Postpartum Depression - Part II

Last week, we started our discussion about postpartum depression (PPD), which is a serious complication of childbirth. Today we will talk about the possible complications of PPD along with the diagnosis and treatment.

What are the complications of PPD?

PPD can have a ripple effect, causing emotional strain for everyone close to a new baby. If not treated, PPD can have several complications for mothers, children, and for the other parent. These complications include:

For mothers -

• Untreated PPD can last for months or longer and sometimes becomes an ongoing depressive disorder.
• Mothers may stop breastfeeding
• Problems bonding with and/or caring for their baby
• Higher risk of suicide
• Increased risk of future episodes of major depression

For children -

• Higher risk of emotional and behavioral problems
• Higher risk of sleeping difficulties
• Higher risk of eating difficulties
• Delays in language development or other developmental milestones

For the other parent -

• Increased risk of depression
• Job difficulties due to additional or unexpected time taken off work

Can PPD be prevented?

The risk for PPD can be decreased by addressing some of the risk factors. This can include making sure that women have support from others during pregnancy and after bringing the baby home, providing breastfeeding support before and after leaving the hospital with the new baby, etc.

Women should also tell their healthcare provider if they have a personal or family history of depression, or other risk factors for PPD. If you are at higher risk, your provider can monitor you closely for symptoms during pregnancy and may recommend early postpartum checkups to screen you for symptoms. If caught early, treatment can start earlier when symptoms may not be as severe. If you have a history of PPD with a prior pregnancy, your provider might recommend treatment with talk therapy or an antidepressant medication immediately after delivery. Most antidepressants are safe to take while breastfeeding.

How is PPD diagnosed?

Your healthcare provider will talk with you about your symptoms to help determine if you have PPD. It is important for you to be honest and open about how you're feeling so that they can make an accurate assessment of your condition.

You may be asked to fill out a questionnaire about your feelings, thoughts, and other symptoms.

Blood tests may be done to rule out other causes for your symptoms, such as thyroid problems.

How is PPD treated?

Treatment for PPD is tailored to the type and severity of your symptoms. Treatment of PPD can include:

• Antidepressant medicines - Including the recently FDA-approved medication called zuranolone (brand name Zurzuvae). This is the first approved pill specifically for postpartum depression. Clinical trial research shows that this pill improves symptoms of PPD much faster than other antidepressants.
• Anti-anxiety medicines - If you are experiencing significant anxiety.
• Psychotherapy - It can help to talk through your feelings and concerns with a mental health professional. They can help you find ways to cope with your feelings and solve problems.
• Support groups - Everyone could use more support!

What things can you do at home to help with baby blues or PPD?

• Get adequate rest
• Accept help from family and friends
• Make time to take care of yourself
• Connect with other new moms
• Avoid alcohol and recreational drugs
• If you are having trouble with breastfeeding, ask your provider about getting help from a professional lactation consultant.

If you or a loved one have symptoms of PPD, contact your healthcare provider. If you have any questions about postpartum depression, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Postpartum Depression

The FDA recently approved the first pill specifically for postpartum depression. Postpartum depression is a type of depression that happens after having a baby. It affects an estimated one in seven mothers in the US. It is a serious and potentially life-threatening complication of childbirth. Today we'll talk more about this condition, including how to recognize it in yourself or your loved ones.

What is postpartum depression?

Postpartum refers to the time after childbirth. Postpartum depression (PPD) is a type of depression that happens after someone gives birth. Sometimes it can even start during pregnancy and continue after childbirth. Symptoms range from mild to severe and may appear within a week of delivery or may develop gradually, even up to a year after delivery. If it is not treated, PPD can last many months or longer.

What are the symptoms of postpartum depression?

It can be normal to feel somewhat overwhelmed when a new baby comes home, even for experienced mothers. If you have any of the following symptoms that last for more than 2 weeks, contact your health care provider:

• Depressed mood or severe mood swings
• Frequent crying
• Anxiety, panic attacks, or restlessness
• Irritability or intense anger
• Fatigue, sometimes overwhelming
• Feelings of guilt or fear that you're not a good mother
• Difficulty bonding with your baby
• Feelings of hopelessness
• Thoughts of harming yourself or your baby
• Recurring thoughts of death or suicide

How is PPD different from the baby blues?

