Understanding PPD Symptomatology & Risks:
Symptoms:
- Loss of pleasure and desire in things you used to enjoy
- A shift in eating habits and cues
- Frightening thoughts
- Feeling worthless or guilty; participating in self-blame
- Paranoia and fear of not being a “good mother”
- Fear of being left along with your baby
- Regular and stark mood changes
- Uncontrollable crying for extensive periods
- Misery
- Inability to sleep; irregular sleep patterns
- Lack of interest in your baby, family, and friends
- Difficulty focusing and making decisions
- Thoughts of hurting yourself or your baby
Risks:
- Change in hormone levels post-birth
- Previous experiences of depression and anxiety
- Family history of mental illnesses
- Stress in perinatal period; adjusting to new life changes
- Having a baby with special needs (premature birth, medical complications, illness)
- First-time motherhood, very young motherhood, or older motherhood
- Co-existing emotional stressors
- Finical and/or employment problems
- Isolation and lack of social support
Processes Of Diagnosis and Measurement:
Both the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the Edinburgh Postnatal Depression Scale (EPDS) screen for the onset of PPD.
The DSM first acknowledged PPD in 1994, classifying it as an onset specifier for Major Depressive Disorder. The fifth and current edition of the DSM continues to conceptualize PPD similarly with an added addition of the perinatal period. While the DSM now validates PPD symptoms during pregnancy, it still limits the time frame of PPD symptom development to four weeks postpartum. This subjects mothers who develop PPD symptoms post-four weeks with no clinical validation, often leaving them undiagnosed and untreated. Despite the consistent lobbying organizations such as Postpartum Support International have done to increase the onset timeframe from four weeks to 6 months postpartum, the four-week limit continues to endure. The DSM argues that PPD symptoms are not seen as distinct enough from Major Depressive Disorder to make any further amendments.
Given the limitations and lacking specificity of the DSM, the EPDS is relied on more frequently in diagnosing PPD (C. Sammon. Personal Correspondence, July 10, 2024). While the EPDS is more acutely focused on measuring PPD, the questions asked (attached below) prove to be quite vague as well as feelings and experiences most parents will naturally have after childbirth. Many clinicians critique the EDPS as a too general tool (Personal Correspondence, July 10, 2024).
Find the current DSM-5-TR Criteria for a Major Depressive Episode and the Edinburgh Postnatal Depression Scale below:
Uptake Obstacles for Non-Incarcerated Women:
Mothers of all social positions are often assigned unfair blame, accusations, and shame. They are simultaneously relied on for everything and scrutinized for every action they make. This societal rhetoric already puts women at risk for struggling through their experiences of PPD alone but when compounded with marginalized identities and related systemic oppression and barriers to equality, suffering from PPD alone becomes that more likely.