ARTICLE TITLE: INSIGHTS ON POST-PARTUM DEPRESSION RUNNING TITLE: POST-PARTUM DEPRESSION
Main Article Content
Keywords
Postpartum depression, Psychosis, Edinburgh postnatal depression scale
Abstract
Postpartum depression is a condition which a woman experiences after childbirth. It is a strong feeling of sadness, anxiety, mood swings, ideas of harming oneself and the baby. Postpartum depression is frequently misdiagnosed and untreated. Mental illness and delivery have a long history dating back thousands of years. Women's capacity to undergo treatment may be hampered by their unwillingness to travel for routine psychotherapy sessions and their concerns about giving antidepressant medication to their unborn child if they are nursing. In the weeks and months after delivery, depression has garnered a lot of attention in both scientific and popular literature because of all of these variables as well as the perception that childbirth is a joyful life experience. Since its creation in 1952, major depression has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM); nevertheless, postpartum depression is not recognized as a distinct diagnostic category. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has classified major depression since its inception in 1952; however, postpartum depression is not acknowledged as a separate diagnostic category. Stress and negative experiences from the past are the main risk factors for postpartum depression. If postpartum depression is not identified and treated, it can be quite hazardous. The Edinburgh Postnatal Depression Scale (EPDS) was introduced to aid medical personnel in identifying PPD-affected mothers; a troubling condition that lasts longer than the "blues". Postpartum depression has numerous causes, including hormonal shifts, bodily changes, and psychological issues. The patient can benefit from appropriate medicine, such as antidepressants, frequent psychiatrist appointments, medication adherence, and family support.
References
2. Hamilton JA, Harberger PN. Postpartum Psychiatric Illness: A Picture Puzzle. Philadelphia: Univ. Pa. Press; 1992.
3. Kanes S, Colquhoun H, Gunduz-Bruce H. Brexanolone (SAGE-547 injection) in postpartum depression: a randomised controlled trial. Lancet. 2017;390:480–9.
4. Horowitz JA, Goodman JH. Identifying and treating postpartum depression. J Obstet Gynecol Neonatal Nurs [Internet]. 2005;34(2):264–73. Available from: http://dx.doi.org/10.1177/0884217505274583
5. Wisner KL, Sit DKY, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry [Internet]. 2013;70(5):490–8. Available from: http://dx.doi.org/10.1001/jamapsychiatry.2013.87
6. Ohara MW, Mccabe JE. Postpartum Depression: Current Status and Future Directions. Annual Review of Clinical Psychology. 2013;9:379–407.
7. Forty L BA, Jones L PhD, Macgregor S PhD, Caesar S, Cooper C B Sc, Hough A BA, et al. Familiality of postpartum depression in unipolar disorder: Results of a family study. Am J Psychiatry [Internet]. 2006;163(9):1549–53. Available from: http://dx.doi.org/10.1176/ajp.2006.163.9.1549
8. Murphy-Eberenz K, Zandi PP, March D, Crowe RR, Scheftner WA, Alexander M, et al. Is perinatal depression familial? J Affect Disord [Internet]. 2006;90(1):49–55. Available from: http://dx.doi.org/10.1016/j.jad.2005.10.006
9. O’hara MW, Swain AM. Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry [Internet]. 1996;8(1):37–54. Available from: http://dx.doi.org/10.3109/09540269609037816
10. Couto TCE, Brancaglion MYM, Alvim-Soares A, Moreira L, Garcia FD, Nicolato R, et al. Postpartum depression: A systematic review of the genetics involved. World J Psychiatry [Internet]. 2015;5(1):103–11. Available from: http://dx.doi.org/10.5498/wjp.v5.i1.103
11. Cleveland Clinic 4/12/2022
https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression
12. Chechko N, Stickel S, Votinov M. Neural responses to monetary incentives in postpartum women affected by baby blues. Psychoneuroendocrinology. 2023 Feb;148:105991. doi: 10.1016/j.psyneuen.2022.105991. Epub 2022 Nov 30. PMID: 36463750.
