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Postpartum Psychological Disorders
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Postpartum psychological disorders include mild conditions, known as baby blues, postpartum depression, and postpartum psychosis.
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The risks of complications increase due to the history of psychological disorders, labor complications, unintended pregnancy, unmarried status, or marital discord (Perry & Hockenberry, 2018).
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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
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Baby Blues
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Onset right after the birth.
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Resolves in several days.
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Postpartum Depression
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Within 4 weeks of childbirth.
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Up to 1 year postpartum.
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Postpartum
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Psychosis
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Within 1 month postpartum.
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Up to second year postpartum when untreated.
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Medical Treatment
Baby Blues
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The condition resolves by itself.
Postpartum Depression
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Mild cases can resolve naturally over 6 months;
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Pharmacologic intervention: antidepressants, mood stabilizers, anti-anxiety agents.
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Electroconvulsive therapy (ECT).
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Alternative therapies: dietary supplements, aromatherapy, massage, acupuncture.
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Psychotherapy.
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Support groups.
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Hospitalization in the most severe cases.
Postpartum Psychosis
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In-hospital treatment is strongly recommended;
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Pharmacologic intervention: mood stabilizers, antidepressants with caution.
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Electroconvulsive therapy (ECT).
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Psychotherapy after an acute phase.
Nursing Care
Baby Blues
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Observation and screening for more severe complications is needed.
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Educate parents and family members to recognize symptoms.
Postpartum Depression
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Request a mental health consult before discharge in case of concerns.
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Supervision of the mother: routine visits, phone calls.
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Screening for suicide thoughts.
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Referral to a mental health practitioner.
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Patient and family member education about pharmacological treatment and lactation.
Postpartum Psychosis
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Administer pharmacological treatment as prescribed.
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Administer reintroduction to the baby.
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Assess for the severe side effects of psychotropic medications.
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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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