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Postpartum Depression: How It Affects Woman and How It Is Treated

Josue Abraham Contreras Jr.
University of Texas at El Paso

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Abstract
Despite postpartum depression affecting many woman, it was not always taken as seriously by
the medical community until the last century along with meteoric rise of the womens suffrage
movement. This paper will focus on the causes of PPD, the symptoms of the disorder, the
chances of a mother acquiring the disorder, how it was mistreated in the past and how it is treated
today, as well statistics and charts that are relevant to the topic. All the information will be
acquired from secondary sources through research and for primary source information through a
scheduled interview with a psychologist.

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There have been many instances in history where mental illnesses were either mistreated
or not taken seriously at all such as postpartum depression. If left undiagnosed, not only is it
potentially dangerous to the mother life but the childs as well. The following questions will be
used to better inform the reader on postpartum by answering them with primary source
information from Dr. Rankin and secondary source information from different articles.

What causes postpartum depression?

What are the chances of a mother getting PPD?
What are the symptoms of PPD?
How was PPD treated in the past?
How is PPD treated today?

The purpose of this paper is to inform the general public about the symptoms and dangers of
postpartum depression and how it could be treated.
What Causes Postpartum Depression?
Postpartum depression is one of the more extreme forms of perinatal anxiety and stress
disorders that affect woman but is less common than post natal blues. PPD can be caused by
hormonal changes, situational risk, and life stresses as listed in the article Postpartum Disorders
by the website MentalHealthAmerica.Net (MHA).
The first cause which is hormonal changes happens when a woman experiences the
greatest hormonal fluctuation levels after giving birth. Intense hormone fluctuations, such as
decreased serotonin levels, occur after delivery and may play a role in the development of
PPD.(MHA, para. 4) Serotonin is a hormone that is a contributor to happiness and mood
balance, so it is only logical that a will woman will not have be able to control her emotions if
she is deficient in serotonin due to the fact that her hormonal levels fluctuate after giving birth.
Another cause to PPD that is outlined in the article are situational risk. A situational risk
for example is when a major event coincides with childbirth, a mother may be more susceptible

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than average to PPD. (MHA, para.4) For example child birth is already a huge change in life
that could cause stress and depression in itself but if additional changes are made such as moving
to a new house or getting married recently after child birth, itll put the mother at a greater risk of
getting postpartum depression. That is why it is advised by doctors to put life plans such as
vacations, weddings, or moves on hold recently after child birth.
The last cause of PPD mentioned in the article Postpartum Depression, are life stresses.
Life stresses for example can be when additional stress that comes from everyday life such as
work, relationships, or house bills are piled on to the stresses of being a mother which can cause
PPD in woman. In order to avoid these additional stresses doctors recommend that that the
mother organize her life that best accommodates the needs of her and her child and have a strong
support system around her. If not done then Ongoing stressful circumstances can compound the
pressures of having a new baby and may trigger PPD. (MHA, para.4)
What are the chances of a mother getting postpartum depression?
The statistics for woman that developed post partum depression arent very accurate since
most woman do not report their symptoms. The stigma against PPD scares woman from
reporting their symptoms out of fear that they will be judged harshly for feeling melancholy
instead of happiness after the birth of their child. This guilt stems from the misconception that
most people mistakenly believe that mothers should be going through the happiest time of their
lives after childbirth but since this is one of the biggest transition periods anyone can go through,
that is far from true.
The statistical data on PPD provided by the article Postpartum Depression on
MentalHealthAmerica states that woman are twice as likely to experience depression in their
lifetime compared to men. It also states that Because women are most likely to experience

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depression during the primary reproductive years (25 to 45), they are especially vulnerable to
developing depression during pregnancy and after childbirth. (MHA, para.1) This statistical
data is very telling because woman are more susceptible to depression than men without
childbirth, now add the stresses of a newborn child and the chances of depression sky rocket.
Even though women are more than likely to experience depression, the chances of a
mother developing full blown PPD are still low. According to the article The stigma of
postpartum depression, nearly 1 in 7 women will experience Postpartum Depression.
(Hatchuel, 2014, para.1) So that means that out of the 4,000,000 average births per year in the
United states, only 571,000 will develop the severe perinatal anxiety and stress disorder. Since it
is not that common, awareness for the disorder is that not that high. Symptoms can easily be
overlooked, or mothers that come forward with these symptoms may be looked down upon by
family or friends.
Although the chances of a woman getting postpartum disorder are not very high, they do
begin to increase when other things are factored in to the equation. For example, Womens Health
USA 2011 states that Postpartum depressive symptoms varied significantly by education level
(USDHH, 2011, para.2) and is proven with a set of data that shows that only 6.9 percent of
mothers with at least 16 years of education under their belt show symptoms of PPD compared to
22.2 percent of mothers with less than 12 years of education showing signs of the disorder. (see
figure.1) The correlation between how much education a mother has to the percentage of mothers
with PPD is very evident in figure.1, but the explanation behind this is unclear. Logic would say
that the less education a mother has received before child birth the higher her chances of her
developing PPD are higher due to the fact that there may be a lack of social skills since not as
much time was spent in a learning environment. Social skills and a strong social support system

