WHAT ARE THE SYMPTOMS OF POSTNATAL DEPRESSION?

A woman may have some or all of the following:
1. Psychological Symptoms
Depression, sadness, irritability, anxiety, loss of confidence, excessive worrying, panic attacks, feelings of unworthiness, anger, resentment, guilt, irrational fears, obsessions, excessive sleepiness or inability to sleep, emotional desolation with lack of feeling for the baby, rejection of the baby or excessive attachment to the baby, feeling spaced out, confusion, reduced intellectual and mental function, preoccupation with death, suicidal thoughts and wishes and desires to harm the baby.
2. Physical Symptoms
Light-headed feelings, low blood sugar, muscle aches and pains with flulike feelings, headaches, increased or decreased appetite or thirst, eating binges with sugar and junk foods, increased or decreased weight, constipation and extreme exhaustion.
Some mothers are too ashamed and feel too guilty to accept or complain that they are depressed and convert their emotional stress into physical symptoms. For instance, a young mother with masked depression may pay frequent visits to her doctor for minor physical complaints such as fatigue, or a crying colicky or vomiting baby. If the doctor cannot find any physical signs of abnormality he should look deeper as the mother may be desperate for- emotional help but cannot ask as she does not want to be stigmatised as an inadequate mother.
It is vital that women with postnatal depression receive early and adequate treatment because if it is allowed to progress it may have a devastating effect upon the family and produce marital conflict and a deterioration in the relationship between the depressed mother and her baby. The babies of depressed mothers are more likely to suffer with feeding and sleeping difficulties and develop mental problems. Professor of psychiatry at Monash university, Professor Bruce Tong, has found that such babies may become either emotionally distant and detached from their mothers or more clinging and demanding and unable to be soothed. Professor Tong found that if the depression continued for twelve months the baby may become irritable with reduced concentration or show less interest in surrounding activities than the babies of non-depressed mothers. If the depression should become deeper, a mother could get to the stage of not coping and may be at risk of harming the baby. She may shake or spank the baby excessively or feel like throwing it on the floor. The guilty feelings engendered by this behaviour make it even more difficult for her to ask for help. A vicious circle develops and it is easy for social isolation to occur.
 3. Sexuality and Postnatal Depression
Women with postnatal depression often have a loss of interest in sex and may even become sexually frigid to the point of being annoyed or repulsed by the advances of their partner. This may be due to a combination of their loss of sex hormones, physical exhaustion, side effects from anti-depressant medication or inadequate contraception, especially if the birth has been painful or traumatic.
Lindy had given birth to a bouncing baby boy in February and all was going well until postnatal depression insidiously set in during the following May. She stopped breastfeeding and her first menstruation which was heralded by severe pre-menstrual syndrome arrived in June. She felt some relief after her menstruation began, although the following months were distressful as she was exhausted and totally disinterested in sex which made her husband irritable and cranky. In September she approached her doctor as she was worried about depression, sexual frigidity, absent periods and continuing milk from her breast even though she had stopped breastfeeding in May.
The presence of inappropriate breast milk in the absence of breastfeeding is called galactorrhoea and is often associated with an excessive production of the lactation hormone called "Prolactin" from the pituitary gland.
Lindy"s doctor told her that her "menstrual clock" situated in the hypothalamus was not working properly and when he measured the blood level of the hormone prolactin it was too high. Once he had ruled out the possibility of a pituitary tumour he started Lindy on a course of Bromocriptine (Parlodel) tablets to reduce her prolactin levels to normal.
If prolactin levels are too high, the ovaries remain in a dormant state and do not produce the female sex hormones oestrogen and progesterone and so regular menstruation does not occur. This is why full-time regular breastfeeding acts as a good contraceptive especially in Third World countries.
Lindy took the Bromocriptine tablets for eight weeks and, once her prolactin levels came down, her breast milk dried up, her menstruation returned and she began once more to feel sexually alive.
Prolactin is not the only hormone that may be out of balance postnatally and if you are suffering with loss of libido or sexual difficulties during your
first postnatal year, it is wise to have a blood test to check your levels of the sex steroid hormones, oestrogen and testosterone as these are largely responsible for creating sexual desire. Also, ask your doctor to check the levels of free testosterone as it is the free or unbound component of testosterone that is active in your body. The best measure of free male hormones is the "free androgen index" or F.A.I, which is easily measured in a simple blood test and this is often very low in women with poor libido or sexual frigidity.
Some women find that the combined oral contraceptive pill is not suiting them postnatally as it may greatly reduce sexual desire as well as cause depression to persist. In such cases you may try a progesterone only contraceptive pill also known as a "mini pill" and if this does not improve matters, consider condoms or a vaginal diaphragm.
4. Physical Exhaustion
During the first six months after childbirth women may suffer with fatigue and lethargy, craving sleep and unable to get through the routine chores. If blood loss at birth was excessive, iron deficiency is common and, especially if breastfeeding, the body"s iron stores quickly become depleted if supplemental iron is not given. If ordinary iron supplements cause constipation, I suggest you try an organic iron supplement such as "hemofactor" which should be taken in a dose of two tablets three times daily on an empty stomach with citrus fruit or vitamin С to aid absorption.
Other mineral deficiencies are not uncommon at this time and supplements of calcium, zinc, magnesium and potassium can be a wonderful aid to boost flagging energy reserves. Magnesium and potassium can be found together in a tablet called "K-Mag" available from pharmacies.
Your body is going through enormous physiological changes and in the first six postnatal weeks the blood volume diminishes and the uterus shrinks back to its non-pregnant size. If you are breastfeeding particularly in a hot climate, dehydration may cause profound exhaustion, and you should drink at least three litres of fluid daily in the form of purified water and/or raw vegetable juices.
If you find that your skin and hair become very dry and your metabolism slows down, ask your doctor to check the function of your thyroid gland as it may have become temporarily under-active. The thyroid gland can be helped along with kelp, spirulina and macrobiotic seaweed preparations and very occasionally it may be necessary to give a course of thyroid hormone tablets.
Some women who have been subjected to excessive and continuous stress postnatally may find that the cause of their fatigue is a temporary underactivity of their adrenal glands known as "adrenal exhaustion". This may also occur after excessive blood loss at the time of birth.
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