Postpartum depression is more widespread than the medical community previously thought, according to a recently released Danish study published in the Journal of the American Medical Association in December of 2005. In fact, women are three times more likely to seek help from an outpatient facility for mental health issues and at least 1.03 women per 1,000 births suffer a mental disorder requiring hospital admission, according to study findings.
The study from the University of Aarhus is especially important because it is one of the largest studies conducted on this subject—tracking 1.1 million first-time parents (1,171 mothers and 658 fathers) who gave birth between 1973 and 2005.
Not only did researchers analyze the incidence of postpartum depression post-birth, but also other mental disorders such as schizophrenia and bipolar disorder during the first three months postpartum.
“This was a huge study and researchers determined that new moms are much more vulnerable to serious mental illness than the men who were followed. And this part was really good to see in print (some of us have been saying this for years): The researchers estimate that postpartum depression isn’t ever diagnosed in approximately 40 to 50 percent of cases, thus suggesting that the problem is greater that the statistics indicate,” says Karen Kleiman, M.S.W., author of several books on postpartum depression and founder of the Postpartum Stress Center of Rosemont, Pennsylvania.
In fact, the study also concludes that first-time mothers are seven times more likely to be hospitalized for a severe mental illness than second-time moms who had given birth eleven to twelve months before. Researchers determined that the greatest risk for mental illness was ten to nineteen days after childbirth, but the risk was still significant three months later.
Experts on postpartum stress say this study concludes what they’ve known for years—that hormonal changes from childbirth can provoke underlying mood disorders in a woman. Why first-time childbirth has more of an impact than second births is not quite known, but experts said it is clear why men from this study did not require as much mental health intervention post birth as women, since they aren’t experiencing the dramatic hormonal fluctuations that moms do.
Kleiman reiterates that not all women who give birth will develop a mental health problem. Fluctuating hormones won’t cause all women to become mentally unstable—but most likely those women who have a genetic predisposition to an illness such as depression may have the depression triggered by the dramatic hormonal imbalance created from childbirth.
With that said, experts are convinced there is a link.
“We are, however, more and more convinced that there is a strong biologic link which explains why biological interventions, such as antidepressant medications are so effective in treating this illness. A woman is most at risk for emotional illness during and after pregnancy than at any other time in her life. The dramatic hormonal and biologic changes are contributing factors but so are psychological, environmental and genetic factors. Areas of vulnerabilities create the opportunity for depression to emerge,” Kleiman says.
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