Postpartum Mental Health Flashcards
PP or Baby Blues
Transient period of ‘depression’ commonly due to hormonal fluctuations, sleep deprivation, role changes affecting 70-80% of PP persons
Baby blues onset
1st PP week, resolves in 10-14 days
Baby blues symptoms
Lack of appetite Difficulty making choices Feelings of sadness Sleep pattern disturbances Feelings of inadequacy Crying easily for no apparent reason Restlessness, insomnia, fatigue Headache Anxiety, anger, sadness Questioning capability of caring for newborn
Baby blues nursing intervention
Education them, reassure normalcy
Emotional support, encouragement
Notify provider if becomes severe, >2 weeks, pt unable to cope w/ daily life and infant care safely
Peripartum depression
Depression during pregnancy affecting 14-23% of birthing persons
Postpartum depression
Moderate to severe depression after giving birth that lasts at least 2 weeks and occurring up to 1 year PP but usually in first 3 months
Postpartum depression Risk Factors
Hormonal changes SES factors Decreased social support Anxiety about new parental role Unintended pregnancy Hx of prior depressive disorder Low self-esteem Hx of IPV Medical conditions - thyroid imbalance, diabetes, infertility Breastfeeding complications Parent of multiples
Postpartum depression sx
Depressed mood or loss of interest in almost all activities AND at least 4 of the following:
- Appetite, weight, sleep, psychomotor activity changes
- Decreased energy, persistent fatigue
- Feelings of worthlessness or guilt
- Difficulty thinking, concentrating, deciding
- Recurrent thoughts of death or suicidal ideation, plan, attempt(s)
Is true postpartum depression diagnosed in the hospital?
No but screening and ID of early signs occurs in hospital or birth setting
Peripartum risk factors
Depression, anxiety during pregnancy Previous PPD Personal/family hx of depression, mental illness, alcoholism Life stressors during pregnancy Traumatic birth experience PTB Infant admission to NICU Medical problems during pregnancy or after birth Financial worries Chronic stressors First pregnancy Age <20 years Use of illegal substances, smoking Unplanned pregnancy Breastfeeding problems Low self-esteem Childcare stress Low social support Fatigue, lack of sleep
PP Depression effects on infant
Different parental interactions, may fail to meet infant needs
More likely to cry/fuss/self-regulate
Behavioral problems, cognitive delays, physical health problems
Depression
Postpartum Psychosis
Dramatic presentation in first few days to weeks PP
Impaired ability to recognize reality, communicate, relate to others
Psych emergency requiring hospitalization
Postpartum Psychosis Risk Factors
Personal or family hx of PP psychosis
Hx of bipolar disorder
PP Psychosis Sx
Pronounced sadness, disorientation, confusion, paranoia
Agitation, restlessness, insomnia, irritability
Rapidly shifting moods (depressed to manic)
Erratic, disorganized behavior
Delusional beliefs common & center on infant
PP Psychosis Risks to Infant
Harm, death