13. Jones I. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the postpartum period. Lancet. 2014;384(9956):1789–99.
14. Sit D, Rothschild AJ, Wisner KL. A review of postpartum psychosis. J Womens Health (Larchmt) [Internet]. 2006;15(4):352–68. Available from: http://dx.doi.org/10.1089/jwh.2006.15.352
15. Bloch M, Rotenberg N, Koren D, Klein E. Risk factors associated with the development of postpartum mood disorders. J Affect Disord [Internet]. 2005;88(1):9–18. Available from: http://dx.doi.org/10.1016/j.jad.2005.04.007
16. Postpartum depression: Risks and early detection. Arch Argent Pediatr [Internet]. 2020;118(3). Available from:
http://dx.doi.org/10.5546/aap.2020.eng.154
17. Comasco E, Sylvén SM, Papadopoulos FC, Sundström-Poromaa I, Oreland L, Skalkidou A. Postpartum depression symptoms: a case control study on monoaminergic functional polymorphisms and environmental stressors. Psychiatr Genet [Internet]. 2011;21:19–28. Available from: http://dx.doi.org/10.10997/YPG.0b013e328341a3c1
18. Binder EB, Newport DJ, Zach EB, Smith AK, Deveau TC, Altshuler LL, et al. A serotonin transporter gene polymorphism predicts peripartum depressive symptoms in an at-risk psychiatric cohort. J Psychiatr Res [Internet]. 2010;44(10):640–6. Available from:
http://dx.doi.org/10.1016/j.jpsychires.2009.12.001
19. Comasco E, Sylvén SM, Papadopoulos FC, Oreland L, Sundströmporomaa I, Skalkidou A. Postpartum depressive symptoms and the BDNF Val66Met functional polymorphism: effect of season of delivery. Arch Womens Ment Health [Internet]. 2011;14:453–63. Available from:
http://dx.doi.org/10.1007/s00737-011-0239-x]
20. Doornbos B, Dijck-Brouwer DAJ, Kema IP, Tanke MAC, van Goor SA, Muskiet FAJ, et al. The development of peripartum depressive symptoms is associated with gene polymorphisms of MAOA, 5-HTT and COMT. Progress in Neuro-Psychopharmacology and Biological Psychiatry [Internet]. 2009;33(7):1250–4. Available from:http://dx.doi.org/10.1016/j.pnpbp.2009.07.013
21. Josefsson A, Sydsjö G, Berg G, Dahl ML, Wadelius M, Nordin C. CYP2D6 genotypes and depressive symptoms during late pregnancy and postpartum. Nord J Psychiatry [Internet]. 2004;58(1):61–4. Available from: http://dx.doi.org/10.1080/08039480310000815
22. Lewis SJ, Araya R, Leary S, Smith GD, Ness A. Folic acid supplementation during pregnancy may protect against depression 21 months after pregnancy, an effect modified by MTHFR C677T genotype. Eur J Clin Nutr [Internet]. 2012;66(1):97–103. Available from: http://dx.doi.org/10.1038/ejcn.2011.136
23. Lin YM, Ko HC, Chang FM, Yeh TL, Sun HS. Population-specific functional variant of the TPH2 gene 2755C& gt; A polymorphism contributes risk association to major depression and anxiety in Chinese peripartum women. Arch Womens Ment Health [Internet]. 2009;12:401–8. Available from:
http://dx.doi.org/10.1007/s00737-009-0088-z]
24. Mehta D, Quast C, Fasching PA, Seifert A, Voigt F, Beckmann MW, et al. The 5-HTTLPR polymorphism modulates the influence of environmental stressors on peripartum depression symptoms. J Affect Disord [Internet]. 2012;136(3):1192–7. Available from:
http://dx.doi.org/10.1016/j.jad.2011.11.042
25. Mitchell C, Notterman D, Brooks-Gunn J, Hobcraft J, Garfinkel I, Jaeger K, et al. Role of mother’s genes and environment in postpartum depression. Proc Natl Acad Sci U S A [Internet]. 2011;108(20):8189–93. Available from: http://dx.doi.org/10.1073/pnas.1014129108
26. Sanjuan J, Martin-Santos R, Garcia-Esteve L, Carot JM, Guillamat R, Gutierrez-Zotes A, et al. Mood changes after delivery: role of the serotonin transporter gene. Br J Psychiatry [Internet]. 2008;193(5):383–8. Available from: http://dx.doi.org/10.1192/bjp.bp.107.045427
27. Sun HS, Tsai HW, Ko HC, Chang FM, Yeh TL. Association of tryptophan hydroxylase gene polymorphism with depression, anxiety and comorbid depression and anxiety in a population-based sample of postpartum Taiwanese women. Genes Brain Behav [Internet]. 2004;3:328–36. Available from: http://dx.doi.org/10.1111/j.1601-183X.2004.00085.x]
28. Fasching PA, Faschingbauer F, Goecke TW, Engel A, Häberle L, Seifert A, et al. Genetic variants in the tryptophan hydroxylase 2 gene (TPH2) and depression during and after pregnancy. J Psychiatr Res [Internet]. 2012;46(9):1109–17. Available from:http://dx.doi.org/10.1016/j.jpsychires.2012.05.011
29. Pinsonneault JK, Sullivan D, Sadee W, Soares CN, Hampson E, Steiner M. Association study of the oestrogen receptor gene ESR1 with postpartum depression--a pilot study. Arch Womens Ment Health. 2013;16:499–509.
