Post Partum Depression

What is Post Partum Depression?

Didactic by Sheryl Jawets


OBJECTIVES

By the end of this discussion, you should be able to:

Contents
  1. Define postpartum emotional disorders and understand the major differences between them.
  2. Be aware that a screening tool exists and be familiar with it.
  3. Understand that maternal PPD can have a significant effect on the pediatric population.
  4. Most importantly, understand that due to the potentially devastating effects of maternal PPD on the child, as a pediatrician you have a major role in diagnosing PPD and providing referrals for psychiatric/support services.

INTRODUCTION

It’s 2 PM, as you prepare to see your first patient of the afternoon, a newborn. You call the patient in and wish the mother congratulations.

“Thank you” she says in a barely audible whisper as she trudges into your office. Odd, you think to yourself, most new parents are more animated than this, but you chalk it up to shyness and exhaustion. Once inside, things do not improve. The mother barely makes eye contact with you, and she answers all of your questions with single word responses in a monotone voice. She holds the infant stiffly in her lap as you conduct your interview and requires 20-30 seconds before she acts to console the baby once he begins crying. You finish your interview a bit faster than usual and conduct the physical exam. At the end of your exam you inform the mother that all is well and make sure she has no additional questions. The infant is healthy and you send mother and baby to make their next appointment for the 2 month visit.

As you prepare to call in your next patient you feel good that you fulfilled your responsibilities in an uncommonly timely and efficient fashion…but wait, did you really fulfill your responsibilities to your patient. Are you sure that mom is merely a little shy and exhausted or is something else going on here? Vaguely, you remember a presentation on post partum depression (PPD). Is that the problem here? Does the mom have the very common and generally uncomplicated post partum blues or does she have true post partum depression, a more serious and potentially debilitating condition?