The transition from pregnancy to postpartum can be difficult for mothers. It can be exciting to welcome a new baby and start life over again, but it’s not an emotional ride for many women. From joy and excitement to fear and anxiety, it can cause a wide range of powerful emotions. The stigma surrounding postpartum depression kept it under the rug for many years. But the growing debate about the struggle for motherhood has opened minds to this reality. In a major step toward recognizing the seriousness of postpartum depression, the United States Food and Drug Administration has approved Zurzuvae (zuranolone), the first oral medication indicated to treat PPD in adults.
What is postpartum depression?
Postpartum depression is usually a depressive episode that usually occurs after childbirth. The postpartum period generally spans the first six weeks after the birth of a child. Women can experience a mix of emotions – anxiety, difficulty sleeping, mood swings and crying spells – also known as “baby blues”.
According to Dr. Pooja C Thukral, Consultant – Obstetrician and Gynecologist, Cloudnine Group of Hospitals, Faridabad, the baby blues disappears within two weeks. But in some women, this baby blues can be severe and they can progress to depression, anxiety or psychosis. Feelings of sadness, guilt and worthlessness take over. This can impact not only the mother-child bond, but also the individual health of mother and child.
Therefore, it is important to be aware of postpartum depression to recognize its signs and seek timely diagnosis and treatment.
FDA approves first oral treatment for postpartum depression
Earlier in August 2023, the FDA announced the approval of the PPD pill. This is an improvement over the IV injection used by some healthcare institutions to treat postpartum depression.
“Having access to oral medication will be a beneficial option for many of these women facing extreme, and sometimes life-threatening, feelings,” Tiffany R. Farchione, MD, director of the FDA’s Center for Drug Evaluation, Division of Psychiatry. and research, reportedly said.
The effectiveness of the pill would have been demonstrated in two randomized studies taking into account the safety of mothers and their child. The FDA recommends a daily dose of 50 mg of Zurzuvae – once a day, for 14 days, in the evening with a fatty meal.
The pill is not without side effects. The FDA makes it clear that it can lead to drowsiness, dizziness, diarrhea, fatigue, colds, and urinary tract infection. In some cases, the use of Zurzuvae can even cause suicidal thoughts and behaviors, as well as fetal harm. “Women should use effective contraception during and for one week after taking Zurzuvae,” the FDA notes.
While this may be a positive step in that direction, there is still a long way to go before the use of the pill can be allowed in India. In the meantime, efforts must continue to raise awareness of postpartum depression, its early detection and treatment.
What are the common risk factors for postpartum depression
Risk factors for PPD are a history of psychiatric illness, discord with a husband or other family members, financial burden, stillbirth, neonatal death, and a previous episode of PPD, says Dr. Pooja C Thukral .
Studies have even observed how the birth of a female baby, lack of family support, a sick or dead baby, a premature or low birth weight baby, an unwanted or unplanned pregnancy can also increase the risk of postpartum depression.
Common signs of postpartum depression
A woman suffering from postpartum depression can usually experience the following situations.
* Loss of appetite and sleep
* Suicidal thoughts
* Thoughts of hurting the baby
Click here to learn more about signs of postpartum depression.
How can you help someone with postpartum depression?
Immediate family members and close friends can play a key role in supporting the mother by taking her to a psychologist or psychiatrist to assess her condition and seek treatment.
“If the symptoms of depression, not being a good mother and excessive crying persist beyond two weeks, a visit to a psychologist is recommended. A mother will be assessed by the psychologist and her medication needs for (general) depression will be assessed,” Dr. Thukral tells Health Shots.
From her own experience with patients with postpartum depression, the expert says that sometimes new mothers just want to be heard without being judged. “Some of them feel better after passing out and I advise some of them to see a psychiatrist immediately depending on the severity of their symptoms.”
The stigma around PPD needs to be broken further. The Indian government should prioritize women’s mental health nationally by making mental health care centers specifically for new mothers available, accessible and affordable, says Dr Thukral.
Sharing some suggestions for reducing the burden of mental health issues on a mother, she adds: “Early recognition and referral to a specialist is important. Visits by health workers to the households of women who cannot access health facilities, particularly screening for their mental well-being, can be a tool to recognize PPD. Questionnaires can also be designed to screen women for symptoms of anxiety/depression after childbirth.
After all, mental health matters!