Dr. Rupali Chadha is a Board-Certified Psychiatrist. She completed her Residency in Psychiatry at the Johns Hopkins Hospital and went on to complete a Fellowship in Forensic Psychiatry as well. Given her expertise, Dr. Chadha frequently is called upon as an expert witness in trials. She is committed to mental wellness and has a passion for total body health, incorporating a multi-dimensional approach that includes nutrition, fitness, and wellness of mind, body, and spirit to build a healthy human. Dr. Chadha shares her insights on Postpartum Depression, often called “baby blues”, that can produce mild to severe mood alteration after delivery.
myDoqter: As a psychiatrist, you have special insight into the topic of postpartum depression. Can you review some of the more common signs and symptoms that may be presenting as part of Postpartum Depression, and which ones in particular we must be aware of?
Dr. Chadha: Sure! The same symptoms of major depressive disorder are common in postpartum depression. Depression is not just low mood, but a syndrome. In this syndrome we see low mood, anhedonia or loss of pleasure at all from any source, sleep and appetite disturbances, anxiety, lack of concentration and/or persistent thoughts of suicide. The lack of pleasure is like the volume of happiness is turned all the way down, and nothing, not your favorite food, sex, or baby snuggles can turn it back up. Complete lack of pleasure and thoughts of suicide often point to a brain depression and not just ‘baby blues’ as explained in the article.
myDoqter: That is a good point – it is important to rule out underlying depression due to brain disease. Do we have an understanding of the mechanism through which postpartum depression occurs and how it differs from major depression?
Dr. Chadha: We believe it is the abrupt estrogen withdrawal that can trigger a postpartum depression. The estrogen withdrawal causes the same or similar changes to a brain when a major depressive disorder occurs in either gender.
myDoqter: Is there any way to prevent postpartum depression?
Dr. Chadha: Unfortunately, no. But we have excellent treatments, both in antidepressants and in a novel IV therapy that turns around mood within hours.
myDoqter: Yes, we have heard about the IV treatment that can be infused in a single session and has been shown to provide rapid relief of symptoms. Are there good treatment options for longer term symptoms and are there special considerations in new mothers who may be breastfeeding?
Dr. Chadha: Yes! SSRI antidepressants are often a good choice, the only drawback is that they do cross over from breast milk, though the damage from a depressed mother is worse than any potential harm most physicians believe. Also, SSRIs take 4-8 precious weeks of baby-bonding and development time before they start to work. If a mother has a history of depression, she can discuss remaining on an SSRI, even during her pregnancy. We have a new IV drug, branded Zulresso, but its costs and associated two-day hospital stay, render it unfeasible in many cases. This IV drug works in 60 hours, as opposed to weeks to months.
To read more about the topic of postpartum depression as well as other women’s health concerns, please visit Speakingofwomenshealth.com.