The reality of postpartum depression
Between 6.5% and 20% of new mothers develop postpartum depression (PPD), though many more may go undiagnosed. PPD symptoms may include:
- Depressed mood or severe mood swings
- Difficulty bonding with their baby
- Withdrawing from family and friends, loss of appetite, or insomnia
- Loss of energy or reduced interest and pleasure in activities they used to enjoy
- Intense irritability, anger, anxiety, and panic attacks
- Fear that they’re not a good mother
“Postpartum depression is a serious and potentially life-threatening condition in which women experience sadness, guilt, worthlessness — even, in severe cases, thoughts of harming themselves or their child,” said Tiffany R. Farchione, M.D., director of the Division of Psychiatry in the FDA’s Center for Drug Evaluation and Research. “And, because postpartum depression can disrupt the maternal-infant bond, it can also have consequences for the child’s physical and emotional development.”
A mother’s mental health
A mother’s depression and anxiety from conception through the first year of the baby’s life is associated with negative developmental outcomes through adolescence, according to a recent study published in JAMA Pediatrics.
In addition to those who experience postpartum depression, about 15% to 23% of women worldwide experience anxiety during pregnancy. 15% deal with anxiety after childbirth. Depression through pregnancy is estimated to affect 10% of women, and 15% face postpartum depression. The burden is greater for women who are experiencing poverty or are teen parents, according to Postpartum Support International.
Perinatal development
For the baby, the perinatal stage — defined as the time from conception through pregnancy (antenatal), birth and the first year of the baby’s life (postnatal) — is “a time of unprecedented growth and sensitivity,” the study said. Exposures and early life experiences may modify a child’s development, starting from when he or she is in the womb to that critical first year as a growing child and onward.
In the study, a mother’s mental health struggles before and after birth was moderately linked with her child’s deficits in language and cognitive and motor development in infancy.
All of these children were more likely to exhibit behaviors that either internalized negative feelings or targeted them toward others. The children experienced and reacted with more negative emotions and were temperamentally difficult through adolescence as well.
“Since risk factors for perinatal depression include life stress and lack of social support, pregnant and postpartum women may be particularly vulnerable,” said Dr. Denise Jamieson, chair of the department of gynecology and obstetrics at Emory University.
“These data that suggest that these [factors] pose risks not just for the mother, but also for her child, not just now but into adolescence, is a stark reminder that the indirect effects of COVID-19 may be long-lasting,” Jamieson added.
New medication for postpartum depression
On August 4, 2023, the FDA approved Zurzuvae (zuranolone), an oral medication to treat PPD in adults. Though healthcare providers could previously provide treatment for PPD via IV injection, Zurzuvae is the first FDA-approved oral treatment.
“Postpartum depression is a serious and potentially life-threatening condition,” said Tiffany R. Farchione, M.D., director of the Division of Psychiatry in the FDA’s Center for Drug Evaluation and Research. “Because postpartum depression can disrupt the maternal-infant bond, it can also have consequences for the child’s physical and emotional development. Having access to an oral medication will be a beneficial option for many of these women coping with extreme feelings.”
