Postpartum Depression Diagnosis and Prognosis- Postpartum depression remains undiagnosed in almost fifty percent of cases. Its symptoms are similar to that of depression.
Postpartum depression can be difficult to diagnose and many cases are not recognised (about 50%). The symptoms of postpartum depression (PPD) are like many other mental illnesses especially depression. If your doctor suspects PPD he will take a detailed history and examine you, and do tests. Here is what you can expect during an evaluation to diagnose postpartum depression.
History and Examination
Your doctor will ask you about symptoms such as what are the symptoms, the duration of the symptoms, and severity of the symptoms. Your doctor would like to know if this the first time you have had these symptoms or have you experienced them before - if yes then did you receive medication for depression earlier? He will ask about factors which increase the risk of depression, such as family or marital problems, work-related or any other stress, mental illness in family members, and drug and alcohol use. Your doctor will examine you for signs of depression such as loss of interest in surrounding, your tone of speech etc.
To determine if you have baby blues or a more severe form of depression, you will be given a depression-screening questionnaire like the Edinburgh Postnatal Depression Scale. This questionnaire has 10 questions, and your answers will help to determine if you have postpartum depression. Depending on your score, you will be referred for further evaluation.
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Currently depression is diagnosed based the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. According to the DSM postpartum depression a subtype of major depression and DSM can be used to evaluate if you are depressed. You will be asked a series of questions in the questionnaire. Based on your answers to the questions your doctor will diagnose if you have depression. DSM criteria indicate that for a woman to be diagnosed with postpartum depression the signs and symptoms of major depression must develop within four weeks of childbirth. Some of the signs and symptoms of a major depressive illness include;
- Feeling depressed nearly every day, which may be indicated by either subjective report (e.g., feels sad) or observation of people close to you (e.g., appears tearful).
- Loss of interest or pleasure in all, or almost all, activities you once enjoyed
- Significant change in weight (weight loss when not dieting or weight gain) or drastic change of appetite (decrease or increase)
- Insomnia (Loss of sleep) or excessive sleepiness or difficulty in going to sleep.
- Irritabilty, restlessness, agitation or delayed psychomotor development.
- Feeling tired and exhausted most of the time —even after adequate rest and sleep.
- Feeling useless, worthless or guiltymost of the time.
- Finding difficult to concentrate and having trouble focusing, making decisions, or remembering things.
- Frequent or constant aches and pain (such as headaches, back pain, aching muscles, and stomach pain).
- Recurrent thoughts of death or suicide (suicidal ideation without a specific plan), or a suicide attempt or a specific plan for committing suicide.
Besides screening and tests for diagnosing postpartum depression your doctor will do tests to rule out other causes of similar symptoms like an underactive thyroid.
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