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POSTNATAL MOOD DISORDERS There are three main categories: I. Postnatal Blues II. Postnatal Depression III. Postnatal Psychosis
I. Postnatal Blues On average it affects about 50% of postnatal women. It usually occurs around day 3 to day 5 after childbirth. Symptoms include mood swings, tearfulness, sleeplessness and irritability.
All postnatal women need sympathetic understanding, empatheic listening and support. The symptoms settle spontaneously within days. II. Postnatal Depression It affects about 10% of postnatal women.
The onset is gradual and insidious, usually within six weeks but can also occur anytime within a year after childbirth. Sometimes, it is difficult to distinguish from the fatigue and mood swings experienced by most mothers as they adjust to the changes and demands after childbirth.
Symptoms Persistent depressed mood Fatigue, irritability, sleeplessness, early morning wakening Anxiety or panicky feeling Feeling of inadequacy, hopelessness
Feeling of being punished Loss of appetite Headache, backache, shoulder pain and abdominal pain Consequences of untreated postnatal depression
Unable to take care of the baby properly on her own or has difficulty in attachment with the baby. Subsequently the child's emotional and cognitive development can be affected. Marital disharmony Who are more prone to have postnatal depression? Unplanned or have ambivalent feeling towards the pregnancy.
Lack of social support after childbirth and lack of adequate rest. High self-expectation of motherhood and feeling of guilt when not meeting one's expectation. Unsatisfactory relationships with family members and unsupportive partner.
Stressful life events such as moving house, loss of significant person or unemployment during pregnancy or after childbirth. Previous history of depression. Management
Early recognition of postnatal depression and seeking help from professionals such as medical or nursing personnel, social worker and clinical psychologist promptly are most important. Counseling with or without drug treatment. Together with emphathetic support from family members and friends, most of the mothers with postnatal depression will recover very soon and resume normal lives.
Tips on prevention Prepare adequately before pregnancy by appropriate family and financial planning.
Couples are highly encouraged to attend antenatal classes together to gain more knowledge on pregnancy, labour and child care to minimize anxiety. Cultivate effective communication with husband and other family members to improve understanding and dupprt.
Ensure mother get enough rest by arranging household and child care help after childbirth. Realistic expectation of parenthood can facilitate adjustment after delivery. Seek help from health professionals in Maternal and Child Health Centres for any child care problems.
Get to know other mothers/couples for experience sharing and social support by joining the child care health talks and support groups in Maternal and Child Health Centres. III. Postnatal Psychosis This is a rare condition which affects about 1 to 2 postnatal mothers per 1000 birth.
It usually occurs within 14 days after delivery or later. Three prominent features Hearing voices Bizarre thoughts of being harmed by others Suicidal and infanticidal ideas
Management This is a psychiatric emergency. Urgent referral to a psychiatrist or attending a hospital accident and emergency department in necessary.
Counseling Services/ Hotlines Yang Memorial Methodist Social Service: Counseling Service 2171 4111 Emotional Support Hotline for married women 2780 9723
Social Welfare Department 24 hrs Hotline 2343 2255 Hospital Authority 24 hrs Telephone Advisory Service 2466 7350 The Samaritan Befrienders Hong Kong 2389 2222
Others Department of Health's Maternal and Child Centres Hotline 2112 9900 Department of Health's Breastfeeding Hotline 2961 8868 24 hours Health Education Hotline 28330111
Your Family Doctor Related website: http://www.postpartum .net Rev. June 2004
 
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Last revision date: 01 September 2006