Postpartum Depression

What is postpartum depression?

They say having a baby is supposed to be the happiest event of your life. Everyone gets excited about the idea but having a baby is not always what you expect. Even if your baby is the cutest one ever born! Having a baby is challenging, both physically and emotionally. It is natural for many new mothers to have mood swings after delivery, feeling happy one minute and depressed the next. These feelings are sometimes known as the “baby blues” and usually start within three days of giving birth and lasting up to 14 days. Up to 80% of mothers experience these blues. Symptoms include sadness, crying spells, poor concentration, and irritability. Reassurance and understanding of what’s going on, taking care of yourself and getting support will help you to feel better. These feelings usually pass without treatment.

Some women, however, may experience a deep and ongoing depression which lasts much longer. This is called postpartum depression. This depression can begin at any time within four weeks post-birth, and may last up to several months or even a year. Postpartum depression is a common illness that can be effectively treated and prevented. The sooner the condition is diagnosed, the more effective the treatment.

Symptoms

Below are some typical symptoms. If you have been feeling any of these symptoms for more than two weeks you may have a postpartum depression.

• Sad and tearful mood
• Worn out, but unable to sleep
• Changes in appetite
• Overwhelmed and can't concentrate or make decisions
• No interest or pleasure in activities you used to enjoy
• Restless, irritable or angry
• Anxiety, you may feel this as aches, chest pain, shortness of breath, numbness, tingling or "lump" in the throat
• Not yourself
• Ashamed, hopeless or frustrated
• A bad mother
• Feelings of inadequacy, guilt, worthlessness
• Not bonding with the baby, afraid to be alone with the baby
• Have repeated scary thoughts about the baby, or of harming the baby
• Suicidal thoughts

How common is it?

Almost 15% of women will suffer from some degree of postpartum depression and other postpartum mood disorders after the birth of a baby. Postpartum depression is the most common complication of child-bearing. Despite the sensational stories in the media, postpartum depression it is not unusual or scary. It is actually quite common.

What causes it?

It is not your fault. It is not a sign of weakness and you don’t have to suffer and tough it out. The exact cause of this disorder is not known but physical, hormonal, social, psychological and emotional factors may all play a part in triggering this illness. It is important to understand that this is a medical condition and you did not bring it on yourself.

Some women are more likely to develop this disorder. You are more at risk if you have:

• Been depressed or anxious during your pregnancy
• A history of depression and/or other mood disorders
• Family members with mood disorders
• Had a recent stressful life event such as a move or a loss in the family, or complicated pregnancy, labour or delivery
• Little social support
• Relationship difficulties with close family members
• Severe premenstrual syndrome (PMS)

How is postpartum depression treated?

There are many safe treatments. As with any medical condition speak with your health care provider to consider risks and benefits to decide what is best for you. Therapy, support networks and medicines such as antidepressants are used to treat postpartum depression. Counseling and psychotherapy has been shown to be an effective treatment and an acceptable choice for women who wish to avoid taking medications while breastfeeding. And social supports by a public health nurse, friends and family can help.

How can family help?

Family can best help by assisting with meals, laundry, shopping etc. Trying to help by taking care of the baby may be more fun but can undermine a new mother’s confidence in her parenting and interfere with the new bond between mother and child. If you are concerned about a family member developing postpartum depression, encourage them to seek out support and to get checked out by their health care provider. If invited, you can offer to accompany them to their initial appointment and convey your concerns.

Coping with postpartum depression

First, remember that you are not alone and you are not to blame. Here are some suggestions for coping:

• Focus on short-term, rather than long-term goals. Build something to look forward to into every day, such as a walk, a bath, a chat with a friend
• Look for free or inexpensive activities; check with your local library, community centre or place of worship
• Take care of yourself. Try to rest, eat healthy foods and get some fresh air and exercise.
• Getting as good nights sleep as possible is important and sleep assisting medications might be helpful.
• Take time for yourself. Accept offers for help with household chores and brief baby-sitting so you can have a break.
• Spend time with your partner and/or close friends
• Share your feelings and ask for help
• Consult your doctor and look for a local support group
• Go to your local emergency room anytime if in crisis (thoughts/plans to hurt yourself, others or baby).

