Peripartum Depression & Ketamine Treatment

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The Many Faces of Postpartum Depression

Formerly referred to as postpartum depression, peripartum depression “refers to depression occurring during pregnancy or after childbirth”; the term peripartum is more inclusive as it recognizes that “depression associated with having a baby often begins during pregnancy” (American Psychiatric Association, 2020).

It is first essential to note the difference between peripartum depression and what we call the “baby blues.” The “baby blues” refers to an acute condition that does not require medical attention as it does not interfere with quotidian life; symptoms include irritability, restlessness, anxiety, and sporadic, seemingly illogical crying episodes (American Psychiatric Association, 2020). A whopping 80% of women experience the “baby blues” (Geisinger, March 9, 2020). This is a somewhat normal response to giving birth.

However, the symptoms of peripartum depression are much more severe and debilitating; new mothers suffering from peripartum depression should seek treatment immediately. In fact, “children of mothers with peripartum depression are at greater risk for cognitive, emotional, development, and verbal deficits and impaired social skills” (American Psychiatric Association, 2020). After all, new mothers experiencing peripartum depression may have issues bonding with their baby, which can, in turn, lead to sleeping and feeding concerns.

In many ways, peripartum depression is similar to dysthymia, or persistent depressive order, as women who experience peripartum depression note feelings of severe, major depression over long periods of time (several months); new mothers experiencing peripartum depression are even at a greater risk of developing dysthymia later on (Johns Hopkins University, 2022). So, what exactly does peripartum depression look like?

As with any mood disorder, one’s lived experience may differ slightly or even dramatically from another’s, yet they hold one thing in common: necessary, mundane activities (i.e., brushing your teeth) become so overwhelming that one’s daily life and habits are disrupted. At this point, medical attention and additional support systems are required. 

Unfortunately, the concept of peripartum depression remains a social taboo, despite the fact that one in nine women experience it (U.S. Department of Health & Human Services, Office on Women’s Health, 2019). It is interesting to note that the American Psychiatric Association claims that actually one in seven women endure peripartum depression.

If peripartum depression is as common as this, whether it be 1 in 9 women or 1 in 7 women, then why do we ostracize the topic from public discourse?

Why Talk About It?

Approximately 20% of new mothers experiencing the “baby blues” will fall into a peripartum depression; this depression is so severe that it can also affect the fathers, so much so that 10% of new fathers will experience symptoms of peripartum depression (Geisinger, March 9, 2020).

Feelings of shame and anxiety wrap new parents experiencing the “baby blues” (let alone peripartum depression) in a chokehold, as we’ve been socially conditioned to believe that having a baby should solely be celebrated as a positive experience. In reality, childbirth can be an incredibly traumatic experience that leaves the mother (and potentially the father) in a state of physical and hormonal disarray.

It is important to note that teen mothers are more likely than adult mothers to experience peripartum depression; according to the Maternity Experiences Survey, peripartum depression was experienced by “14.0% among teen mothers and 7.2% among adult mothers” (Kim, Connolly, Tamim, 2014). This significant discrepancy indicates that social support is crucial for new mothers who experience peripartum depression, regardless of age, race, and ethnicity;  “lack of support can be associated with postpartum depression and can compromise both the mother and infant” (Corrigan, Kwasky, Groh, 2015). In this way, we should normalize the idea that childcare responsibilities include self-care for the mother and father.

 To make matters worse, there is little in the way of economic support for new mothers, whether they are experiencing peripartum depression or not. A primary channel of economic support for new mothers is paid parental leave; while Estonians get 80 weeks, Americans typically get 0 (Francis, Cheung, Berger, 2021).

As previously mentioned, children bonding with their primary caregiver is essential in their development; “successful attachment and bonding in the first two years of life predict healthy later development on a range of fronts, from mental health to educational skills” (Reeves, 2019). Apart from the very real necessity of allowing new parents to care for their newborn child properly, there lies a fundamental economic argument: studies have shown “paid parental leave increases women’s participation in the workforce and reduces gender pay ” (Francis, Cheung, Berger, 2021).

In this way, the need to call for social and economic reform is not just obvious - it’s necessary.

Postpartum Depression & Ketamine

In recent years, studies have shown that “ketamine is proved to have an anti-depression effect with a single administration” (Yao, Song, Zhang, Guo, Zhao, 2020). So, why shouldn’t we explore ketamine’s benefit when it comes to peripartum depression?

Parturient women or women about to give birth who experience prenatal depression (depressive episodes prior to giving birth) are at a severely increased risk of suffering from peripartum depression (Wang, 2019). A study conducted at Peking University First Hospital explored the potential of low-dose S-ketamine treatment “administered after childbirth [to] reduce the incidence of postpartum depression in parturients with prenatal depression” (Wang, 2019). 

A double-blind, randomized clinical trial published in the Journal of Medicine and Life examined women undergoing caesarian sections and the administration of ketamine in the general anesthesia process. This particular study relied on the Edinburgh Postnatal Depression Scale (EPDS) to gather data in three stages: prior to the caesarian section and then two and four weeks after the caesarian section (Alipoor, Loripoor, Kazemi, Farahbakhsh, Sarkoohi, 2021). Although the authors of this study highlight the importance of further research in this specific field, their research found that “using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression” (Alipoor, Loripoor, Kazemi, Farahbakhsh, Sarkoohi, 2021).

Yet another double-blind, randomized clinical trial published in the journal Brain and Behavior studied healthy women (meaning women who weren’t predisposed to peripartum depression through previous mental disorders) undergoing a caesarian section; results showed that “operative intravenous ketamine (0.25 mg/kg) can reduce the postpartum depressive symptoms for 1 week” (Yao, Song, Zhang, Guo, Zhao, 2020).

Avesta Ketamine & Wellness Treatment Options

If you’re a new mother struggling to navigate the trials and tribulations of childbirth and newborn care, Avesta Ketamine & Wellness is here to help support you in your journey towards mental and physical well-being.

As a fully stacked ketamine infusion clinic - with two locations in Bethesda, Maryland, and McLean, Virginia – and a new location coming to DC this spring, Avesta Ketamine & Wellness specializes in ketamine infusion therapy as a means of treating a multitude of mood disorders, especially including peripartum depression. 

Avesta Ketamine & Wellness provides a safe space for peripartum patients to obtain this treatment option. We are here to assist you in your journey as pregnancy ends and motherhood begins.

Contact us today for your free consultation - we can’t wait to help you find your joy again.

 

 

Sources:

Alipoor, M., Loripoor, M., Kazemi, M., Farahbakhsh, F., & Sarkoohi, A. (2021). The effect of ketamine on preventing postpartum depression. Journal of Medicine and Life, 14(1), 87–92. https://doi.org/10.25122/jml-2020-0116

Corrigan, C. P., Kwasky, A. N., & Groh, C. J. (2015). Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States. The Journal of Perinatal Education, 24(1), 48–60. https://doi.org/10.1891/1058-1243.24.1.48

Dysthymia. (n.d.). Retrieved March 16, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysthymia

How does the U.S. compare to other countries on paid parental leave? Americans get 0 weeks. Estonians get more than 80. (2021, November 11). Washington Post. https://www.washingtonpost.com/world/2021/11/11/global-paid-parental-leave-us/

Parental-leave policies. (n.d.). European Institute for Gender Equality. Retrieved March 16, 2022, from https://eige.europa.eu/publications/gender-equality-index-2019-report/parental-leave-policies

Reeves, R. V. (2019, January 31). The Power of Love: Why maternal depression is an economic mobility issue. Brookings. https://www.brookings.edu/research/the-power-of-love-why-maternal-depression-is-an-economic-mobility-issue/

Wang, D.-X. (2021). Effects of Low-dose S-Ketamine on Incidence of Postpartum Depression in Parturients With Prenatal Depression: A Randomized, Double-blind, Placebo-controlled Trial (Clinical Trial Registration study/NCT03927378). clinicaltrials.gov. https://clinicaltrials.gov/ct2/show/study/NCT03927378

What Is Postpartum Depression? (n.d.). Retrieved March 16, 2022, from https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression

Yao, J., Song, T., Zhang, Y., Guo, N., & Zhao, P. (2020). Intraoperative ketamine for reduction in postpartum depressive symptoms after cesarean delivery: A double-blind, randomized clinical trial. Brain and Behavior, 10(9), e01715. https://doi.org/10.1002/brb3.1715

 

 

Author
Dr. Ladan Eshkevari, PhD, CRNA, FAAN Dr. Eshkevari is the lead clinician at Avesta, and is a long time researcher and educator in physiology, biophysics, and anesthesiology. She is passionate about assisting patients with retractable, difficult to treat mood disorders, and relies on the latest research to bring evidence to Avesta's practice to better understand and serve patients.

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