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Flashcards in Post-Partum Depression Deck (20)
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Postpartum Psychiatric Disorders

-Postpartum Depression
-Postpartum Anxiety
-Postpartum Psychosis


Morning sickness is from

increased estrogen, progesterone and hCG


Reflux during pregnancy is from

increased gastric emptying time and decreased sphincter tone


Constipation during pregnancy is from

decreased motility, increased water absorption


Reasons for pregnancy back pain

-Increased lumbar lordosis
-Myofascial strains
-Paraspinal muscle strain/muscle spasm
-Lumbar-sacral junction compression


Hormone levels after birth

-Estrogen and progesterone levels drop
-Prolactin and oxytocin stimulate lactation



-Post partum bleeding
-Vaginal discharge containing blood, mucus and uterine tissue
-usually happens for 4-6 weeks


Postpartum recovery

-caring for tears/episiotomy wounds
-postpartum depression
-constipation and hemorrhoids
-breast problems
-diastas recti (post partum belly pooch- wait for dr to give okay to exercise)
-uterine problems (kegels)


Postpartum Blues

-aka baby blues
-a transient condition
-Mild depressive symptoms such as dysphoria (sadness,
tearfulness, irritability and anxiety
-decreased concentration
-Develop in 50-75% of women within 2-3 days of delivery


During Postpartum Blues, symptoms usually peak ______ and resolve _______

peak over the next few days (within 2-3 days of deliver) and resolve within 2 weeks


Major Depressive Disorder with Permpartum Onset

This specifier can be applied to the current or, if full criteria are not currently met for a major depressive episode, most recent episode of major depression if onset of mood symptoms occurs during pregnancy or in the 4 weeks following delivery.


Do hormones play a role in peripartum depression?

-hormone levels and changes in levels DO NOT correlate with mood symptoms
-Progesterone and estrogen levels drop postpartum. Cortisol, thyroid and other large hormonal shifts also occur.
-Women who get peripartum depression are more sensitive to hormone fluctuations


Postpartum anxiety disorders include

Panic Disorder (intense fear of harm/harming any, palpitations, hyperventilation, sweating, difficulty caring for baby, leaving baby)

OCD (intrusive thoughts, images of grievous harm to baby, mother sometimes images herself inflicting harm)


Perinatal depression/anxiety treatment

-decrease stress
-support groups
-psychotherapy (interpersonal, cognitive behavioral, supportive)


Postpartum Psychosis

-one of rarest psych disorders
-rapid onset of severe maternal symptoms
-potential for a catastrophic outcome, such as infanticide or suicide


Etiology of Postpartum Psychosis

-significant drop in estrogen/progesterone (estrogen affects the monoaminergic system especially serotonin and dopamine)
-hx if bipolar/psychosis
-families with bipolar in which at least 1 woman had a manic or psychotic episode within 6 weeks of having a baby
-sleep disruption
-lack of partner support


Clinical presentation of Postpartum Psychosis

-acute onset within the first 2 weeks after delivery in 65% of cases
-elated, dysphoric, or labile mood
-insomnia, agitation and bizarre behavior
-Psychotic symptoms include mood-incongruent delusions with frequent content related to the infant (eg, the infant being harmed), thought broadcasting, ideas of reference, delusions of control, or command hallucinations.


4% of women with postpartum psychosis commit _______ and 5% commit _________

4%- infanticide
5%- suicide


Any mother who presents with a postpartum mood or psychotic disorder should be asked about __________

thoughts of harming herself or the infant

-The lack of reality testing and disorganized behavior can lead to unsafe and neglecting behaviors even in the absence of clear infanticidal ideation


Treatment for Postpartum Psychosis

1. Mood stabilizers: lithium, valproic acid, divalproex sodium, carbamazepine and lamotrigine

2. Atypical Antipsychotics: olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, lurasidone, or asenapine

3. Antidepressants: help manage depression. Usually along with a mood stabilizer or antipsychotic. Antidepressant along can sometimes trigger a manic episode.