Postpartum Psychological Disorders

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  • 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.
Postpartum Psychological Disorders

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.

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