Let’s Talk About the Postpartum Depression

The birth of a child can be one of the biggest and happiest events in a woman's life. Having a newborn is exciting, it fulfills you, but at the same time, it is difficult, stressful.

Pregnancy and the period immediately after birth are periods of risk for a woman's mental health. Postpartum depression (PPD) is the most common postpartum disease. There is a time interval (even a few weeks) between the birth and the onset of depression, which does not set in brutally but in an insidious manner. It usually occurs between the second and eighth postnatal week.

Postpartum depression is characterized by numerous episodes of crying, irritability, marked fatigue, decreased sexual interest, anxiety, headache, palpitations, chest pain, changes in appetite, negative thoughts, difficulty making decisions, concentration, memory, sleep problems (not due to the child crying or having to be fed), despair, sometimes even a feeling of fear, shame or guilt to suicidal thoughts.

Normally there is a short period (3–5 days) immediately after birth when the new mother feels an inexplicable sadness until her body adapts to the new condition (physical, hormonal, and mental). If this period is prolonged and the symptoms increase, consult a doctor.

It is estimated that one in ten mothers will experience postpartum depression. Women who develop DPP may go undiagnosed because their mother is most often seen by an obstetrician at birth and a six-week check-up. There is still the family doctor and the pediatrician who examines the mother and the baby, but this also happens weekly in the first month after the birth and then every two months.

It is important to diagnose depression after birth. There is specific treatment. Untreated can diminish the joy of being a mother. Moreover, the child is at a higher risk of developing depression over time.

Depression can negatively affect the mother-child relationship

Numerous factors are associated with DPP: biological, interpersonal, intrapsychic. There are no racial differences, but rather some socio-economic ones: mothers from disadvantaged backgrounds have a greater predisposition to depression.

Regardless of this, family support has a central role: both that of the husband and that of friends and parents. The couple's problems are also at the root of the DPP, as is domestic violence. Other elements can play a detrimental role on the mental state of the young mother: multiple pregnancies, fetal malformation, or drug addiction. It seems that women living in the city are more at risk of this disease than women in the country.

And the context of the birth is very important: prolonged labor, difficult expulsion, use of forceps, general anesthesia, cesarean section are circumstances that favor depression. If the pregnancy was not desired, the woman is unprepared, the birth and the demands of the newborn to feed induce the feeling of self-depreciation and incompetence that can trigger the symptoms.

A psychiatric history, a negative perception of a change in body image, a marked sadness from the first postpartum days, or even a euphoric state are alarm signals. Irritable, the mother misunderstands her baby, who in turn becomes agitated and creates a vicious circle that can lead to neglect or abuse.

The role of family and friends

The newborn of a depressed mother is nervous, may vomit, and even die suddenly. DPP also has repercussions on the couple's life: husband's depression and, in almost one in ten cases, divorce. The role of the family and especially of the husband is very important in the therapy of postpartum depression, which is desirable to encourage her in discussions to show her understanding, to offer her emotional support.

It is good to limit the visits and to say with courage "no" when the new mother does not want them. The help of people who offer to contribute to household chores is auspicious. It should be noted that DPP is treated and the treatment leads to complete remission. The therapy depends on the severity of the depression (through psychotherapy and medication, with antidepressants frequently in combination with anxiolytics and hypnotics, recommended by the specialist, if the woman is not breastfeeding, when they are contraindicated).

When hospitalization is necessary, it will be done preferably mother-child. The mother needs to relearn to take care of the child, in parallel with the improvement of his condition. Couple or group therapies are very effective. The earlier DPP is recognized and treated, the sooner a woman can enjoy her new life as a mother!