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Postpartum Depression: An Essential Overview for the Practitioner

Sarah J. Breese McCoy, PhD
Volume: 104 Issue: 2 February, 2011

Abstract:

Postpartum depression (PPD) is a cross-cultural form of major depressive disorder that affects some 13% of women and can have serious health consequences for both the mother and her child. Easy-to-use, reliable, self-administered screening tools are available. PPD may have a variety of etiologies, which include changing plasma levels of estrogen and progesterone, postpartum hypothyroidism, sleep deprivation, or difficult life circumstances. Standard treatments for PPD include psychotherapy and antidepressants. However, treatment of a thyroid condition or insomnia, or even regular exercise or massage may also be beneficial. PPD is underdiagnosed, therefore more screening is needed. Obstetricians and pediatricians have a unique opportunity to test women for PPD, but general practitioners may encounter patients with undiagnosed PPD, too. These physicians could positively impact the lives of depressed mothers and their children by identifying them, then treating or providing referrals for care as appropriate.


Key Points


* The etiology of postpartum depression is still uncertain, but various physiological and psychosocial causes have been investigated.


* Although the mainstays of treatment for postpartum depression are still psychotherapy and antidepressant medications, management of sleep disturbances, exercise, massage, and treatment of other contributing conditions such as thyroiditis may also be beneficial.


* Postpartum depression is currently underdiagnosed. Therefore, primary care physicians such as obstetricians, pediatricians, and general practitioners are in a unique position to positively impact suffering women and their children by screening for the disorder and providing referrals for treatment.

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