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Did you know? – The prevalence rate of postpartum depression among new mothers is about 10%. Almost every new mother notices alterations in their feelings or mood after giving birth. Disturbances in function, affect or thought processes are characteristics of affective or mood disorders. When this condition affects the family after giving birth it can be categorized as either postpartum blues, postpartum depression or postpartum psychosis.

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Difference Between Postpartum Blues, Depression and Psychosis

Postpartum blues is a mild depression only. It is also known as ‘baby blues,’ or ‘maternity blues.’ This is a frequent concern of new mothers. The condition begins in the first week and it lasts no longer than 2 weeks and is characterized by insomnia, fatigue, irritability, tearfulness, anxiety and unstable mood. Baby blues is self-limiting, meaning to say, after 2 weeks it goes away. However, mothers benefit greatly when the family and health care team are providing empathy and support.

Postpartum depression (PPD) on the other hand occurs during the first 3 weeks to 3 months but it may occur anytime during the first year after giving birth. Primigravidas are more likely to develop PPD. Women experiencing PPD has less interest in her environment, feels the infant is demanding. She also has strong feelings of guilt, unworthiness, shame and frequently expresses a sense of loss of self. Clinical signs and symptoms are generalized fatigue, irritability, anxiety, concentration and decision-making difficulties, appetite changes, sleep disturbances and altered weight. PPD is differentiated from postpartum blues by checking out the symptoms’ number, intenurssity and persistence.

Postpartum psychosis is a rare condition. The clinical manifestations generally surfaces within 1-3 months of delivery. One important risk factor for developing postpartum psychosis is a history of bipolar disorder. Symptoms noted to affected individuals are sleep problems, confusions, irritability, agitation, hallucinations and delusions. What makes this condition dangerous, is the possibility of the mother to kill her baby. Furthermore, poor appetite, feelings of worthlessness and guilt and inordinate concern towards the health of the infant are also manifested by affected mother.

Comparison of Postpartum Blues, Depression and Psychosis
POSTPARTAL BLUESPOSTPARTAL DEPRESSIONPOSTPARTAL PSYHOSIS
ONSET1-10 days after giving birth1-2 months after giving birthWithin first to third month after giving birth
SYMPTOMSSadness, tearsAnxiety, feelings of loss, sadnessDelusions or hallucinations of harming infant or self
INCIDENCE70% of all births10% of all births1% to 2% of all births
ETIOLOGYProbably caused by hormonal changes, stress of life changesHistory of previous depression, hormonal response, lack of social supportPossible activation of previous mental illness, hormonal changes, family history of bipolar disorder
THERAPYSupport, empathyCounseling, drug therapyPsychotherapy, drug therapy
NURSING NOTEOffering compassion and understandingReferring to counselingReferring to counseling, safeguarding mother from injury to self or to newborns.

Comparison Table Source: Pillitteri, A. (2007). Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family. 5th Edition

Nursing Care Plan Postpartum Depression

Postpartum depression not only affects the woman negatively but it has an impact on the entire family. Oftentimes, it causes relationship difficulties and causes strains on each family member’s usual coping strategies. To keep depression away, mothers, especially the young ones, should be prepared for the rapid lifestyle changes occurring after birth. During the prenatal period, a discussion about the postpartum period and parenting should be discussed to provide anticipatory guidance about the early weeks at home.

Can we predict whether a woman will develop postpartum depression or not? The answer is uncertain, as childbirth can produce variety of reactions from different women. For those who developed postpartum depression, counseling and antidepressant therapy may be required. This is crucial to keep a mother-infant bonding healthy, keep other children in the family in good condition and maintain optimum health for the whole family in general.

References:

  • Murray, S. & McKinney, E. (2006). Foundations of Maternal-Newborn Nursing. 4th Edition
  • Pillitteri, A. (2007). Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family. 5th Edition
  • Doenges, M. , Moorhouse, M., Geissler-Murr, A. (2004). Nurse’s Pocket Guide: Diagnoses, Interventions and Rationales. 9th Edition
  • Videbeck, S., (2008). Psychiatric-Mental Health Nursing. 4th Edition 
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Daisy Abastar holds a degree in Bachelor of Science in Nursing. Her work experiences include Nursing Local Board Examination Reviewer, Clinical Instructor, NC2 Examination Reviewer and Caregiver Lecturer. Subjects handled: Psychiatric, Obstetric, Pediatric and Fundamentals of Nursing. She also specialized in these areas: ER, Orthopedic Ward and the DR. In addition to passing NLE, she also passed IELTS examination. Her written works are combined learning from theoretical to actual nursing background and ongoing research.