Postpartum depression

Balintfy: The biological changes in mothers after childbirth are very significant and important. But for some parents, this postpartum period can lead to a type of depression thought to be associated with drastic changes in hormone levels. Dr. Peter Schmidt at the National Institute of Mental Health says, postpartum depression is estimated to affect roughly 13-percent of all new mothers.

Schmidt: So each year in the United States there are approximately half a million women who are at risk of developing postpartum depression. So, clearly this is an important condition to the public health of this country, these are prevalent conditions that are associated with considerable morbidity.

O’Leary: Many women, probably at least fifty percent, experience what are called the baby blues for a week or two after giving birth.

Balintfy: Kathleen O’Leary is with the Women’s Mental Health Program at NIMH. She explains that women may feel tearful, emotionally very sensitive, overwhelmed or just not like themselves.

O’Leary: And this is not unusual. If these symptoms go on for more than two weeks or become more intense or women start experiencing some of the other symptoms of depression, then they should really seek help.

Balintfy: Symptoms of depression can vary depending on the individual but can include sad, anxious or “empty” feelings, feelings of hopelessness, pessimism, or worthlessness. O’Leary adds that what starts out as sleep deprivation issues for new mothers, can transform into the more serious problems of depression.

O’Leary: If someone feels that they would be better off dead or that others would be better off without them, then that is the most serious sign that means that a medical professional needs to be consulted about this as soon as possible.

Balintfy: Research has shown some women are at greater risk of experiencing postpartum depression. That includes women who have had postpartum depression with a previous child; women who have had depression, whether treated or untreated, at another time in their lives; as well as women who have bipolar disorder. NIMH investigators have conducted extensive research into postpartum depression, its causes and possible treatments. Dr. Schmidt explains that current research includes the indication that estradiol, a form of estrogen, has a rapid antidepressant effect on women with postpartum depression.

Schmidt: Because of our earlier work it suggested that declining levels of estrogen during the postpartum around delivery might contribute to triggering the onset of depression. And there had been some preliminary open trials showing that estradiol may have an effective antidepressant action in some of these women. So, we have a study now in which we’re using estradiol, physiological levels, so comparable to what a woman would be exposed to during her normal cycle and we give that in a controlled trial to women who have current postpartum depression.

Balintfy: The possibility of successful hormone treatment along with effective therapy has been very encouraging for many women. For more information on postpartum depression and NIMH research on depression, visit www.nimh.nih.gov. This is Joe Balintfy, National Institutes of Health, Bethesda, Maryland.