More information

For further information about postpartum depression contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

Related Web Sites:

Centre for Addiction and Mental Health

Canadian Mental Health Association

Pacific Postpartum Support Society

Postpartum Support International

Depression After Delivery

Online PPD Support Group

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What is Schizophrenia?

Schizophrenia is a mental health condition caused by a disorder of the brain's functioning. It can seriously disturb the way people think, feel and relate to others. People with schizophrenia are often misunderstood and blamed for their behaviour. It is important to understand that this is a medical disorder and it is not the person’s fault. It’s not due to lack of effort, intelligence, or anything a parent, family or friends did or didn’t say or do.

How common is schizophrenia?
About one person in 100 develops schizophrenia. Men and women are affected equally; however, men tend to have their first episode of schizophrenia in their late teens or early 20s. With women, it is usually a few years later.

What are the symptoms?
The symptoms of schizophrenia vary greatly from person to person, from mild to severe. A specialist is needed to make the diagnosis, especially because there is no such thing as a simple schizophrenia test.
Making it even harder to diagnose, schizophrenia often starts slowly. When the symptoms first appear, usually in adolescence or early adulthood, they may seem more confusing than serious.

In the early stages, people with schizophrenia may find themselves losing the ability to relax, concentrate or sleep. They may start to shut their friends and family out of their lives. Work or school begins to suffer; so does their personal appearance. During this time they may talk in ways that could be difficult to understand and they may start to perceive things in an unusual way.

Once it has taken hold, schizophrenia tends to come and go.

Other symptoms may include include:

•delusions (false beliefs that are not consistent with the person's culture, and have no basis in fact, maybe weird or paranoid)

•hallucinations (people hear, see, taste, smell or feel something that does not actually exist)

•disorganized thought (unconnected thoughts that make it impossible to communicate clearly with other people)

•disorganized mood (finding it hard to express feelings; feeling inappropriate or intense bursts of emotion; feeling empty of any emotions)

•disorganized behaviour (odd behavior or cannot complete everyday tasks such as bathing, dressing appropriately and preparing simple meals)

•changes in sensitivity (more sensitive and aware of other people; or withdrawn and seeming to pay no attention to others).
Causes

No single cause has been found for schizophrenia, although there is a clear genetic link.

Treatments
Treatment usually consists of medication and counseling. Antipsychotic medications are the main class of drugs used to treat schizophrenia. Psychotherapy can offer understanding, reassurance and suggestions for handling the emotional aspects of the disorder and providing less stressful living situations. Social supports for housing, finances and employment or daily activity are important for treatment and recovery. Families, friends and coworkers can benefit from education and support.

Recovery
It is impossible to predict how well a person will recover after the onset of the disorder. Some will recover almost totally. Some people will need medication and support for the rest of their lives.

More information

For further information about schizophrenia contact a community organization or your family doctor to find out about support and resources available in your community.

Websites:

National Network for Mental Health

Schizophrenia Society of Canada

Canadian Mental Health Association

Centre for Addiction and Mental Health

mentalhealthminute.com

What is Psychosis?

What is psychosis?

Psychosis is a loss of contact with reality due to an interruption in how the brain works. When people can't tell the difference between what is real and what is not, it is called a psychotic episode. A first episode of psychosis is often very frightening, confusing and distressing, particularly because it is an unfamiliar experience.

Sometimes psychosis emerges gradually over time, so that symptoms might be ignored in the early stages. Other times, symptoms appear suddenly and are very obvious to the individual and those around them. Symptoms vary from person to person and can change over time.

Who gets psychosis?
Psychosis can affect anyone; however, people with a family history of serious mental illness are at increased risk of developing psychosis.
Psychosis usually first appears in a person's late teens or early 20s. Approximately three out of every 100 people will have a psychotic episode in their lifetime. Psychosis occurs in men and women and across all cultures and socioeconomic groups.

A number of mental illnesses can include psychosis as a symptom, including schizophrenia

What are the symptoms of psychosis?

