PPD
Self Test
It is very important to detect PPD early.
In most of the cases, PPD is preventable
and early detection of risk factors can lead to early diagnosis
and early treatment.
Depression Self-Screeners:
Quick Inventory of Depressive Symptomatology
Falling Asleep:
I never take longer than 30 minutes to fall asleep. (0 point)
I never take longer than 60 minutes to fall asleep. (1 points)
I take at least 30 minutes to fall asleep, more than half
the time. (2 points)
I take more than 60 minutes to fall asleep, more than half
the time. (3 points)
Sleep During the Night:
I do not wake up at night. (0 points)
I have a restless, light sleep with a few brief awakenings
each night. (1 point)
I wake up at least once a night, but I go back to sleep
easily. (2 points)
I awaken more than once a night and stay awake for 20 minutes
or more, more than half the time. (3 points)
Waking Up Too Early:
Most of the time, I awaken no more than 30 minutes before
I need to get up. (0 points)
More than half the time I awaken more than 30 minutes before
I need to get up. (1 point)
I almost always awaken at least one hour or so before I
need to, but I go back to sleep eventually. (2 points)
I awaken at least one hour before I need to, and can't go
back to sleep. (3 points)
Sleeping
Too Much
I sleep no longer than 7-8 hours/night, without napping
during the day. (0 points)
I sleep no longer than 10 hours in a 24-hour period including
naps. (1 point)
I sleep longer than 12 hours in a 24-hour period including
naps.(2 points)
Feeling
Sad:
I do not feel sad. (0 points)
I feel sad less than half the time. (1 point)
I feel sad more than half the time. (2 points)
I feel sad nearly all of the time. (3 points)
Decreased
Appetite:
There is no change in my usual appetite. (0 points)
I eat somewhat less often or lesser amounts of food than
usual. (1 point)
I eat much less than usual and only with personal effort.
(2 points)
I rarely eat within a 24-hour period, and only with extreme
personal effort or when others persuade me to eat.
(3
points)
Increased
Appetite:
There is no change from my usual appetite. (0 points)
I feel a need to eat more frequently than usual. (1 point)
I regularly eat more often and/or greater amounts of food
than usual. (2 points)
I feel driven to overeat both at mealtime and between meals.
(3 points)
Decreased
Weight (Within the Last Two Weeks):
I have not had a change in my weight. (0 points)
I feel as if I've had a slight weight loss. (1 point)
I have lost 2 pounds or more. (2 points)
I have lost 5 pounds or more. (3 points)
Increased
Weight (Within the Last Two Weeks):
I have not had a change in my weight. (0 points)
I feel as if I've had a slight weight gain. (1 point)
I have gained 2 pounds or more. (2 points)
I have gained 5 pounds or more. (3 points)
Concentration/Decision
Making:
There is no change in my usual capacity to concentrate or
make decisions. (0 point)
I occasionally feel indecisive or find that my attention
wanders. (1 point)
Most of the time, I struggle to focus my attention or to
make decisions. (2 points)
I cannot concentrate well enough to read or cannot make
even minor decisions. (3 points)
View
of Myself:
I see myself as equally worthwhile and deserving as other
people. (0 points)
I am more self-blaming than usual. (1 point)
I largely believe that I cause problems for others. (2 points)
I think almost constantly about major and minor defects
in myself. (3 points)
Thoughts
of Death or Suicide:
I do not think of suicide or death. (0 points)
I feel that life is empty or wonder if it's worth living.
(1 point)
I think of suicide or death several times a week for several
minutes. (2 points)
I think of suicide or death several times a day in some
detail, or I have made specific plans for suicide or have
actually tried to take my life. (3 points)
General Interest:
There is no change from usual in how interested I am in
other people or activities. (0 points)
I notice that I am less interested in people or activities.
(1 point)
I find I have interest in only one or two of my formerly
pursued activities. (2 points)
I have virtually no interest in formerly pursued activities.
(3 points)
Energy
Level:
There is no change in my usual level of energy. (0 points)
I get tired more easily than usual. (1 point)
I have to make a big effort to start or finish my usual
daily activities (for example, shopping, homework, cooking
or going to work). (2 points)
I really cannot carry out most of my usual daily activities
because I just don't have the energy. (3 points)
Feeling
Slowed Down:
I think, speak, and move at my usual rate of speed. (0 points)
I find that my thinking is slowed down or my voice sounds
dull or flat. (1 point)
It takes me several seconds to respond to most questions
and I'm sure my thinking is slowed. (2 points)
I am often unable to respond to questions without extreme
effort. (3 points)
Feeling
Restless:
I do not feel restless. (0 points)
I'm often fidgety, wringing my hands, or need to shift how
I am sitting. (1 point)
I have impulses to move about and am quite restless. (2
points)
At times, I am unable to stay seated and need to pace around.
