Urinary Incontinence Leads to Depression in New Mothers
Urinary Incontinence Basics
Urinary incontinence can occur when the muscles in the bladder walls contract without warning or with unusual force; it can also occur when the muscles at the bladder entrance don’t form a tight enough seal to keep urine from flowing outward. Some people with these problems leak small amounts of urine, while others experience much more significant uncontrolled urine flows. In addition to pregnancy and childbirth, unique urinary incontinence factors in women include menopause and specific anatomical details of the female urinary tract. Risk factors shared by both women and men include strokes, nerve damage, age-related physical changes, birth defects and complications of multiple sclerosis.
The National Kidney and Urologic Diseases Information Clearinghouse lists specific forms of urinary incontinence that include urge incontinence, stress incontinence, an overactive bladder and mixed incontinence. People affected by urge incontinence lose control of their bladders after experiencing a sharp urge to urinate. People with stress incontinence lose control of their bladders as a result of physical pressure associated with such things as sneezing, coughing, or body changes related to female reproduction. People with overactive bladders lose control of their bladders as a result of malfunctions in the nerves that control bladder contraction. People with mixed incontinence have combined symptoms of more than one type of incontinence (usually stress and urge incontinence); women are particularly susceptible to this form of the condition.
Postpartum Depression Basics
Postpartum depression sometimes arises in the aftermath of a common form of “down” mood in new mothers called postpartum blues. It can also arise separately in new mothers who never go through a normal “blue” phase. Like men and women affected by the disorder called major depression, women with postpartum depression can develop a number of symptoms in addition to a generally depressed mental state, including sleep disruptions, abnormally low energy, a drop in concentration skills, appetite changes, intense forms of guilt or other negative feelings, anxiousness and suicide- or death-related fixations. Additional potential symptoms specifically associated with postpartum depression include lack of interest in a newborn, an inability to care adequately for a newborn, and negative or malicious thoughts or actions toward a newborn. Women who don’t receive treatment for postpartum depression symptoms can develop long-term depression.
Connections Between the Two Conditions
In the study published in the British Journal of Obstetrics and Gynaecology, a team of researchers from McMaster University initially set out to discover whether women who give birth vaginally and through cesarean section have differing risks for developing postpartum depression (the answer to this research question was no). During the course of this investigation, they inadvertently discovered that women who develop urinary incontinence in the aftermath of childbirth experience postpartum depression at almost double the rate of women who don’t develop urinary incontinence after giving birth. In fact, the effects of urinary incontinence were strong enough to qualify the condition as one of the top five risk factors for postpartum depression, along with relatively low levels of postpartum health, lack of participation in breastfeeding, readmission to the hospital following childbirth, and a relatively young age (25 or under).
In a study published in 2007 in International Urogynecology Journal and Pelvic Flood Dysfunction, a team of Dutch researchers examined the relative effects of vaginal birth and cesarean section on a woman’s risks for developing some form of urinary incontinence. The authors of this study concluded that women who develop stress incontinence during the initial phases of pregnancy have higher chances of experiencing stress incontinence after childbirth, regardless of the method of birth involved. During the period of time most commonly associated with postpartum depression (one to three months following childbirth), women who give birth vaginally have somewhat elevated risks for urge incontinence, although these risks disappear after one year. Women who give birth vaginally also have increased risks for stress incontinence in the year following childbirth.