Symptoms of psychosis can vary from person to person and may change over time. Some common symptoms are:

•changes in thinking patterns (difficulty concentrating; loss of memory; disconnected thoughts)

•delusions (fixed, false beliefs that are not consistent with the person's culture, and have no basis in fact, sometimes weird or paranoid)

•hallucinations (people hear, see, taste, smell or feel something that does not actually exist)

•changes in mood (finding it hard to express feelings; feeling inappropriate or intense bursts of emotion; feeling empty of any emotions; depression)

•very disorganized behaviour (strange behaviours, or cannot complete everyday tasks such as bathing, dressing appropriately and preparing simple meals)

•thoughts of death or suicide

•feeling their thoughts have sped up or slowed down

•feeling preoccupied with unusual ideas

•belief that others can manipulate their thoughts; or that they can manipulate the thoughts of others

What causes psychosis?

There can be many causes for the brain to not work properly and start imagining things. Sometimes psychosis is secondary to a toxic substance like drugs, alcohol, supplements or medications. Sometimes it’s due to a medical disturbance like an infection, hormone abnormality, seizure disorder, or other medical illness. Sometimes it’s secondary to a severe mood disorder like depression or bipolar disorder. Often it’s a primary psychosis due to reasons that we do not entirely know the cause of.

In some cases, we do not know what causes a first episode of psychosis. Current research shows that biological and genetic factors raise the risk of having psychosis. Brain chemistry may effect psychosis. What’s clear is that it’s not due to a person being weak, or unintelligent or anything they or their family did or didn’t do or say.

When psychosis occurs for the first time it is difficult to know the cause. Psychosis is associated with a number of medical conditions including schizophrenia, depression, bipolar (manic-depressive) disorder and substance abuse, among others. Because the first episode of psychosis can signal a variety of conditions, it is important to seek a thorough medical assessment.

Can psychosis be treated?
Psychosis can be treated, and many people make a good recovery, especially if they get help early. Treatment usually consists of medication and counseling.
Throughout treatment, families can receive support and education during sessions with the treatment team.

Medication called antipsychotic medication is usually essential. It relieves symptoms of psychosis and may prevent further episodes of illness. With proper treatment, most people recover fully from the first episode of psychosis. For many, the first episode is also the last. Antipsychotic medications have many benefits, and as with all medication some risks and side effects. It’s important to discuss these with your care provider. And research and newer treatments are being developed.
Sometimes people with psychosis benefit from hospitalization for safety, support and stabilization at some point in their treatment and recovery path.

Recovery
Recovery from a first episode of psychosis varies from person to person. Sometimes symptoms go away quickly and people are able to resume their regular life right away. Other people may need several weeks or months to recover. Some people will need medication and support for the rest of their lives.

More information

For further information about psychosis contact a community organization or your family doctor to find out about support and resources available in your community.
Websites:

National Network for Mental Health

Schizophrenia Society of Canada

Canadian Mental Health Association

Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Australia

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What is Obsessive Compulsive Disorder? (OCD)

What is obsessive compulsive disorder?

Everyone experiences concern and uneasiness from time to time. We may worry about a problem at work or school, about money, health, or if the Leafs are going to win the Stanley Cup. But if you can’t stop worrying and it’s interfering with your life you may be experiencing obsessions as part of obsessive compulsive disorder (OCD). Sometimes you know the thing you’re worrying about is ridiculous and makes little sense, but it bothers you anyway. For example, someone with OCD may have a constant worry that they have left the stove on, or not locked the door, even though you know you had. Or maybe you have to repetitively check, clean or organize things way beyond what’s reasonable, but you feel compelled to anyhow. It often annoys people around you and can cause problems for you at work, or in your relationships.
When worries overwhelm someone, we call them "obsessions." Obsessions are uninvited thoughts that surface in the mind over and over again. People with OCD know their obsessions are unrealistic, but they can't get rid of them, they can't control them, and they can't ignore them.

To relieve the feelings of distress and anxiety, people with OCD often try to reduce their anxiety by acting out certain rituals, or compulsive behaviours, over and over again. These rituals may include repeated washing, checking and arranging things, and counting. Performing these actions give people only temporary relief from their anxiety.

Who suffers from OCD?
OCD afflicts about one adult in 40, making it twice as common as schizophrenia and bipolar disorder, and the fourth most common psychiatric disorder. OCD is believed to be a disorder that is related to family history and how someone’s brain works. OCD can occur in people of all ages, but it generally begins before age 40. Studies show that the disorder usually begins during adolescence or early childhood. It affects men and women equally.