(3 points)
Depression
Self-Screener Results:
(Range 0-27)
None 0-5
Mild 6-10
Moderate 11-15
Severe 16-20
Very Severe 21+
NOTE: The above cutoff points are based largely
on clinical judgment rather than on empirical data.
© 2000, A. John Rush, M.D., Quick Inventory of Depressive
Symptomatology (Self Report) (QUIDS-SR)
Edinburgh
Postnatal Depression Scale
Please
underline the answer, which comes closest to how you have
felt in the past seven days, not just how you feel today.
IN THE PAST 7 DAYS
A.
I have been able to laugh and see the funny side of things
(0) As much as I always could
(1) Not quite so much now
(2) Definitely not quite so much now
(0) No, not at all
B.
I have looked forward with enjoyment to things
(0) As much as I ever did
(1) Rather less than I used to
(2) Definitely less than I used to
(3) Hardly at all
C.
I have blamed myself unnecessarily when things went wrong
(3) Yes, most of the time
(2) Yes, some of the time
(1) Not very often
(0) No, never
D.
I have felt worried and anxious for no very good reason
(0) No, hardly at all
(1) Hardly ever
(2) Yes, sometimes
(3) Yes, very often
E.
I have felt scared or panicky for no very good reason
(3) Yes, quite a lot
(2) Yes, sometimes
(2) No, not much
(1) No, not at all
F. Things have been getting on top of me
(3) Yes, most of the time I havent been able to cope at all
(2) Yes, sometimes I havent been coping as well as usual
(1) No, most of the time I have coped quite well
(0) No, I have been coping as well as ever
G.
I have been so unhappy that I have had difficulty sleeping:
(3) Yes, most of the time
(2) Yes, sometimes
(1) Not very often
(0) Not at all
H. I have felt sad and miserable:
(3) Yes, most of the time
(2) Yes, quite often
(1) Not very often
(0) No, never
I.
I have been so unhappy, that I have been crying:
(3) Yes, most of the time
(2) Yes, quite often
(1) Only occasionally
(0) No, never
J.
The thought of harming myself has occurred:
(3) Yes, quite often
(2) Sometimes
(1) Hardly ever
(0) Never
The
total score is calculated by adding together the scores for
each of the ten items underlined.
Score of 9/10 should be further evaluated by psychiatric
professional
Score of 12/13 - most likely experiencing a major depression
NOTE:
If your score were high on any of these tests, would be
the best to call your doctor, OB/GYN doctor or your child’s
pediatrician.
PPD
Treatment
Postpartum depression is treated much like other types of
depression. Support, counseling (“talk therapy”)
and medications can help. Treatment depends on the nature
and severity of the postpartum depression and it is important
to recognize that it is both temporary and treatable.
Breastfiding and medication
Women who are breastfeeding their infants and plan to take
medication must be informed that all psychotropic medications
, including antidepressants, are secreted into breast milk.
Concentrations of medication in breast milk vary widely, and
some of them have toxic effect in infants. Long-term effects
of exposure to mother’s medication in breastfeeding
infants are not known. The best advice for women who want
to continue breastfeeding is to talk to their doctors to determine
the most suitable treatment option.
Other
postpartum mental health disorders:
Postpartum
PTSD (Post Traumatic Stress Disorder)
Since the childbirth is by itself major life change and can
cause a great deal of stress and could result in PTSD or PPD.
“Baby
Blues”
Baby blues refers to mild depressive symptoms that are common
to many new mothers (approximately 50 percent). New mothers
could develop symptoms in 3-4 days after delivery and lasts
for the couple of weeks. This condition is characterized by
sudden mood swings that range from euphoria to intense sadness.
Symptoms of baby blues include mild depression, anxiety, mood
swings, irregular eating and sleeping pattern, and difficulty
concentrating. These symptoms are normal reaction to the stress
and added parental responsibility that having a baby brings.
The baby blues usually resolve by it self and does not require
treatment.
Postpartum
psychosis
Postpartum psychosis is mental illness that is more serious
and requires immediate medical treatment. Hallucinations and
delusions, bizarre behavior and feelings characterize postpartum
psychosis. These symptoms usually appear within the first
two months after the childbirth. New mothers with postpartum
psychosis could hurt the babies including child abuse and
infanticide, or commit suicide. This condition is rare and
affecting one in 1000 new mothers, and postpartum psychosis
cause significant distress and dysfunction. Postpartum psychosis
is a serious mental illness that affects one in 500-1,000
new mothers. The onset is usually within the first three months
after delivery and may cause the mother to completely lose
touch with reality. She may have thoughts of harming herself
or her child. Counseling, combined with medication and education
in stress reduction, generally leads to recovery.
Postpartum
Depression
Women who experience the “baby blues” are at an
increased risk of developing PPD. The condition PPD occurs
in 10 to 20 percent of pregnancies and is characterized by
more intense feelings of sadness, despair, anxiety and irritability.
The symptoms are longer lasting and may occur anytime within
the first year. It often affects a woman's ability to function,
and without medical attention, the symptoms may worsen.
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