Postpartum Psychological Disorders

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Postpartum Psychological Disorders

Postpartum psychological disorders include mild conditions, known as baby blues, postpartum depression, and postpartum psychosis.
The risks of complications increase due to the history of psychological disorders, labor complications, unintended pregnancy, unmarried status, or marital discord (Perry & Hockenberry, 2018).
Postpartum psychosis requires significant attention as infanticide and suicide are observed in 4% and 5% of the women suffering from PP , respectively (Sharma, Rai & Pathak, 2015, p. 216). Therefore, it is of utmost importance to scan for the symptoms of postpartum depression, as it poses a threat to the life and well-being of a mother and a newborn baby.

Onset and Duration

Baby Blues
- Onset right after the birth.
- Resolves in several days.
Postpartum Depression
- Within 4 weeks of childbirth.
- Up to 1 year postpartum.
Postpartum
Psychosis
- Within 1 month postpartum.
- Up to second year postpartum when untreated.

Medical Treatment

Baby Blues

The condition resolves by itself.

Postpartum Depression

Mild cases can resolve naturally over 6 months;
Pharmacologic intervention: antidepressants, mood stabilizers, anti-anxiety agents.
Electroconvulsive therapy (ECT).
Alternative therapies: dietary supplements, aromatherapy, massage, acupuncture.
Psychotherapy.
Support groups.
Hospitalization in the most severe cases.

Postpartum Psychosis

In-hospital treatment is strongly recommended;
Pharmacologic intervention: mood stabilizers, antidepressants with caution.
Electroconvulsive therapy (ECT).
Psychotherapy after an acute phase.

Nursing Care

Baby Blues

Observation and screening for more severe complications is needed.
Educate parents and family members to recognize symptoms.

Postpartum Depression

Request a mental health consult before discharge in case of concerns.
Supervision of the mother: routine visits, phone calls.
Screening for suicide thoughts.
Referral to a mental health practitioner.
Patient and family member education about pharmacological treatment and lactation.

Postpartum Psychosis

Administer pharmacological treatment as prescribed.
Administer reintroduction to the baby.
Assess for the severe side effects of psychotropic medications.
Patient and family member education about pharmacological treatment and lactation.

References

Perry, S. E., & Hockenberry, M. J. (2018). Maternal child nursing care (6th ed.). St. Louis, MO: Elsevier.

Sharma, I., Rai, S., & Pathak, A. (2015). Postpartum psychiatric disorders: Early diagnosis and management. Indian Journal of Psychiatry, 57(6), 216.