How to treat OCD
While a complete cure for OCD is rare, specialized treatment can bring many people long-term relief from their symptoms.
Two effective treatments for OCD have been developed: medication and a type of psychotherapy called cognitive-behavioural therapy (CBT). Used together, these treatments can be effective.
Psychotherapy techniques used to combat OCD symptoms involve encouraging a person to stay in contact with the object or situation that forms the obsession, and to not perform the ritual to ease the pressure of that obsession. Depending on the intensity of the therapy, improvement may be seen within 2 or more months. Yes, the best thing to help is to purposely expose yourself to the feared thought or situation and not be allowed to engage in the compulsive safety activity that’s become an unnecessary compulsive habit. Technically therapists refer to this as “exposure and response prevention”.

Coping with OCD
With early diagnosis and the right treatment, people can avoid the suffering that comes with OCD. They also have a greater chance of avoiding depression and relationship problems that often exist with OCD. Families, friends and coworkers can benefit by understanding what’s going on in OCD. Family, friends and coworkers often get pulled in to someone’s OCD demands in an effort to try and be helpful. But before long they feel hostage to the OCD demands and can become resentful. It’s best if they don’t participate in another person’s OCD demands, even though the person with OCD may protest.

More information

For further information about OCD contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

Websites:

Centre for Addiction and Mental Health

Obsessive Compulsive Foundation

Anxieties.com

Canadian Network for Mood and Anxiety Treatments

mentalhealthminute.com

What is Depression?

It’s part of normal human existence to feel down, depressed and sad at times. We have all said ‘I’m so depressed’ after being dumped or failing an exam, or when your favorite team loses the game. But when a health care provider talks about Depression they’re referring to something different. Clinical depression, medical depression or a Major Depressive Episode is more than being sad or feeling down. Clinical Depression is a condition which can affect your thoughts, feelings, physical health and behaviors. The people who called named the condition Depression must not have been very wise, as naming a clinical condition with the same name as a normal mood feeling creates confusion.

The main symptom of depression includes a sad, hopeless mood that:
•is present most days and lasts most of the day
•lasts for more than two weeks
•interferes with your ability to perform at work, at school or in social relationships.

For some the main symptom of depression is not as much their mood as much as
•a loss of interest or pleasure in things they usually are interested in or enjoy

Other symptoms of major depression may include:
•Changes in appetite or weight loss or gain
•Trouble falling asleep, staying asleep or sleeping too much
•Loss of interest in work, hobbies, people or sex
•Withdrawal from family members and friends
•Irritability
•Loss of energy, feeling very tired
•Trouble concentrating, remembering and making decisions-you might fear you’re developing Alzheimer’s disease
•Crying easily, or feeling like crying but being not able to
•Thoughts of suicide (which should always be taken seriously)
•A loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions).
•Feeling worthless, helpless or hopeless
•Overwhelming feelings of sadness or grief

Who gets depression?
At any given time, almost three million Canadians have serious depression. It occurs in 10-15% of men and 15-25% of women

What causes depression?
There is no one cause of depression, neither is it fully understood, however several factors may play a part. These include a family history of depression, problems with brain chemistry, or a major stress in a person's life.

Types of depression

Different types of depression have different symptoms. These include:

•Seasonal depression or seasonal affective disorder
Usually affected by the weather and time of the year.

•Postpartum depression
Occurs in women, following the birth of a child. About 13 per cent of women will experience this type of depression.

•Depression with psychosis
Depression may become so severe that a person loses touch with reality and experiences hallucinations (hearing voices or seeing people or objects that are not really there) or delusions (beliefs that have no basis in reality).

•Dysthymia
A chronically low mood with moderate symptoms of depression.
Depression is not a weakness or character flaw. It’s not your fault. It is a clinical condition. If you think you may be suffering from depression, don’t be embarrassed. This is not something you can fix alone, but a health professional can help!

How to treat depression
Depression is the most treatable of mental illnesses. Between 80-90% of all depressed people respond to treatment and nearly all depressed people who receive treatment see at least some relief from their symptoms.
The most commonly used treatments are medication, psychological, lifestyle and relationship counseling and sometimes electroconvulsive therapy. These treatments may be used individually or in combination. Support from family, friends and self-help groups can also make a big difference.

More information

For further information about depression contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

To see if you might be suffering from clinical Depression try a self test at http://www.checkupfromtheneckup.ca/

Web Sites:

National Institute of Mental Health
http:www//nimh.nih.gov

Depression is a Treatable Illness: A Patient's Guide http://mentalhealth.com/bookah/p44-dp.html

Understanding Depression
http://www.camh.net/about_addiction_mental_health/depression.html

Online Depression Screening
Sponsored by the National Mental Health Association
http://www.depression-screening.org/screeningtest/screeningtest.htm

Mood Disorders Association
http://www.mooddisorders.on.ca/dep.html

Canadian Mental Health Association http://www.cmha.ca/bins/content_page.asp?cid=3-86-87〈=1

Canadian Network for Mood and Anxiety Treatments
http://www.canmat.org

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What is Anxiety Disorder?

Anxiety is the body’s natural response to a stressful or dangerous situation. In these situations the body reacts by causing the heart to beat faster, the palms to sweat and the mind to race. These are normal responses to stress and danger that we have all experienced when public speaking or walking down a dark alley alone. The physical symptoms are the result of stress hormones like adrenaline activating your body. They’re not generally dangerous but they can be uncomfortable when you don’t know why they’re occurring.

An anxiety disorder is when one's body reacts to a situation as though it is highly stressful but in fact the situation is not at all dangerous. In many cases the person recognizes these fears as irrational, yet they are unable to control how their body is reacting.

If you have broken into a cold sweat with your heart pounding while waiting in line at the supermarket, you may be suffering from an anxiety disorder. Reacting this way is not your fault. These conditions are medical disorders and help is available.
What are the symptoms of an anxiety disorder?
After experiencing such panic attacks, individuals with anxiety disorder often begin to avoid certain things, like road trips and airplanes, only entering situations if there is a chance of escape.

Agoraphobia, a type of anxiety disorder, is the fear of being in places or situations which would be difficult to escape from, or in which it would be difficult to find help, should a person suffer a panic attack. People with agoraphobia often avoid public transport or shopping malls; others refuse to leave their homes, sometimes for years at a time.

Social anxiety disorder, or social phobia is another form of anxiety where people suffer from extreme shyness and fear social interactions like meeting new people, speaking to others or social events. The focus of the fear is on being judged or scrutinized by others about how you look, what you say or what you assume people are thinking about you. It results in avoiding social situations or tolerating them with great distress, or abusing alcohol or substances to try and tolerate the fear.

Generalized anxiety disorder is an ongoing feeling of worry and physical anxiety that is there most all of the time. It may never build up to a panic attack. The worry is usually about normal things like family, finances, health etc.

Many individuals with anxiety disorders have difficulty with relationships, school, work and social activities.

Who gets anxiety disorders?

Anxiety disorders, including phobias and panic disorder, are among the most common of mental health problems. It is estimated that 2 million Canadians suffer from panic disorders. Women are roughly twice as likely as men to be diagnosed with panic disorder.

How can anxiety disorders be treated?

Treatment exists to help people with phobias and panic disorder, and research into new therapies and techniques continues.
Currently, the best evidenced ways to treat an anxiety disorder include medication, cognitive-behaviour therapy (CBT) or a combination of the two. Treatment choice will depend on the type of anxiety disorder as well as any additional illnesses such as depression or alcohol abuse. Another useful technique includes relaxation training.
More information

For further information about anxiety disorder and agoraphobia contact a community organization or your family doctor to find out about support and resources available in your community.

Web Sites:

Mood Disorders Association of Ontario
http://www.mooddisorders.ca

National Network for Mental Health
http://www.nnmh.ca

Anxieties.com
http://www.anxieties.com/home.htm

NIMH Anxiety Disorders Education Program
http://www.nimh.nih.gov/anxiety

Canadian Mental Health Association
http://www.cmha.ca/bins/index.asp

Anxiety Disorders Association of Ontario
http://www.anxietyontario.com

Psych Direct (McMaster University)
http://www.fhs.mcmaster.ca/direct

Canadian Network for Mood and Anxiety Treatments
http://www.canmat.org

Social Phobia/social anxiety Association
http://www.socialphobia.org

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What is Bipolar Disorder?

