Peripartum depression (PPD) is a type of major depressive disorder characterized by depression that occurs during pregnancy or within 12 months after delivery. It can manifest in various forms, such as prenatal depression and postpartum depression, that can occur during pregnancy and childbirth. It is a serious mental health condition that affects many women.
It can significantly impact the emotional well-being of the mother and the family. Symptoms of peripartum depression can include disturbed thoughts, anxiety, persistent feeling of sadness, physical symptoms such as fatigue, insomnia, difficulty concentrating, and changes in appetite.
Epidemiology
The exact prevalence of PPD is challenging to determine due to varying definitions and diagnostic criteria. However, estimates suggest globally that a significant number of pregnant women experience mental disorders, particularly depression, during and after pregnancy, with an estimated 10% during pregnancy and 13% after childbirth.
In developing countries, the prevalence of peripartum depression is higher, with approximately 15.6% during pregnancy and 19.8% women after childbirth. Risk factors for PPD include a history of depression or other mental health disorders, stress, lack of social support, and adverse life events.
Women experiencing PPD may have symptoms such as anxiety, fatigue, lack of motivation, persistent feeling of sadness, difficulty in bonding with the baby, and thoughts of self-harm.
Anatomy
Pathophysiology
The pathophysiology of peripartum depression involves a complex interaction of biological, psychological, and social factors. Hormonal changes after childbirth, such as fluctuations in estrogen, progesterone, and thyroid hormones, can impact a woman’s mood and emotional well-being, potentially leading to PPD.
These hormones can also affect the levels of neurotransmitters, such as serotonin and norepinephrine, in the brain, which can impact mood and emotional regulation. Additionally, sleep disturbances caused by these hormonal changes can further contribute to feelings of depression.
Individuals with a history of depression, anxiety, or other mental health disorders may be at an increased risk of PPD, as well as those with a family history of depression. It is also worth noting that PPD is a multifactorial condition, and the underlying causes may vary from person to person.
Etiology
The etiology of peripartum depression is not fully understood, but it is thought to be caused by a combination of biological, psychological, and social factors. Hormonal changes that occur during pregnancy and after childbirth, such as a decrease in estrogen and progesterone levels, may play a role in the development of PPD.
All women are at risk of experiencing psychiatric disorders during pregnancy and the first year after delivery due to hormonal changes and stress associated with pregnancy.
However, factors such as poverty, lack of education, migration, limited access to healthcare, violence, abuse, conflict, multiple pregnancies, and a lack of support from a partner can increase the risk. Psychological factors such as a history of depression or anxiety, stress, and lack of social support may contribute to developing PPD.
Genetics
Prognostic Factors
The prognosis varies depending on the severity of the depression and the individual’s response to treatment. With proper treatment, most women will see an improvement in their symptoms and eventually recover.
It is also important to note that some women may have chronic depression, which can last for months or even years after childbirth. In such cases, the prognosis may be less favorable and may require long-term management and treatment.
Early identification and treatment are important for improving outcomes, as untreated PPD can negatively affect the mother, the child’s development, and the family.
Immediate release tablet-
100 mg orally every 12 hours. Increase the dose to 100 mg every 8 hours. If no clinical improvement is seen, maximize the dose up to 150 mg every 8 hours.
Sustained release tablet-
150 mg orally each day. Increase the dose to 150 mg every 12 hours. If no clinical improvement is seen, maximize the dose up to 150 mg every 12 hours.
Extended-release tablet-
150 mg orally each day. Increase the dose to 450 mg each day. If no clinical improvement is seen, maximize the dose up to 300 mg each day.
Aplenzin-
174 mg orally each day. Increase the dose after 4 days, to 348 mg. Do not increase the dose to more than 522 mg each day.
Forfivo XL-
450 mg orally each day
Can be utilized in patients who already are receiving 300 mg/day of bupropion
For a total of 60 hours (2.5 days), administer ZULRESSO as a continuous intravenous (IV) infusion as follows:
0-4 (hrs): Initiate with a dosage of 30 mcg/kg per hour continuous intravenous (IV) infusion
4-24 (hrs): the dose be increased to 60 mcg/kg per hour continuous intravenous (IV) infusion
24-52 (hrs): the dose be increased to 90 mcg/kg per hour (For individuals who cannot tolerate 90 mcg/kg per hour, decrease dose to 60 mcg/kg per hour) continuous intravenous (IV) infusion
52-56 (hrs): reduce to 60 mcg/kg per hour continuous intravenous (IV) infusion
56-60 (hrs): reduce to 30 mcg/kg per hour continuous intravenous (IV) infusion
For a total of 60 hours (2.5 days), administer ZULRESSO as a continuous intravenous (IV) infusion as follows:
Age: >15 years
0-4 (hrs): Initiate with a dosage of 30 mcg/kg per hour continuous intravenous (IV) infusion
4-24 (hrs): the dose be increased to 60 mcg/kg per hour continuous intravenous (IV) infusion
24-52 (hrs): the dose be increased to 90 mcg/kg per hour (For individuals who cannot tolerate 90 mcg/kg per hour, decrease dose to 60 mcg/kg per hour) continuous intravenous (IV) infusion
52-56 (hrs): reduce to 60 mcg/kg per hour continuous intravenous (IV) infusion
56-60 (hrs): reduce to 30 mcg/kg per hour continuous intravenous (IV) infusion
Future Trends
Media Gallary
References
News
Female Surgeons in NHS Face Rampant Sexual Harassment
Posted on
News
Gene Therapy Promises Restoration of Motor Function
Posted on
News
Ultra-Processed Foods Linked to Elevated Depression Risk in Women
Posted on
News
Research Reveals How Language Shapes Social Memory in the Brain
Peripartum depression (PPD) is a type of major depressive disorder characterized by depression that occurs during pregnancy or within 12 months after delivery. It can manifest in various forms, such as prenatal depression and postpartum depression, that can occur during pregnancy and childbirth. It is a serious mental health condition that affects many women.
