Postpartum Depression

About this course

Postpartum depression (PPD) is a variation of clinical depression that occurs after childbirth, typically within the first few weeks to months, and can last up to a year or longer. Also known as postnatal depression, it is a serious mental health and mood disorder that can happen to anyone who has recently given birth, regardless of whether it is their first pregnancy. Despite its seriousness, research suggests as much as half of new mothers with PPD go undiagnosed. Lack of education, misconceptions, and social stigma prevent women from seeking treatment, and even those diagnosed forgo treatment for various reasons. This course takes a closer look at postpartum depression, its causes, risk factors, and differences from major depression. This course also discusses how patients with PPD can seek help, current treatment options, and nursing considerations for the best health outcomes.

Learning objectives

• Review the hormonal changes that occur in the postnatal period, and how those changes can affect postpartum depression.
• Review risk factors associated with postpartum depression.
• Understand the signs and symptoms associated with postpartum depression, and how they differ from major depression.
• Differentiate between baby blues and postpartum depression.
• Review therapeutic and medication treatment options for postpartum depression.

Course outline

16 sections · finish in any order across devices

1. 1

   Introduction

   Postpartum depression (PPD) is a variation of clinical depression that occurs after childbirth, typically within the first few weeks to months, and can last up to a year or longer. Also known as postnatal depression, it is a serious mental health and mood disorder that can happen to anyone who has r

   4 min

2. 2

   Postpartum Depression Definition

   Postpartum depression (PPD) is primarily characterized by overwhelming sadness and hopelessness. These symptoms typically develop within the first few weeks of childbirth, with the highest incidence within the first 3 to 6 months. Postpartum depression is often mistaken for the "baby blues," a milde

   4 min

3. 3

   Postpartum Depression and Major Depression Differences

   While postpartum depression (PPD) and major depression have several similar symptoms, they are medically different in terms of context, mechanisms, and risk factors.9 As the name suggests, PPD specifically affects women in the postpartum period, typically within the first few weeks to months after c

   4 min

4. 4

   Risk Factors

   While the exact mechanism of postpartum depression (PPD) remains unknown, researchers have identified certain biological and psychosocial factors that may increase the likelihood of developing PPD.1,7 One of the most prevalent factors included a personal medical history of depression or PPD, with fi

   4 min

5. 5

   Signs and Symptoms

   The presentation of postpartum depression (PPD) is like feelings associated with “baby blues,” such as mood swings, tearfulness, irritability, confusion, and fatigue. However, “baby blues” typically peak in the first week and do not require any intervention, but if its associated feelings intensify

   4 min

6. 6

   When to Seek Help

   New mothers must seek help as soon as they notice any signs or symptoms of postpartum depression (PPD) for better chances of effective treatment and recovery. This is especially true for any new mothers with a personal or family history of depression, PPD, or other mood disorders.1,10 Initial warnin

   4 min

7. 7

   When to Intervene

   The postpartum period can be stressful for many new mothers. Unfortunately, social norms have many believing it is supposed to be a difficult time and to prove they are “good mothers,” they will try to adjust by ignoring or hiding symptoms of PDD. Because of this ideology and attempting to mask PDD,

   4 min

8. 8

   Who to Contact

   There are several professionals available who can provide support and assistance for postpartum depression (PPD), and any of them can be contacted.11,12The primary healthcare provider, such as the obstetrician-gynecologist (OB-GYN) or Midwife, is an excellent starting point. These professionals are

   4 min

9. 9

   Medication Options

   In cases of PPD where symptoms are severe or other therapeutic interventions are ineffective, medication can prove to be a valuable adjunct to the treatment plan.1,16 There are however, many concerns regarding the pharmacologic treatment of PPD, including unpredictable metabolic changes, infant expo

   4 min

10. 10

    Selective Serotonin Reuptake Inhibitors

    Selective serotonin reuptake inhibitors (SSRI) are a class of antidepressant medications to treat the depressive symptoms seen in PPD. Their mechanism of action works by boosting the level of serotonin in the brain, which can improve mood over a few weeks to months. Some SSRIs, such as sertraline or

    4 min

11. 11

    Serotonin-Norepinephrine Reuptake Inhibitors

    Similarly, serotonin-norepinephrine reuptake inhibitors (SNRI) like venlafaxine, can also be effective as they increase serotonin and norepinephrine levels in the brain. They are only prescribed when SSRIs are ineffective, as they have comparatively stronger side effects. While SNRIs are considered

    4 min

12. 12

    Tricyclic Antidepressants

    Tricyclic antidepressants (TCA) such as amitriptyline or nortriptyline, are an older class of medication that works on multiple neurotransmitters in the brain. They are reserved for use only when other options are ineffective because of the severity of potential side effects. In addition to the side

    4 min

13. 13

    Screening and Assessment

    Healthcare professionals should be trained to recognize the early signs of PPD during pregnancy or after delivery to identify mothers at risk of progressing with more serious symptoms. Standardized assessments and regular evaluations can help providers determine a mother's emotional well-being, mood

    4 min

14. 14

    Emotional Support

    Healthcare professionals should provide emotional support to new mothers with PPD (patients) by actively listening in a non-judgmental manner so they can express their feelings and concerns, while validating the mother’s experiences and providing reassurance that she is not alone in facing the chall

    4 min

15. 15

    Monitor Treatment and Symptoms

    The healthcare professional should maintain regular follow-up appointments to assess the mother's emotional well-being progress and adjust the treatment plan as needed. They should be vigilant for any signs of symptoms worsening, lack of improvement, suicidal ideation, or thoughts of self-harming or

    4 min

16. 16

    Conclusion

    Postpartum depression is a worrying mental health disorder that has negative consequences on both the new mother and her infant. Its high prevalence rate and comparatively lower diagnosed cases raise serious public health concerns about the lack of awareness and education surrounding the well-being

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

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• Grigoriadis, S. (2020). Postpartum depression. Postpartum Mental Health Disorders: A Casebook, 21-30. https://doi.org/10.1093/med/9780190849955.003.0004
• Miller, L. J. (2002). Postpartum Depression. JAMA, 287(6), 762. https://doi.org/10.1001/jama.287.6.762
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• Depression. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/depression#part_10948
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• Leight, K., Fitelson, E., Kim, S., & Baker, A. (2010). Treatment of post-partum depression: a review of clinical, psychological and pharmacological options. International Journal of Women’s Health, 3, 1–14. https://doi.org/10.2147/ijwh.s6938
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• Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R. (2021). Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis. JMIR MHealth and UHealth, 9(10), e32544. https://doi.org/10.2196/32544
• Hantsoo, L., Ward-O’Brien, D., Czarkowski, K. A., Gueorguieva, R., Price, L. H., & Epperson, C. N. (2013). A randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression. Psychopharmacology, 231(5), 939–948. https://doi.org/10.1007/s00213-013-3316-1
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• Meltzer-Brody, S., Colquhoun, H., Riesenberg, R., Epperson, C. N., Deligiannidis, K. M., Rubinow, D. R., Li, H., Sankoh, A. J., Clemson, C., Schacterle, A., Jonas, J., & Kanes, S. (2018). Brexanolone injection in post-partum depression: two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials. The Lancet, 392(10152), 1058–1070. https://doi.org/10.1016/s0140-6736(18)31551-4
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