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after all, are essential to coping and overcoming any hardships that come along with having a
child. When a individual is in a learning environment, it is essential to communicate ideas and
opinions to properly receive a quality education which then can later be translated into every day
life such as building the support system necessary to avoid PPD.
If you tell a someone about a dangerous criminal but do not describe how they look, how
is that person going to report or avoid said criminal? That is the exact same error many
healthcare providers are committing by telling woman to come in for postnatal check ups without
informing them about postpartum depression. Woman are at a higher risk of not reporting any
symptoms to post partum depression if they are not appropriately educated on the disorder before
hand.

Figure.1 (USDHH, 2011)

What are the symptoms of postpartum depression?

Postpartum depression has many symptoms that are similar to those of lesser perinatal
anxiety and stress disorders which leads to PPD being overlooked during check ups. One of the

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most dangerous symptoms a mother can experience are scary, ego-dystonic thoughts about
baby. (Hatchuel, 2014, para.5) These thoughts can be anything from abandoning their child to
actually hurting it. This does not necessarily mean that the mother is a bad person but if left
untreated could escalate to deadlier circumstances such as postpartum psychosis in the following
example: Lakeview mother charged with first-degree murder in the death of her 8-month-old
son was suffering from postpartum psychosis. (Meisner, 2011, para.1) The mother had no
previous criminal record and is a DePaul University graduate, so it was a shock to her husband
and her family that she would ever do such a thing. This is the worst case scenario for PPD when
left untreated and it is very rare when mothers actually act on those thoughts, but just because it
is rare does not mean it should not be taken more seriously.
Due to the mother having disturbing thoughts about her child, another symptom of PPD
is guilt, and is one of the main reasons this disorder goes unreported in many cases. The mother
will feel that she is not fit to be a parent and feel despair. This is one of the most telltale signs of
PPD, but out of shame or even fear of having their child taken away they will avoid telling
anyone.
Another symptom of PPD is Difficulty sleeping, exhaustion (Hatchuel, 2015, para.5)
which can lead to additional symptoms such as Weepiness, excessive worry, agitation, anxiety.
(Hatchuel, 2015, para.5) When humans do not get enough rest they tend to act out of the ordinary
and are at risk of falling into depression, so when a new mother is sleep deprived it only
amplifies the symptoms of not only post partum depression but paranoia as well. Although it is
normal for a mother to be protective of her child, mothers will worry about anything and
everything and sometimes will refuse to let anyone hold their child. This could also lead to

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unpredictable mood swings; such as being agitated very easily or a lot of crying for absolutely no
reason at all.
How was postpartum depression treated in the past?
There has always been a stigma against postpartum depression, but the farther back in
time you go the darker the stigma gets. In the article Historical Understandings of Depression
by Mark Dombeck, talks about how depression was treated throughout history including
postpartum depression. The first example the article uses, is how ancient civilizations treated all
kinds of depression by using exorcism techniques (such as beatings, restraint, and starvation)
designed to drive demons out of the afflicted person's body as treatments (Dombeck, 2007,
para.3) because they thought depression was some form of demonic possession. Another early
form of treatment for PPD was blood letting, which is the process of draining blood out of
certain parts of the body since health experts at the time though depression was caused by fluid
imbalances in the body.
Although there were some advancements in healthcare for not mental illness, after the fall
of the Roman empire, health sciences took a few steps backwards as the dark ages came upon the
world. Treatments got more gruesome going as far as exorcisms, and other more barbaric
strategies such as drowning and burning (Dombeck,2007, para.6) since people thought that
depression was a infectious disease that could take over a whole population. Despite the
renaissance, the era of forward thinking taking hold across Europe, it was still common place to
throw people with depression into lunatic asylums and have witch hunts and executions of the
mentally ill. During the 19th century, the medical community began to believe that depression
was inherited and that there was no use in treatment since the belief was that there was no way in
changing their state of mind. Since this is what was believed at the time, being removed from

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society and institutionalized for the rest of their lives remained the prevalent solution which
definitely was not good at all. Asylums had a very infamous reputation for starving, beating, and
constantly drugging their patients in order to make sure they stay in a unstable state of mind so
they would remain institutionalized. This remained the go too treatment all the way up until the
1960s, but as the technology got better they even began using electro therapy to shock the
depression out of a patient but it obviously did more bad than good. It was especially worse for
woman in these institutions, with rape and abuse cases happening much more frequently than in
male institutions. Most of history woman with postpartum depression suffered greatly.

How is PPD treated today?

