression?
Postpartum Depression
Risk first time is 10%
One episode risk increases to 20 %
But chance of remaining well is still 80%
Self-care, stress reduction, quick assessment
and treatment of new depression reduces
risk and effects of illness
Postpartum Depression
Take Home Point:
Community service providers can be
critical as sources of support, recognition
of a woman’s struggle, knowledge of local
resources and leadership in reducing
stigma in mental health care for mothers.
Postpartum Depression can be a serious
but treatable illness with a good outcome
with care.