It can significantly impact the emotional well-being of the mother and the family. Symptoms of peripartum depression can include disturbed thoughts, anxiety, persistent feeling of sadness, physical symptoms such as fatigue, insomnia, difficulty concentrating, and changes in appetite.
The exact prevalence of PPD is challenging to determine due to varying definitions and diagnostic criteria. However, estimates suggest globally that a significant number of pregnant women experience mental disorders, particularly depression, during and after pregnancy, with an estimated 10% during pregnancy and 13% after childbirth.
In developing countries, the prevalence of peripartum depression is higher, with approximately 15.6% during pregnancy and 19.8% women after childbirth. Risk factors for PPD include a history of depression or other mental health disorders, stress, lack of social support, and adverse life events.
Women experiencing PPD may have symptoms such as anxiety, fatigue, lack of motivation, persistent feeling of sadness, difficulty in bonding with the baby, and thoughts of self-harm.
The pathophysiology of peripartum depression involves a complex interaction of biological, psychological, and social factors. Hormonal changes after childbirth, such as fluctuations in estrogen, progesterone, and thyroid hormones, can impact a woman’s mood and emotional well-being, potentially leading to PPD.
These hormones can also affect the levels of neurotransmitters, such as serotonin and norepinephrine, in the brain, which can impact mood and emotional regulation. Additionally, sleep disturbances caused by these hormonal changes can further contribute to feelings of depression.
Individuals with a history of depression, anxiety, or other mental health disorders may be at an increased risk of PPD, as well as those with a family history of depression. It is also worth noting that PPD is a multifactorial condition, and the underlying causes may vary from person to person.
The etiology of peripartum depression is not fully understood, but it is thought to be caused by a combination of biological, psychological, and social factors. Hormonal changes that occur during pregnancy and after childbirth, such as a decrease in estrogen and progesterone levels, may play a role in the development of PPD.
All women are at risk of experiencing psychiatric disorders during pregnancy and the first year after delivery due to hormonal changes and stress associated with pregnancy.
However, factors such as poverty, lack of education, migration, limited access to healthcare, violence, abuse, conflict, multiple pregnancies, and a lack of support from a partner can increase the risk. Psychological factors such as a history of depression or anxiety, stress, and lack of social support may contribute to developing PPD.
The prognosis varies depending on the severity of the depression and the individual’s response to treatment. With proper treatment, most women will see an improvement in their symptoms and eventually recover.
It is also important to note that some women may have chronic depression, which can last for months or even years after childbirth. In such cases, the prognosis may be less favorable and may require long-term management and treatment.
Early identification and treatment are important for improving outcomes, as untreated PPD can negatively affect the mother, the child’s development, and the family.
Immediate release tablet-
100 mg orally every 12 hours. Increase the dose to 100 mg every 8 hours. If no clinical improvement is seen, maximize the dose up to 150 mg every 8 hours.
Sustained release tablet-
150 mg orally each day. Increase the dose to 150 mg every 12 hours. If no clinical improvement is seen, maximize the dose up to 150 mg every 12 hours.
Extended-release tablet-
150 mg orally each day. Increase the dose to 450 mg each day. If no clinical improvement is seen, maximize the dose up to 300 mg each day.
Aplenzin-
174 mg orally each day. Increase the dose after 4 days, to 348 mg. Do not increase the dose to more than 522 mg each day.