30. Feng YF, Zhou YY, Duan KM. The role of extrasynaptic GABA receptors in postpartum depression. Mol Neurobiol [Internet]. 2024;61(1):385–96. Available from: http://dx.doi.org/10.1007/s12035-023-03574-7
31. Maguire J, Mody I. Neurosteroid synthesis-mediated regulation of GABAA receptors: Relevance to the ovarian cycle and stress. J Neurosci.. 2007;27(9):2155–62. Available from:
http://dx.doi.org/10.1523/jneurosci.4945-06.2007
32. Tsetsenis T, Ma XH, Lo Iacono L, Beck SG, Gross C. Suppression of conditioning to ambiguous cues by pharmacogenetic inhibition of the dentate gyrus. Nat Neurosci. 2007;10(7):896–902. Available from:http://dx.doi.org/10.1038/nn1919
33. Li X, O’Malley BW. Unfolding the action of progesterone receptors. J Biol Chem [Internet]. 2003;278(41):39261–4. Available from:http://dx.doi.org/10.1074/jbc.r300024200
34. Maguire J, Neurosteroid IM. Synthesis-Mediated Regulation of GABAA Receptors: Relevance to the Ovarian Cycle and Stress J Neurosci. 2007;27:2155–62. Available from:
http://dx.doi.org/10.1523/JNEUROSCI.4945-06.2007
35. Myoclinic24/12/2022https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
36. Leight K, Fitelson, Kim S, Baker A. Treatment of post-partum depression: a review of clinical, psychological and pharmacological options. Int J Womens Health [Internet]. 2010;1. Available from: http://dx.doi.org/10.2147/ijwh.s6938
37. Hirst KP, Moutier CY. Postpartum major depression. Am Fam Physician. 2010 Oct 15;82(8):926-33..
38. Sit DKY, Wisner KL. Identification of postpartum depression. Clin Obstet Gynecol [Internet]. 2009;52(3):456–68. Available from:http://dx.doi.org/10.1097/grf.0b013e3181b5a57c
39. Wisner KL, Peindl KS, Gigliotti T, Hanusa BH. Obsessions and compulsions in women with postpartum depression. J Clin Psychiatry [Internet]. 1999;60(3):176–80. Available from: http://dx.doi.org/10.4088/jcp.v60n0305
40. Hirst KP, Moutier CY. Postpartum Major DepressionUniversity of California. Vol. 82. San Diego, School of Medicine, La Jolla, California; Number; 2010.
41. Cox JL, Holden JM, Sagovsky R. Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression scale. Br J Psychiatry [Internet]. 1987;150(6):782–6. Available from:http://dx.doi.org/10.1192/bjp.150.6.782
42. https://greenspacehealth.com/en-ca/wp content/uploads/sites/3/2022/11/img-19274-1548450903-2086689468.png
43. Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002 Jul 18;347(3):194-9. doi: 10.1056/NEJMcp011542. PMID: 12124409.
44. Hirst KP, Moutier CY. Postpartum Major Depression Am Fam Physician. Vol. 82. San Diego, School of Medicine, La Jolla, California; 2010.
45. Dorothy K. Sit, M.D.1 and Katherine L. Wisner, M.D., M.S. The Identification of Postpartum Depression Clin Obstet Gynecol. 2009 Sep; 52(3): 456–468. doi: 10.1097/GRF.0b013e3181b5a57c
46. Jairaj C, Seneviratne G, Bergink V, Sommer IE, Dazzan P. Postpartum psychosis: A proposed treatment algorithm. J Psychopharmacol [Internet]. 2023;37(10):960–70. Available from:
http://dx.doi.org/10.1177/02698811231181573
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Abhishek B J
Assistant Professor, Department of Pharmacy Practice, KLE College of Pharmacy Hubli, Karnataka- 580031.A Constituent unit of KLE Academy of Higher Education and Research, Belagavi, Hubballi, Karnataka- 580031, India. ORCID ID: 0009-0001-8821-8877, Mob: 7411223912
Miss. Akshata M Purantar
Pharm D Intern, Department of Pharmacy Practice, KLE College of Pharmacy, Hubballi, Karnataka- 580031.A Constituent unit of KLE Academy of Higher Education and Research, Belagavi, Hubballi, Karnataka- 580031, India. ORCID ID:0009-0006-2726-071X, Mob: 7026854998
Dr. Sanathkumar B Nyamagoud
Assistant Professor, Department of Pharmacy Practice, KLE College of Pharmacy Hubli, arnataka-580031.A Constituent unit of KLE Academy of Higher Education and Research, Belagavi, Hubballi, Karnataka- 580031, India. ORCID ID: 0000-0002-5111-7685, Mob: 795389889
Miss. Bibikhuteja Jungliwale
Pharm D Intern, Department of Pharmacy Practice, KLE College of Pharmacy, Hubballi, Karnataka- 580031.A Constituent unit of KLE Academy of Higher Education and Research, Belagavi, Hubballi, Karnataka- 580031, India. ORCID ID:0009-0004-8337-8742 Mob:9945241838
Dr AHMV Swamy
Professor and head, Department of Pharmacy Practice, KLE College of Pharmacy Hubli, Karnataka- 580031.A Constituent unit of KLE Academy of Higher Education and Research, Belagavi, Hubballi, Karnataka- 580031, India. ORCID ID: 0000-0002-1984-3708, Mob: 7795641008