Up to 75% of new moms experience baby blues after delivery. This can start within the first 2-3 days after delivery and may last from a few days up to 2 weeks. Baby blues resolves without treatment. Symptoms are much milder than PPD, and can include feelings of sadness, anxiety, crying, feeling overwhelmed, or trouble sleeping. PPD may be mistaken for baby blues at first, but the symptoms of PPD are more intense and last longer. Baby blues should not interfere with your ability to care for your baby or handle your normal daily tasks.

Why is PPD sometimes not recognized or treated?

Sometimes it is not recognized because no one asks a new mom how she is feeling. Some women may feel embarrassed or guilty about their symptoms.

In addition, many mothers are hesitant to reveal their symptoms to family members or health care providers. They often fear they will be judged on their parenting or think that people will think they are a bad mother.

Anyone can develop postpartum depression. It absolutely does not mean you are a bad mom!

Are some women at higher risk of developing PPD?

Although anyone can develop PPD, there are some factors that may increase your risk. They include:

• Personal or family history of depression or bipolar disorder
• Having depression during pregnancy
• Having little or no support from family and friends
• Problems with a previous pregnancy or birth
• Current relationship or money problems
• Age younger than 20
• Having alcoholism or other substance abuse issues
• Having a baby with special needs
• Having difficulty breastfeeding
• Pregnancy was unplanned or unwanted

What is postpartum psychosis?

Postpartum psychosis is a rare condition that usually develops within the first week after delivery. The symptoms are quite severe. Symptoms include:

• Feeling confused or lost
• Having obsessive thoughts about your baby
• Hallucinating or having delusions
• Sleep problems
• Having too much energy
• Feeling paranoid
• Making attempts to harm yourself or your baby

Next week we will continue our discussion about PPD, including talking about the complications of PPD and how it is diagnosed and treated.

If you have any questions about postpartum depression, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

How UV Radiation Affects Your Eyes

We have talked about the effects of ultraviolet (UV) radiation on your skin. You may have also heard about UV radiation causing damage to your eyes. But are you protecting your eyes on a regular basis? Today, we will talk about the common eye problems that can be caused or worsened by UV radiation exposure and how you can protect your eyes from these conditions.

What are the harmful effects of UV light on the eyes?

UV radiation contributes to the formation of free radicals, which can cause permanent damage to body tissues, including the eyes. Some of the common eye problems associated with UV exposure include:

• Cataracts – Clouding of the lens of the eye, which can lead to blindness.
• Retina degeneration – Breakdown of the back surface of the eye that is responsible for converting the light into neural signals and sending these signals to the brain, resulting in vision.
• Macular degeneration – Breakdown of the part of the retina that gives the eye clear vision in the center of your visual field. Macular degeneration can lead to blindness.
• Melanoma of the eye – Melanoma is a serious form of cancer. When melanoma occurs in the eye, it is usually in the middle layer of your eye, but can also develop on the eyelid, or on the surface of the eye.
• Pterygium – A growth that begins in the white of the eye, which can grow to block your vision.
• Sunburn of the cornea – A very painful condition.
• Other skin cancers of the eyelids

How can you protect your eyes from the negative effects of UV radiation?

Although some conditions can be treated, such as surgery to remove cataracts, you may not be able to fix your eyes once they are damaged. But you can ensure that your eyes stay as healthy as possible by taking a few practical steps. Here are some tips to do just that:

Use protective eyeglasses:

• Always use eye protection – In the summer at the beach or the lake, or in the snow in winter.
• When buying a new pair of sunglasses, look for labels that indicate the glasses block 99-100% of UVA and UVB rays.
• If you wear glasses full-time, consider "photochromic" lenses, also called transition lenses, which eliminate the need for a separate pair of prescription sunglasses. They always provide complete UVA and UVB protection, whether the lenses are clear or dark at the time.
• Your glasses should reduce glare and not distort natural colors.
• When sunlight hits water or snow, the reflection is stronger, making the risk for eye damage even greater. The more light your glasses block in this situation, the better.

