Abstract
Abstract
There is growing evidence that perinatal depression does not arise and develop in the same way for all women. We show here examples of how, for some, the symptoms start in pregnancy and resolve postpartum. For other women the symptoms are triggered by parturition itself. In a third group women experience a constant level of symptoms throughout. To enable research into the biochemical basis for these differences, the subtypes must be identified.
There is a large rise in plasma oestrogen, progesterone, corticotropic releasing hormone (CRH), and cortisol levels during pregnancy; cortisol, in late gestation, reaches levels found in Cushing’s syndrome and major melancholic depression. Upon parturition levels of all these hormones decrease rapidly. Cortisol, oestrogen and progesterone all have strong psychoactive effects, and their sudden withdrawal may contribute to mood changes. It is possible that depression that starts in pregnancy more closely resembles the melancholic type associated with hypercortisolaemia, while depression that arises postpartum shows more of the symptomatology of the atypical type. Some women experience mild bipolar II depression postpartum, a subtype also associated with atypical symptoms. Different putative factors (genetic, hormonal and social) probably play a greater or lesser part in the etiology of postnatal depression in different women. It is important to distinguish time of onset and resolution of perinatal affective disorder when investigating causal factors and symptom profile.
There is growing evidence that perinatal depression does not arise and develop in the same way for all women. We show here examples of how, for some, the symptoms start in pregnancy and resolve postpartum. For other women the symptoms are triggered by parturition itself. In a third group women experience a constant level of symptoms throughout. To enable research into the biochemical basis for these differences, the subtypes must be identified.
There is a large rise in plasma oestrogen, progesterone, corticotropic releasing hormone (CRH), and cortisol levels during pregnancy; cortisol, in late gestation, reaches levels found in Cushing’s syndrome and major melancholic depression. Upon parturition levels of all these hormones decrease rapidly. Cortisol, oestrogen and progesterone all have strong psychoactive effects, and their sudden withdrawal may contribute to mood changes. It is possible that depression that starts in pregnancy more closely resembles the melancholic type associated with hypercortisolaemia, while depression that arises postpartum shows more of the symptomatology of the atypical type. Some women experience mild bipolar II depression postpartum, a subtype also associated with atypical symptoms. Different putative factors (genetic, hormonal and social) probably play a greater or lesser part in the etiology of postnatal depression in different women. It is important to distinguish time of onset and resolution of perinatal affective disorder when investigating causal factors and symptom profile.
| Original language | English |
|---|---|
| Title of host publication | New Research on Postpartum Depression |
| Place of Publication | New York |
| Publisher | NY: Nova Science Publishers |
| ISBN (Print) | 1-60021-284-0 |
| Publication status | Published - 2006 |