On postnatal distress

Having a baby is usually considered as a joyful experience, however, the adaptation to a newborn can be demanding and challenging, and the process of adjustment may lead to unexpected outcomes. As in every critical situation, mood changes and general signs of distress, anxiety and/or depression might be experienced during the postpartum period. However it is important to notice that postnatal levels of distress are highly related to antenatal distress, therefore, it has been argued that there is a continuum of perinatal distress that first develops during pregnancy and extends into the postpartum period.

The most common disorders that might be experienced in the postpartum are Postpartum Blues (PPB) and Postpartum depression (PPD).
PPB, known as well as maternity blues and baby blues, refers to a type of mood lability which may be accompanied by sadness, fatigue, and irritability. It commencement is usually set within 48 hours after delivery, and in most cases remits after twelve or fourteen days without treatment (Beck, 2003; Benett & Indman, 2003).
It is experienced by 30%~75% of new mothers, and is therefore the most common condition during the postpartum period, yet it may be an unsettling experience for mothers(Chaudron, 2006).

Postpartum Depression (PPD) has been described as a depressive episode experienced up to a year after childbirth, showing a highest point prevalence at two months postpartum and 6 months postpartum (Beck, 2006). The diagnostic criteria include the presence of symptoms such as: insomnia or hypersonmnia, psychomotor agitation or retardation, fatigue, changes in appetite, feelings of worthlessness or guilt, decreased concentration, and suicidality; additionally depressed mood and/or loss of interest or pleasure must be experienced.
This disorder is present in approximately 13% of women, and usually requires both pharmacological and psychological treatment (Beck, 2006). It has shown to have negative consequences for the mother’s well-being and the development of children in the cognitive, emotional and social realms (Beck, 2006), therefore many efforts have been oriented to define risk factors and develop screening

The similarity between Postpartum blues' symptoms and Postnatal depression has led to confusion and misuse of both terms (Beck, 2006; Chaudron, 2006)¸however these disorders vary not only in terms of severity and intensity, but also in terms of quality since PPB symptoms are experienced along with a predominant mood of happiness which lacks some depression characteristics like reduced interest in living or inability to enjoy things (Wisner et al, 2003).

References

Beck, C. (2006). Postpartum depression, it isn´t just the blues. AJN.106, 40-49

Bennett SS, Indman P. Beyond the blues. Prenatal and postpartum depression. San Jose, CA: Moodswings Press; 2003

Chaudron, L. (2006) Critical issues in perinatal psychiatric emergency care. Psychiatric times. 23, 36 - 51