wamss notes perinatal mental health Flashcards
postpartum depression
Low mood & depressive symptoms in the postpartum period 4weeks post birth
epidemiology of post party depression
3-6%
Can affect males as well as females
50% begin prior to delivery
criteria of post party depression
Fits the criteria for MDD with onset in the peripartum period: 4 weeks post birth
Sx of post party depression
Sadness, worry or empty mood
Labile mood
Frustration, irritability, anger
Guilt, shame, worthlessness, hopelessness
Low energy & libido
Fatigue
Changes in sleep or appetite
Decreased concentration
Fear of not taking care of baby
Infanticidal thoughts
screening for post party depression
Edinburgh Postnatal Depression Scale
causes of post party depression
Rapid alteration in hormones – withdrawal of oestrogen, progesterone & endorphins…
Physical mental & emotional exhaustion + sleep deprivation
risk factors of post party depression
Prenatal anxiety or depression
Personal or family history of depression or postnatal depression
Birth-related psychological or physical trauma
Poor marital relationship or single
Low socioeconomic status
Unwanted / unplanned pregnancy
treatment for post party depression
Social & psychological therapy & support
Group therapy, home visits
SSRI sometimes utilised
baby blues
Transient condition in which shortly after childbirth mother experiences variety of Sx similar to depression but resolves within 2 weeks
epidemiology of baby blues
70%
symptoms of baby blues
Weepiness & bursting into tears
Mood swings
Anxiousness & hypersensitivity to criticism
Low spirits & irritability
Poor concentration & indecisiveness
Feeling ‘unbonded’ with baby
Restless insomnia
Anxiety & Depressive Sx
causes of baby blues
Rapid alteration in hormones – withdrawal of oestrogen, progesterone & endorphins
Physical mental & emotional exhaustion + sleep deprivation
Increases risk for episode of postpartum major depression
baby pinks
post partum euphoria
Mild to severe form of mania in the postpartum period
Can progress to postpartum psychosis
post partum euphoria may progress to
post partum psyhcosis
baby blues increase risk of
post partum depression
post partum psychosis
Rare psychiatric emergency in which psychotic & other mood symptoms beginning suddenly in the first two weeks after childbirth.
epidemiology of post party psychosis
1:1000 births
50% have prior mental illness
symptoms of post party psychosis
- Mania- high mood & racing thoughts
- Depression
- Severe confusion
- Loss of inhibition
- Paranoia
- Hallucinations
- Delusions
treatment for post party psychosis
Hospitalisation
Antipsychotics or mood stabilisers
Assess for infanticide
prognosis for post party psychosis
Most severe Sx 2-12 weeks
Can take 6months – year to recover
50-70% reoccurrence
premenstrual dysphoric disorder
Symptoms of mood lability, irritability & anxiety that occur repeatedly around the onset of menses and then decrease or dissipate
criteria for premenstraul dysphoric disorder
In the majority of menstrual cycles at least 5 symptoms are present in the week before the
onset of menses & start to improve a few days after the onset of menses & become minimal
or absent in the week post-menses
- Marked lability (mood swings)
- Marked irritability or anger
- Marked depressed mood
- Marked anxiety or tension
- Decreased interest in usual activities
- Difficulty concentrating
- Appetite change
- Sleep disturbances
- Sense of being overwhelmed or out of control
Physical Sx such as breast tenderness, joint pain, bloating, weight gain