Dr. Rankin is a psychologist in El Paso that has experience in dealing with perinatal
disorders such as postpartum depression. One of the very first things the Dr. said when asked
how postpartum depression is treated was First, the symptoms have to be identified and learn
what is causing each one of them to absolutely make sure that postpartum depression is the right
diagnosis. This makes a lot of sense because without identifying the symptoms, a mother could
be wrongly diagnosed and left untreated for what is truly disturbing her state of mind. Dr. Rankin
then says that after diagnosing what I have found to be the best course of action depending on
the severity of the disorder, I will try to avoid drugs prescribing drugs all together and refer the
patient to a therapist familiar with interpersonal psychotherapy. What interpersonal
psychotherapy is according too the article 8 Types of Psychotherapy for Postpartum Depression
Treatment by Kate Kripke, is teaching of communication skills that assist in building
relationships, stronger social support, and increased confidence. (Kripke, 2013, para.4) The first
step that is taken in the process is acknowledge any kind of change or loss that comes with child

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birth to overcome any grief. This could be anything from change in body figure, change in
relationships with family or friends, or even change in scenery with a move. Step two is
encouraging a smoother transition into a life as a mother and into a new social life. This means
getting better situated in a life where most of your time will be spent taking of the new child such
as less time to sleep and more time spent changing, feeding, and putting to sleep new baby. Its
pretty much a whole new life a brand new mother with have to transition too. Step 3 is settling
any disputes that will eventually arise when the child arrives. These disputes are unavoidable
since there will be shorter fuses between each other due to the lack of rest. There will also be a
lack of communication since taking care of a baby is the equal of a full time job. Without settling
these disputes within the family, the support system that is necessary for recovery of the patient,
will be very weak.
Dr. Rankin goes on to say As the patient shows improvement in all these fields, I will
ask them to come in every other month until a year passes after birth but if no improvement is
shown more frequent visits to the therapist and medicines to ease the symptoms are prescribed.
The doctor later says that its rare when the therapy he refers has no affect on the patient and that
he has never had to recommend to institutionalize a patient saying that institutionalization is
only for very extreme measures but does not believe he will ever have to come to that point. He
also said Postpartum depression is just a much more severe form of baby blues. Baby blues are
mood swings a mother can experience right after giving birth. The doctor said that if these
mood swings last longer than two weeks after birth, it is more likely than not that it could be
postpartum depression and should seek help immediately.
On the rare occasion that a woman has to receive much more medical attention compared
to the average case of PPD I according to Dr. Rankin is When the mother starts experiencing a

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much more rare and extreme form of PPD which is called postpartum psychosis, more
aggressive treatments are required. The reason a different style of treatment must take place is
because PPP is a rare form of PPD where the mother is more susceptible to acting on thoughts
that could be dangerous to herself, child or anyone else that is around. There has even been cases
where mothers have claimed to have heard voices in their heads telling them to do evil or
questionable things. The Dr. said that It is advised that the mother is always supervised when
experiencing these symptoms and without the proper medical attention necessary to treat this
disorder, can prove to very dangerous.
CONCLUSION
Postpartum depression is a very serious disorder and is imperative that the general public
should be aware and well informed on the subject. Symptoms can be easily identified if well
informed and the mother can receive the treatment most beneficial to her. The dangers that come
with the later stages of the disorder can be completely avoided if it receives the proper attention
from a certified doctor. The stigma that also comes with the disorder also only exist because the
people that perceive the stigma to be true are also ill informed. When woman can come forward
without worry about their symptoms, then those same women will be able to actually experience
all the joy that comes with having a child.

Reference Page
U.S. Department of Health and Human Services, Health Resources and Services
Administration, Maternal and Child Health Bureau. Women's Health USA 2011. Rockville,
Maryland: U.S. Department of Health and Human Services, 2011.

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Hatchuel, E. (2014, July 6). The stigma of postpartum depression. Retrieved April 08, 2016,
from http://www.evolveclinicalservices.com/blog/85-the-stigma-of-postpartum-depression
Postpartum Disorders. (n.d.). Retrieved April 08, 2016, from
http://www.mentalhealthamerica.net/conditions/postpartum-disorders
Meisner, J. (2011, April 14). Woman accused of killing son had severe postpartum
depression, lawyer says. Retrieved April 08, 2016, from
http://articles.chicagotribune.com/2011-04-14/news/ct-met-suffocation-death20110414_1_postpartum-psychosis-new-moms-experience-infant-death-case
Kripke, K. (2013, March 21). 8 Types of Psychotherapy for PPD Treatment. Retrieved April
08, 2016, from http://www.postpartumprogress.com/8-types-of-psychotherapy-forpostpartum-depression-treatment
Dombeck, M. (2007, September 19). Historical Understandings Of Depression. Retrieved
April 08, 2016, from https://www.mentalhelp.net/articles/historical-understandings-ofdepression/

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