Wear a wide-brimmed hat:

• This can be especially helpful for children or others who aren't used to wearing sunglasses.
• A wide brim on a hat can block up to 50% of UV radiation.
• It can also limit UV rays that might hit the eyes from above or around your glasses. Wear the hat in addition to the glasses when you can.

Avoid overexposure to the sun:

• Stay out of the sun at peak hours for UVB rays.
• Sit in the shade of a tree or use an umbrella at the beach, in addition to your sunglasses.
• This is especially important for people who:
  • Have had eye surgery
  • Are taking certain prescription medications that may increase your eyes' sensitivity to light.

What else should you do to keep your eyes healthy?

Pay attention to your eye health by seeing your eye doctor regularly, especially if you have any of the following symptoms:

• Sensation of flashes or specks of dust in your vision
• Poor or blurry vision
• A growing dark spot on the eye
• Loss of peripheral vision
• A change in the shape of your pupil

If you have any questions about UV safety, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

UV Safety Awareness - Part II

Last week, we talked about UV radiation and how it damages our skin. Today, we will talk more about the cancers associated with UV radiation exposure as well as how to protect your skin from the sun.

What skin cancers are associated with UV radiation exposure?

Melanoma:

• Melanoma is the most serious form of skin cancer.
• It is now one of the most common cancers among adolescents and young adults ages 15-29.
• Although melanoma only accounts for about 3% of skin cancer cases, it causes more than 75% of skin cancer deaths.
• UV exposure and sunburn, especially during childhood, are risk factors for melanoma.
• Other possible risk factors for melanoma include some genetic factors and some immune systems disorders.

Basal Cell Carcinoma:

• Basal cell carcinomas are the most common type of skin cancer tumors.
• They usually appear as small, fleshy bumps on the head and neck, but can occur on other areas of the skin that have been exposed to the sun's radiation.
• This skin cancer grows slowly.
• If recognized early, these tumors can be completely removed.
• It does not spread through the blood stream to other parts of the body, as melanoma does.
• It can cause considerable damage in the area directly adjacent to the tumor. It can grow directly into the bone and even through the skull into the brain as the tumor grows larger.

Squamous Cell Carcinoma:

• Squamous cells are present in many places in your body, and squamous cell carcinoma can occur anywhere squamous cells are found. These facts about squamous cell carcinoma of the skin refer only to cancer that forms in the squamous cells found in the skin.
• These tumors develop in the middle and outer layers of the skin, including the lips.
• They may appear as nodules, or as red, scaly patches, or sometimes as ulcers or sores that don't heal, but can develop into large masses.
• This cancer is usually not life-threatening but can be aggressive.
• If not recognized early, it can spread to other parts of the body.

How can you prevent skin damage from UV radiation?

It isn't possible to completely prevent skin cancer or undo previous effects of UV radiation and sun damage, but you can take the following steps to reduce your risk:

• Apply sunscreen with a sun protection factor (SPF) of 30 or greater, 20-30 minutes before sun exposure and then every 2-3 hours after. Don't forget to put sunscreen on your ears and in the part of your hair.
• Reapply sunscreen sooner if you get wet or sweat significantly.
• Wear sunglasses with total UV protection.
• Wear a hat that has a brim.
• Do not use tanning beds. Do not let your children or teenagers use tanning beds.
• Select cosmetic products that offer UV protection, such as moisturizers or lip balms.
• Avoid direct sun exposure as much as possible during peak UVB radiation hours, between 10 am and 4 pm.
• Perform skin self-exams regularly to become familiar with existing skin growths and to notice any changes in your skin or new growths.
• If you notice any change to your skin that concerns you, see your family doctor or a dermatologist to have it evaluated.
• Nearly 80% of a person's lifetime sun exposure occurs before age 18. Protect young children from UV radiation. Be a good role model and teach your family habits to protect skin from UV radiation.

If you have any questions about UV safety, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor