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Working Through Postpartum Depression
by Stephen A. Peterson 
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Working Through Postpartum Depression
© 2013


Stephen A. Peterson

A young woman asking for help: “I just recently had a baby and at times I don’t feel very well. I sometimes feel sad, tired and anxious. One day I did not want to be around my baby. I’ve been this way for about a week. Can you tell what’s wrong with me?”

Based upon her descriptions the young woman was informed she might be experiencing postpartum depression (PPD). She was further informed that she is not evil or uncaring as a mother but needed to be examined by her doctor to determine if this is the case.

Postpartum depression is not uncommon for a woman to experience following the birth of her child. Several mental health agencies report somewhere between 5% to as many as 25% of all woman during their reproductive years will be affected by this problem. Some researchers believe more new mothers have postpartum depression related symptoms that go unnoticed and subsequently unreported.

This short piece will briefly inform young mothers in order to help them take charge of their mental and physical health an important period of their lives.

It is normal to experience mood shifts, mild feelings of sadness and irritability. This often referred to as “the baby blues”. The beginning symptoms generally last a few days but not more than a week. Should the symptoms remain beyond these periods, full blown postpartum depression is more likely the problem.

The following are usual culprits:

1. Trouble sleeping;
2. Hopelessness;
3. Crying;
4. Feeling of guilt;
5. Loss of appetite;
6. Overeating;
7. Feelings of inadequacy;
8. Low energy;
9. Frustration and anger;
10. Suicidal ideations;
11. A lack of interest in the baby;
12. A fear of harming the baby;
13. Withdrawal from other family members and friends;
14. Withdrawal from activities once enjoyed by the mother.

Though identified more than 40 years ago, professionals concerned with postpartum depression do not know significant information of its full impact upon new mothers. The emotional changes that occur after a child is born is reported to be related to a variety of issues yet to be researched. While research continues, it is important new mothers seek professional medical help immediately if they believe they are experiencing postpartum depression. Below is the Edinburgh Postnatal Depression Scale (EPDS) developed by J. L. Cox, J. M. Holden and R. Sagvosky. In 1987 to help identify symptom in order obtain help if needed. It is important that the instructions be followed as indicated.

Edinburgh Postnatal Depression Scale (EPDS)

Postpartum depression is the most common complication of childbearing. The 10 question Edinburgh Postnatal Depression Scale (EPDS) is a valuable and efficient way of identifying patients at risk for “perinatal” depression. The EPDS is easy to administer and has proven to be an effective screening tool.

Mothers who score above 13 are likely to be suffering from a depressive illness of varying severity. The EPDS score should not override clinical judgment. A careful clinical assessment should be carried out to confirm the diagnosis. The scale indicates how the mother has felt during the previous week. In doubtful cases it may be useful to repeat the tool after 2 weeks. The scale will not detect mothers with anxiety neurosis, phobias or personality disorders.

Women with postpartum depression need not feel alone. They may find useful information on the websites of the National Women’s Health Information Centerand from groups such as Postpartum Support International< www.chss.iup.edu/postpartum and Depression after Delivery< www.depressionafterdelivery.com.>

Instructions for using the Edinburgh Postnatal Depression Scale:

1. The mother is asked to check the response that comes closest to how she has been feeling in the previous 7 days.

2. All items must be completed.

3. Care should be taken to avoid the possibility of the mother discussing her answers with others. (Answers come from the mother or pregnant woman.)

4. The mother should complete the scale herself, unless she has limited English or has difficulty with reading.

Edinburgh Postnatal Depression Scale

Name:_____________________________ Address:___________________________

Your Date of Birth: ___________________ ___________________________

Baby’s Date of Birth: _________________ Telephone Number: __________________

As you are pregnant or have recently had a baby, we would like to know how you are feeling. Please check the answer that comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today.

Here is an example, already completed.

I have felt happy:
 Yes, all the time
 Yes, most of the time (x ) This would mean: “I have felt happy most of the time” during the past week.
 No, not very often Please complete the other questions in the same way.
 No, not at all

In the past 7 days:

1. I have been able to laugh and see the funny side of things
 As much as I always could
 Not quite so much now
 Definitely not so much now
 Not at all

2. I have looked forward with enjoyment to things
 As much as I ever did
 Rather less than I used to
 Definitely less than I used to
 Hardly at all

3. I have blamed myself unnecessarily when things went wrong *
 Yes, most of the time
 Yes, some of the time
 Not very often
 No, never

4. I have been anxious or worried for no good reason
 No, not at all
 Hardly ever
 Yes, sometimes
 Yes, very often
5. I have felt scared or panicky for no very good reason *
 Yes, quite a lot
 Yes, sometimes
 No, not much
 No, not at all

6. Things have been getting on top of me *
 Yes, most of the time I haven’t been able to cope at all
 Yes, sometimes I haven’t been coping as well as usual
 No, most of the time I have coped quite well
 No, I have been coping as well as ever

7. I have been so unhappy that I have had difficulty sleeping *
 Yes, most of the time
 Yes, sometimes
 Not very often
 No, not at all

8. I have felt sad or miserable *
 Yes, most of the time
 Yes, quite often
 Not very often
 No, not at all

9. I have been so unhappy that I have been crying *
 Yes, most of the time
 Yes, quite often
 Only occasionally
 No, never

10. The thought of harming myself has occurred to me *
 Yes, quite often
 Sometimes
 Hardly ever
 Never

Administered/Reviewed by: ___________________________ Date: _____________________
Users may reproduce the scale without further permission providing they respect copyright by quoting the names of the authors, the title and the source of the paper in all reproduced copies.

Source: Cox, J. L., Holden, J. M. and Sagovsky, R (1987). Detection of postnatal depression. Development of the 10 item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150: 782-786.

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