Shedding light on postpartum depression

By Dr. Dimple Sahay, for the Auburn Reporter

In May, Pacific Medical Centers created One More Question. The concept stemmed from an impactful story by a Pacific Medical Centers (PacMed) primary care provider after a local family came in for a routine visit.

The PacMed provider noticed something was off with one of the children and decided to move forward with depression screening. The questions this primary care provider asked revealed the child was planning to end his life that evening. Through the screening and recognition of depression, the child was able to receive the resources and support needed.

Pacific Medical Center’s One More Question campaign encourages us to become present when asking One More Question in our own lives; when checking in with a friend, patient, coworker or family member, it is important to remember we can all make a difference in someone’s outcome.

While the One More Question campaign addresses all types of depression, one type of depression that has only recently begun to gain mainstream awareness is postpartum depression. In an effort to reduce the stigma around this topic, Dr. Dimple Sahay with Pacific Medical Centers has provided valuable insights on how to effectively identify and treat this type of depression.

What is postpartum depression?

Postpartum depression is a more severe form of depression that comes in the postpartum period, which means after giving birth. The postpartum period is defined as the first 12 months after childbirth. Postpartum depression should be differentiated from “baby blues” which are generally mild and start two to three days after delivery, and usually resolve within two weeks.

What are the causes of postpartum depression?

The etiology of postpartum depression is unclear. It is thought to be from sudden hormonal changes in the body after childbirth and some women are more sensitive to this. Several other factors play a role though. For example, previous history of postpartum depression, inadequate social support, marital status and young maternal age can also play a role.

What are signs/signals new moms should look out for if they aren’t sure they are experiencing postpartum depression?

Symptoms can vary from mild to severe. Usually, symptoms emerge two to three weeks after delivery but can happen anytime. Symptoms include fearfulness, sleep and appetite disturbance, loss of interest, feelings of guilt, incompetence, fatigue poor concentration, sad mood and suicidal thoughts in many cases.

How can those suffering with postpartum depression be treated?

The first step in treating patients at Pacific Medical Centers is to do a screening exam for postpartum depression during their visit with their health care provider. Once diagnosis is established, we perform a thorough physical and conduct routine lab testing to rule out other causes of depression before we start psychiatric treatment. For those with mild symptoms, we recommend individual or group psychotherapy. For moderate to severe symptoms, we recommend psychotherapy in adjunct with medication. It is important to note that antidepressants are prescribed based on the severity of symptoms. Physicians consider a patient’s history with antidepressants prior to choosing a treatment plan.

How long do those suffering from postpartum depression experience symptoms?

This may vary from patient to patient. Early identification of symptoms and early treatment with close follow-up can help with full recovery. It is recommended that patients should continue the treatment even after they start feeling better and discuss the duration of treatment with their physician. Symptoms can relapse if treatment is stopped too early.

How many women get postpartum depression each year?

The overall incidence of postpartum depression in the United States is estimated to be 8 to 10 percent.

Why is it important to address postpartum depression during Mental Health Awareness Month?

Postpartum depression is a common complication of pregnancy with significant adverse effects if undiagnosed and untreated. It not only affects the mother but also affects the children, families and community. Also, persistent depressive symptoms can lead to poor mother infant bonding, delays in infant growth, increased risk of depression and anxiety for the child later in life.

What else should people know about postpartum depression?

Postpartum depression, if left untreated, can also become a risk factor for chronic depression. It’s important for patients to recognize these symptoms and seek medical help. Women who are pregnant or breast-feeding are often reluctant to start medications due to fear of harming their child. However, it is best to recognize and report these symptoms, and have a thorough risk-versus-benefit discussion with their physician to formulate a treatment plan.

To learn more about Pacific Medical Centers and the One More Question campaign, visit depression.pacmed.org.

Dr. Dimple Sahay is a family medicine provider at Pacific Medical Centers (PacMed) at its Renton location. She received her medical education at NKP Salve Institute in Nagpur, India and University of Illinois in Chicago, IL. Dr. Sahay is also a member of the American Board of Family Medicine. Her medical interests include preventative medicine, wellness care, urgent care, dermatology and occupational medicine. In her free time, Sahay enjoys traveling, hiking, listening to music and baking.

Pacific Medical Centers (PacMed) is a multi-specialty medical group with nine neighborhood clinics in the Puget Sound area. Founded in 1933, the PacMed network is one of the largest throughout the Puget Sound and offers patients more than 150 providers for primary and specialty care. PacMed’s culture focuses on its mission of delivering high-quality health care focused on the individual needs of its diverse patient population with an emphasis on improving the quality of health in the community.