Depression is a subtle thing. It can easily take on the disguise of other illnesses or temporary conditions.

Tired? Who isn’t? Sad? Well, the world can be depressing. Worried? Yeah, that’s why we all have grey hairs. Can’t sleep well? Join the club. Aren’t hungry? You’re just too busy. Unfocused? You just need to simplify. Irritable? It’s that time of the month. Don’t want to socialize? You’ve been at work all day.

Even for those who have lived with depression for years, it can be easy to dismiss another serious episode because so many of the symptoms mirror what most of the general population suffers from. It’s only when the symptoms have escalated and you are at the point where your functioning just isn’t normal that you may then snap your fingers and say, oh yeah, this again. But it’s only when you call depression by its name that you can adequately deal with it. And this is the case with postnatal depression as well.

BMJ recently published a letter in response to a previous article titled, Management of postnatal depression. In the letter, the author, Ruth V. Reed, warned people about the effects postnatal depression can have on children. Effects such as:

… reduced cognitive development, violence, and disturbances in behavior and patterns of play.

Reed goes on to note that treating postnatal depression can be difficult because the waiting time to receive cognitive therapy is usually quite lengthy and taking drugs for depression is more complicated when a new mother is breastfeeding her child.

Since the effects of postnatal depression can be serious and since the number of women who suffer from this condition are quite substantial, I think that better ways of identifying and treating postnatal depression need to be developed. As noted earlier, depression doesn’t always appear to be depression and getting help for this in the midst of caring for a new child can seem overwhelming. I believe that one way of treating this condition more effectively is by clear communication between the patient and her gynecologist before birth.

Ideally, frank discussions about postnatal depression between patient and doctor would happen briefly throughout the pregnancy. This would lessen the stigmatization surrounding depression as well as send a signal to the patient that the doctor takes this condition seriously.

Although education about depression, including postnatal depression, is readily available, the doctor is oftentimes not involved. Just knowing that your doctor is aware of this condition and is going to be asking you about your state of mind after you give birth can make it easier to be honest if you do experience postnatal depression.

Included in these discussions should be a conversation about medicine options, including the issues that are inherent with breastfeeding. A simple checklist for the patient to use in the weeks and months after delivering can help her and her doctor become aware of any sneaky postnatal depression that may be present.

Since the birth of a child is a wonderful yet busy and stressful time, a plan for possible postnatal depression would help everyone involved. The patient can make decisions before the indecision of depression and the tiredness that comes with an infant brings. The family can experience peace of mind knowing that, if depression were to occur, they have a viable plan in place. The doctor knows that most of the decisions were made by the patient and has opened a dialogue that can lead to faster treatment. All in all, a few minutes of openness can lead to better management of postnatal depression.

Reference

R. V Reed (2008). Don’t forget children and fathers BMJ, 337 (aug27 1) DOI: 10.1136/bmj.a1414

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