Forfivo XL-
450 mg orally each day
Can be utilized in patients who already are receiving 300 mg/day of bupropion
For a total of 60 hours (2.5 days), administer ZULRESSO as a continuous intravenous (IV) infusion as follows:
0-4 (hrs): Initiate with a dosage of 30 mcg/kg per hour continuous intravenous (IV) infusion
4-24 (hrs): the dose be increased to 60 mcg/kg per hour continuous intravenous (IV) infusion
24-52 (hrs): the dose be increased to 90 mcg/kg per hour (For individuals who cannot tolerate 90 mcg/kg per hour, decrease dose to 60 mcg/kg per hour) continuous intravenous (IV) infusion
52-56 (hrs): reduce to 60 mcg/kg per hour continuous intravenous (IV) infusion
56-60 (hrs): reduce to 30 mcg/kg per hour continuous intravenous (IV) infusion
For a total of 60 hours (2.5 days), administer ZULRESSO as a continuous intravenous (IV) infusion as follows:
Age: >15 years
0-4 (hrs): Initiate with a dosage of 30 mcg/kg per hour continuous intravenous (IV) infusion
4-24 (hrs): the dose be increased to 60 mcg/kg per hour continuous intravenous (IV) infusion
24-52 (hrs): the dose be increased to 90 mcg/kg per hour (For individuals who cannot tolerate 90 mcg/kg per hour, decrease dose to 60 mcg/kg per hour) continuous intravenous (IV) infusion
52-56 (hrs): reduce to 60 mcg/kg per hour continuous intravenous (IV) infusion
56-60 (hrs): reduce to 30 mcg/kg per hour continuous intravenous (IV) infusion
medtigo
Peripartum Depression
Updated :
September 6, 2023
Peripartum depression (PPD) is a type of major depressive disorder characterized by depression that occurs during pregnancy or within 12 months after delivery. It can manifest in various forms, such as prenatal depression and postpartum depression, that can occur during pregnancy and childbirth. It is a serious mental health condition that affects many women.
It can significantly impact the emotional well-being of the mother and the family. Symptoms of peripartum depression can include disturbed thoughts, anxiety, persistent feeling of sadness, physical symptoms such as fatigue, insomnia, difficulty concentrating, and changes in appetite.
The exact prevalence of PPD is challenging to determine due to varying definitions and diagnostic criteria. However, estimates suggest globally that a significant number of pregnant women experience mental disorders, particularly depression, during and after pregnancy, with an estimated 10% during pregnancy and 13% after childbirth.
In developing countries, the prevalence of peripartum depression is higher, with approximately 15.6% during pregnancy and 19.8% women after childbirth. Risk factors for PPD include a history of depression or other mental health disorders, stress, lack of social support, and adverse life events.
Women experiencing PPD may have symptoms such as anxiety, fatigue, lack of motivation, persistent feeling of sadness, difficulty in bonding with the baby, and thoughts of self-harm.
The pathophysiology of peripartum depression involves a complex interaction of biological, psychological, and social factors. Hormonal changes after childbirth, such as fluctuations in estrogen, progesterone, and thyroid hormones, can impact a woman’s mood and emotional well-being, potentially leading to PPD.
These hormones can also affect the levels of neurotransmitters, such as serotonin and norepinephrine, in the brain, which can impact mood and emotional regulation. Additionally, sleep disturbances caused by these hormonal changes can further contribute to feelings of depression.
Individuals with a history of depression, anxiety, or other mental health disorders may be at an increased risk of PPD, as well as those with a family history of depression. It is also worth noting that PPD is a multifactorial condition, and the underlying causes may vary from person to person.
The etiology of peripartum depression is not fully understood, but it is thought to be caused by a combination of biological, psychological, and social factors. Hormonal changes that occur during pregnancy and after childbirth, such as a decrease in estrogen and progesterone levels, may play a role in the development of PPD.
All women are at risk of experiencing psychiatric disorders during pregnancy and the first year after delivery due to hormonal changes and stress associated with pregnancy.
However, factors such as poverty, lack of education, migration, limited access to healthcare, violence, abuse, conflict, multiple pregnancies, and a lack of support from a partner can increase the risk. Psychological factors such as a history of depression or anxiety, stress, and lack of social support may contribute to developing PPD.
The prognosis varies depending on the severity of the depression and the individual’s response to treatment. With proper treatment, most women will see an improvement in their symptoms and eventually recover.
It is also important to note that some women may have chronic depression, which can last for months or even years after childbirth. In such cases, the prognosis may be less favorable and may require long-term management and treatment.
Early identification and treatment are important for improving outcomes, as untreated PPD can negatively affect the mother, the child’s development, and the family.
Free CME credits
Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.
Digital Certificate PDF
On course completion, you will receive a full-sized presentation quality digital certificate.
medtigo Simulation
A dynamic medical simulation platform designed to train healthcare professionals and students to effectively run code situations through an immersive hands-on experience in a live, interactive 3D environment.
medtigo Points
medtigo points is our unique point redemption system created to award users for interacting on our site. These points can be redeemed for special discounts on the medtigo marketplace as well as towards the membership cost itself.
Community Forum post/reply = 5 points
*Redemption of points can occur only through the medtigo marketplace, courses, or simulation system. Money will not be credited to your bank account. 10 points = $1.
All Your Certificates in One Place
When you have your licenses, certificates and CMEs in one place, it's easier to track your career growth. You can easily share these with hospitals as well, using your medtigo app.
