Introduction
Women who experience significant changes in their normal thinking and mood after pregnancy may be genetically predisposed to such changes. Their condition is related to a type of mood disorder known as bipolar disorder. A bipolar disorder is characterized by moods that swing between elation and depression.Women who have never had symptoms of a diagnosable mood disorder may find that after giving birth their thinking and moods change. These changes are more common with women who have significant mood changes during their pre-menstrual periods.
If the woman has a family history of mood disorders she is at an elevated risk for pregnancy-related mood and thought changes. Post-partum (sometimes referred to as post-birth) mood changes should be treated with great care.
Those who are most vulnerable to mood disorders may experience significant changes, including having thoughts that are unusual and bizarre, and even feeling suicidal. A woman who has never felt this way before or had this type of thinking may feel ashamed and not divulge this to her physician.
Recently women in the news such as actress Brooke Shields and singer Marie Osmond have disclosed the depression, mood swings, delusional and terrifying thinking they had after having given birth. Brooke Shields recalls that this was, “the most devastating challenge I have ever faced.” Marie Osmond in her book, “Behind the Smile” describes in detail what it is like to have to, “fake it” for the benefit of others.
By the second trimester of her pregnancy a woman’s body is producing 50 times the amount of Progesterone that it did before pregnancy. Progesterone acts on the brain much like an antidepressant does. The big letdown comes after the woman gives birth, because her Progesterone level then drops dramatically. Marie Osmond found out that her own mother also had this “post-partum depression” but never discussed it due to the image she wanted to project.
- Severe sadness or emptiness; emotional numbness or apathy
- Withdrawal from family, friends, or pleasurable activities
- Constant fatigue, trouble sleeping, overeating, or loss of appetite
- A strong sense of failure or inadequacy
- Intense worry about the baby or a lack of interest in the baby
- Thoughts about suicide; fears of harming the baby
Incomplete Diagnoses
A woman may receive the wrong diagnosis of her problem if her physician fails to take a comprehensive history. If a woman’s symptoms are treated without properly assessing her vulnerabilities (i.e. familial and personal history), this may lead to an inaccurate diagnosis, and more severe problems later on for her and her family.
If the woman has a family history of alcoholism, bipolar disorder, schizophrenia, even rage and anger management problems or any other mental problems, the physician should proceed with extreme caution and monitor very closely for any of the symptoms of a mood disorder. These include, but are not limited to feeling anxious, depressed, nervous, jittery, high, maniacal, mood swings, unusually high energy to name a few. Women who have a history of significant premenstrual moodiness also have an elevated risk of post-partum depression.
There is also research that says that those that have a rapid response to antidepressants such as feeling better in just a few days, rather than the more usual 2-3 weeks are at greater risk for these problems.
Treatment Options
A woman may receive better care if her obstetrician has a good working relationship with a specialist in treating mood disorders, and that would be a psychiatrist, or other well-qualified specialist. Unfortunately, not even all psychiatrists or other mental health care providers are well versed in the genetics of mood disorders, or fully understand the relationship of hormonal and genetic vulnerabilities. A specialty service that routinely deals with and understands these relationships can offer the type of cutting edge interventions that can prevent and assist women that find themselves in the turmoil of moods and hormones interacting together to cause emotional uproar.
A woman who has recently given birth will probably need more than a 15-minute visit to discuss her ongoing mood and thinking changes that are a normal part of adjustment after giving birth.
Social workers, especially those working as Medical Social Workers often have the ability to work with women who have recently given birth. Screening and history taking is a role in which Social Workers can assist the public in better preventative healthcare.
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
