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Targeting postpartum depression

I delivered my son 6 weeks ago and have been tired and depressed. My mother tells me that I need to be evaluated for postpartum depression. What is happening to a woman’s body for her to get depressed after delivering a baby?

The “postpartum” period typically refers to the first year after delivering a baby. If you are experiencing a postpartum depression, you may be suffering from persistent sadness accompanied by low motivation, low energy, apathy, difficulty with sleep and poor concentration. Unlike the “baby blues,” which involves increased moodiness but not difficulty in caring for oneself or the baby, postpartum depression may impair your ability to interact with your family and bond with your infant son.

You are not alone; postpartum depression may occur in up to 10 percent of women. Although there may be several associated risk factors, the biological causes may include changes in brain activity, thyroid disturbances and changes in brain chemicals.

For example, a 2010 study from the American Journal of Psychiatry indicated that women with postpartum depression exhibited decreased activity in the left front and inside part of the brain in an area that is responsible for awareness of the feelings and needs of others (including their babies). This may explain why women with postpartum depression often neglect the care for their babies.

On the average, postpartum thyroiditis occurs in about 8 percent of women after delivery, causing either low or high thyroid functioning. Disturbances in the thyroid can cause fatigue, anxiety, depression and insomnia. Fortunately, most women return to normal thyroid functioning within one year after delivery, but about 25 percent of women with a history of postpartum thyroiditis will develop permanent hypothyroidism within 10 years.

Postpartum thyroiditis is an autoimmune disorder (where the body’s immune system attacks the thyroid) that occurs as a rebound response from the natural braking of the immune system that occurs during pregnancy.

After soaring during pregnancy, estrogen decreases to its lowest point three days after childbirth. During that time, monoamine oxidase-A (an enzyme that breaks down dopamine, serotonin and norepinephrine) increases in its activity. Similar to a Pac-man figure, this enzyme gobbles up these important chemicals, possibly resulting in depression, anxiety and poor concentration. A 2010 study from the Archives of General Psychiatry suggested that with postpartum depression, there may be a 43 percent increase in this enzyme four to six days following childbirth.

Fortunately, postpartum depression is a treatable condition; treatment not only improves your well-being, but also your ability to bond with your baby. Speak with your health care provider to assess your thyroid functioning and determine if your current symptoms warrant treatment for postpartum depression.

Dr. Jay Fawver practices mind-body medicine with Parkview Physicians Group. Send questions to Terri Richardson at The Journal Gazette, 600 W. Main St., Fort Wayne, IN 46802, or email trich@jg.net. Please put “Ask the Doctor” for the subject line.

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