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Pre and Postpartum Mental Health

Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. Onset is typically between one week and one month following childbirth. PPD can also negatively affect the person's child. While the exact cause of PPD is unclear, the cause is believed to be a combination of physical and emotional factors.[1] These may include factors such as hormonal changes and sleep deprivation.[1] Risk factors include prior episodes of postpartum depression, bipolar disorder, a family history of depression, psychological stress, complications of childbirth, lack of support, or a drug use disorder.[1] Diagnosis is based on a person's symptoms.[2] While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks. Among those at risk, providing psychosocial support may be protective in preventing PPD. Treatment for PPD may include counseling or medications. Types of counseling that have been found to be effective include interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychodynamic therapy.[2] Tentative evidence supports the use of selective serotonin reuptake inhibitors (SSRIs). Postpartum depression affects about 15% of women around childbirth. Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[3] Postpartum psychosis, a more severe form of postpartum mood disorder, occurs in about 1 to 2 per 1,000 women following childbirth. Postpartum psychosis is one of the leading causes of the murder of children less than one year of age, which occurs in about 8 per 100,000 births in the United States.[

Emotional • Persistent sadness, anxiousness or "empty" mood • Severe mood swings • Frustration, irritability, restlessness, ange • Feelings of hopelessness or helplessness • Guilt, shame, worthlessness • Low self-esteem • Numbness, emptiness • Exhaustion • Inability to be comforted • Trouble bonding with the baby • Feeling inadequate in taking care of the baby

Behavioral • Lack of interest or pleasure in usual activities • Low or no energy • Low libido • Changes in appetite • Fatigue, decreased energy and motivation • Poor self-care • Social withdrawal • Insomnia or excessive sleep

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