Everyone has ups and downs; feeling happy, sad and angry is normal. But if you are experiencing extreme mood swings, laughing more than you normally would or crying at the smallest thing, you may be suffering from bipolar disorder. It used to be called Manic Depression.

Bipolar disorder is no one’s fault. It does not come from a “weak” or unstable personality. It’s got nothing to do with being smart or with your intelligence. It is a condition that can be treated.

Bipolar disorder typically consists of three states:
1. a high state, called “mania”, or hypomania when part way high
2. a low state, called “depression”
3. a well state, during which many people feel normal and function well.

Typically a person with Bipolar disorder will have episodes throughout their life in which they’re mood may be high, low or regular. Low mood depressed states are more common than high typically lasting for months. Low periods usually last longer than high periods, which typically last days, weeks or a few months. There are well periods of regular mood as well.

Signs and symptoms of mania include but are not limited to:
•Extreme happiness
•Extreme irritability
•Rapid, unpredictable emotional changes
•Racing thoughts
•Overreacting, misinterpreting events
•Increased interest in activities
•Overspending
•Feeling invincible or all powerful, inflated self-esteem
•Excessve energy
•Decreased need for sleep
•Increased sexual drive, sexual indiscretions
•Poor judgment

Signs and symptoms of depression include but are not limited to:
•Sad mood
•Preoccupation with failures or inadequacies and a loss of self-esteem
•Feelings of uselessness, hopelessness, excessive guilt
•Slowed thinking, forgetfulness, difficulty in concentrating and in making decisions
•Loss of interest in work, hobbies, people
•Social isolation
•Abnormal drowsiness
•Agitation
•Changes in appetite or weight - eating too little or too much
•Oversleeping or insomnia
•Decreased sexual drive
•Suicidal thoughts

Prevalence

You or someone you care about may have been diagnosed with bipolar disorder. You may now feel alone in facing the problems of the illness, but you are not alone. About one to two per cent of adults worldwide suffer from bipolar disorder. Men and women are affected equally.

What causes bipolar disorder?
Unfortunately we do not know the answer to this question! However, research shows that genes play a strong role. Stress or difficult family relationships do not cause the illness but these factors may "trigger" an episode in someone who already has the illness. In some women, bipolar disorder may appear during pregnancy or shortly after it. There are medical clues to the brain’s mood regulation system not working as it should and allowing the normal ups and downs to swing too far and for too long.

How can bipolar disorder be treated?
The most common treatments are medication and counselling/psychotherapy. These can be used alone or in combination with other treatments. Approximately one in three people with bipolar disorder will remain completely free of symptoms just by taking mood stabilizing medication. These mood stabilizers return mood to their normal state and try to prevent illness episodes and keep moods in a healthy range. Like other medical disorders such as high blood pressure or diabetes, bipolar disorder can be effectively managed and controlled by combining treatment and a healthy lifestyle. Unfortunately people sometimes get so unwell that they require hospitalization for support and to protect them from their illness.

More information

For further information about bipolar disorder contact a community organization or your family doctor to find out about support and resources available in your community.

Websites:
"Bipolar Screening Tool"
http://www.fhma.com/bipolar_02.html

Treatment of Bipolar Disorder: A Guide for Patients and Families, Kahn/Ross/Printz/Sachs, 2000.
http://www.psychguides.com/Bipolar_2000_Guide.pdf

Bipolar Disorder: A Summary of Clinical Issues and Treatment Options, Canadian Network for Mood and Anxiety Treatments, 1997
http://www.canmat.org/psychs/index.html

Mood Disorders Association
http://www.mooddisorders.on.ca/bipolar.html

Canadian Mental Health Association
http://download.cmha.ab.ca/Edmonton/Bipolar%20Disorder.pdf

National Network for Mental Health
http://www.nnmh.ca

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Treatment

This section focuses on getting help and learning about options that are available. Here you'll find helpful links and information about treatments including talk therapies, individual, marital and family counseling. Learn about the use of medications for mental health problems including sleep agents, antidepressants, anti-psychotics and anti-anxiety drugs. Learn about how other medical illnesses and physical conditions can affect our mental health. Massage therapy, meditation, acupuncture, and even spiritual assistance can also help keep our mental health on track. Please come back soon for new information.

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