Medical conditions with a postpartum flare pattern – including postpartum thyroiditis, multiple sclerosis and rheumatoid arthritis – have an etiology related to immune system dysregulation. Earlier this year, we reviewed an article suggesting that some cases [...]
Postpartum psychosis is the most severe form of postpartum psychiatric illness, affecting about 1 out of every 1000 births. Postpartum psychosis occurs most frequently in first-time mothers, typically within the first two weeks after delivery. [...]
How does postpartum depression affect a mother’s ability to care for and parent her child? Various studies have demonstrated that depressed mothers may be less attuned to their children’s needs, either being less responsive to the baby or, in some cases, too intrusive. Researchers have speculated that this mismatch between mother and baby may contribute to problems with infant bonding, delays in development and emotional dysregulation.
A mother’s emotional relationship with her baby begins during her pregnancy. The mother’s feelings about her baby, described as bonding, typically grow and intensify after the baby’s birth and become the foundation of the mother’s relationship with her child.
Postpartum psychosis is a rare but serious psychiatric illness, occurring in about 1 to 2 per 1000 women after delivery. Because postpartum psychosis carries significant risks for both the mother and her child, most women with this illness are psychiatrically hospitalized. Electroconvulsive therapy (ECT) is an effective treatment for postpartum psychosis and may reduce the risks associated with medication exposure in the nursing infant; however, very few research studies have focused on the use of ECT in this setting and it is less commonly used in the United States than in other countries. A recent study explores the safety and advantages of ECT for the treatment of women hospitalized for postpartum psychosis.
In our clinic, we often see women who come in for the treatment of depression and/or anxiety after the cessation of breastfeeding. Many question if breastfeeding may protect against postpartum depression and if the cessation of breastfeeding is a trigger for postpartum depression and/or anxiety. However, the research examining the association between postpartum depression and breastfeeding has been somewhat difficult to interpret.
This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women with severe depression that significantly impairs their ability to function and to care for their child. Women with severe PPD are also at higher risk for suicide.Â
While postpartum depression can affect all women, there are certain populations which appear to be at particularly high risk, including women of lower socioeconomic status. These women have limited access to resources and have multiple stressors including housing problems, financial strain, and being a single parent. Researchers recently piloted an intervention randomized controlled trial involving 540 participants at an inner-city hospital in East Harlem, New York. The primary goal of this psychoeducational intervention was to reduce the risk of postpartum depression among black and Latina mothers.
Given the prevalence of postpartum OCD and obsessive symptoms in women with postpartum depression, we should devote more time to this topic. This is an informative and well-written article by Alice Wolton on postpartum OCD in Forbes. In this piece, she mentions a recent study from Timpano and colleagues at the University of Miami where cognitive behavioral therapy (CBT) was used to prevent postpartum OCD.Â
