Definition
What is postpartum depression?
For the new mother, the birth of the baby can provoke a cascade of intense and conflicting emotions, ranging from excitement and joy to attacks of anger and anxiety, but it can also result in something that is not expected, such as postpartum depression.
Many "novice" mothers experience a physiological malaise called "baby blues," which often occurs after the baby is born and which generally includes mood swings and crying fits that resolve quickly. Other new mothers, however, undergo a more severe and lasting form of depression, known as post-partum depression. Finally, even more rarely, an extreme form of postpartum depression known as postpartum psychosis occurs after the baby is born.
Postpartum depression is neither a weakness nor a character flaw. Sometimes it is simply a complication of childbirth. If you experience postpartum depression, prompt treatment can help keep your symptoms under control and enjoy your baby to the fullest.
Symptoms
How does postpartum depression manifest itself?
Symptoms are different and depend on the type of postpartum depression.
Symptoms of the so-called baby blues, which lasts only a few days to a maximum of one or two weeks, can include:
- Mood swings
- Anxiety;
- Sadness;
- Irritability;
- Cry;
- Loss of concentration;
- Sleep disorders.
When experiencing genuine postpartum depression, the symptoms may be similar to those of the baby blues, but of greater intensity and longer duration, sometimes interfering with the ability to take care of the baby, or in the management of other activities.
Postpartum depression can be characterized by these symptoms:
- Loss of appetite
- Insomnia;
- Intense irritability and anger;
- Heavy tiredness;
- Loss of interest in sex
- Loss of enthusiasm for life
- Feelings of shame, guilt and inadequacy;
- Severe mood swings
- Difficulty in bonding with your child;
- Isolation from family and friends;
- Thoughts of harming or hurting the baby.
Postpartum depression, if left untreated, can last for months or longer.
If postpartum depression evolves into postpartum psychosis or if after the birth of the baby you go directly to postpartum psychosis (rare condition, but which if it occurs begins in the first two weeks after birth), the symptoms are still more stringent and may include:
- Confusion and disorientation;
- Hallucinations and delusions;
- Paranoia;
- Attempt to hurt yourself or the child.
Generally, if you feel depressed after the birth of your baby, you may be reluctant or embarrassed to talk about your state of mind. However, it is important to call your doctor if the signs and symptoms of depression show any of these characteristics:
- They don't disappear after two weeks;
- They get worse;
- They make it difficult for the new mother to take care of her baby;
- Thoughts of harming or hurting the baby arise.
If you suspect that postpartum psychosis is developing, you should see your doctor right away. Do not wait and hope that the condition will improve on its own, as - if neglected - postpartum psychosis can lead to life-threatening thoughts or behaviors.
For further information: Postpartum Depression SymptomsCauses
What are the Causes that can give rise to Postpartum Depression?
There is no single cause responsible for postpartum depression; physical factors, lifestyle and emotional state can play a favorable role in the development of the pathology.
- Physical changes: After the birth of your baby, a dramatic drop in hormone levels (estrogen and progesterone) can contribute to postpartum depression. Other hormones produced by the thyroid gland can decrease dramatically, leaving you feeling tired, lazy and depressed. Changes in blood volume, blood pressure, immune system and metabolism are additional factors that can lead to mood swings and fatigue.
- Emotional factors: when you go through a period in which you lack the correct rest and you are overwhelmed by sleep, even small daily problems can be difficult to solve. Thus, one may be concerned about one's ability to care for the newborn; one may feel less attractive or struggling with one's sense of identity; you may feel that you have lost control of your life. All of these factors can lead to postpartum depression.
- Influence of lifestyle: A fussy baby or having older siblings, breastfeeding difficulties, financial problems, and lack of support from a partner or other loved ones can lead to postpartum depression.
Risk factors
What are the Risk Factors that can favor the onset of Postpartum Depression?
Postpartum depression can arise after the birth of any child, not just after the firstborn. The risk increases if:
- There is a history of depression, both during a previous pregnancy and at other times of life;
- You have experienced stressful events in the past year, such as pregnancy complications, illness or job loss;
- Problems have arisen in the relationship with your partner;
- We are going through a period of financial problems;
- The pregnancy was either unplanned or unwanted.
The risk of developing postpartum psychosis is higher in women who have bipolar disorder.
Complications
Left untreated, postpartum depression can interfere with mother-child bonding and cause serious family problems. Children of mothers who have not promptly treated postpartum depression will most likely have behavioral problems, such as difficulty sleeping and eating, temper tantrums and hyperactivity. Furthermore, it is possible that these children experience delays in language development.
Untreated postpartum depression can last for months or even longer; sometimes it can become a chronic depressive disorder. Even when treated, this condition can increase a woman's risk of developing major depression in the future.
Therapy
How is Postpartum Depression Treated?
Therapy varies based on the severity of the depression and individual needs.
If you are in a so-called baby blues phase, this will generally disappear on its own within a few days, up to a maximum of two weeks. In the meantime, take as much rest as possible, accepting the help of family and friends. It is important to relate to other new mothers and avoid alcohol, which can make mood swings worse. If you have an underactive thyroid, your doctor may prescribe replacement therapy.
Postpartum depression itself is often treated through proper counseling and therapy. When it comes to counseling, it may be helpful to discuss your distress with a psychiatrist, psychologist, or other mental health professional. Through specialist advice, you can find a better way to cope with your feelings, solve problems and achieve realistic goals. Sometimes family or couples therapy can help too.
Another possible solution derives from the use of antidepressant drugs, which are generally prescribed in case of post-partum depression. If you are still breastfeeding, it is important to know that whatever medication you take will also go into the milk produced by your breasts. However, some antidepressants can also be used during breastfeeding because they have a very low risk of causing adverse effects to the baby. It is obviously important to speak with your doctor to discuss the possible risks and benefits associated with using specific antidepressants.
The other path that can be followed involves hormonal therapy. The pharmacological supply of estrogen could counteract the rapid decline of the natural counterpart that accompanies the birth of the child, thus alleviating the signs and symptoms of post-partum depression that some women experience. However, research on the actual efficacy of hormone therapy in postpartum depression is still limited. Therefore, it is necessary to evaluate with your doctor, as seen for antidepressant therapy, the risks and benefits to which you are encountering.
An adequate treatment of post-partum depression allows you to recover from this disorder in a few months. Obviously, in some cases the therapy lasts a while ?? moreover, the important thing is to continue it until you begin to feel better and it is the doctor himself who recommends it. An early suspension of therapy can in fact cause relapses.
On the other hand, the treatment of post-partum psychosis is more difficult. In fact, it requires immediate admission to a hospital. Once the patient's safety is ensured, she may be given a variety of medications, such as antidepressants, antipsychotics, and mood stabilizers, to control signs and symptoms. Sometimes anticonvulsant therapy is prescribed, during which small, low-intensity electric shocks are applied to the brain to produce the same brain waves that occur during a seizure. The chemical changes that occur following the application of electric current can reduce symptoms of depression, especially when other treatments have been ineffective or when immediate results are desired.
Treatment of postpartum psychosis can call into question the mother's ability to breastfeed her baby. In fact, separation from the baby makes breastfeeding difficult, and some treatments used for postpartum psychosis are not recommended for women who are breastfeeding.
For further information: Drugs for the Treatment of Postpartum DepressionLifestyle and DIY Remedies
Postpartum depression is generally not a condition that you can treat on your own, however you can do something concrete for yourself to help build your treatment plan and speed up recovery, such as:
- Choose a healthy lifestyle. This includes regular physical activity, such as a walk with your baby to be included in your daily activities. Eat healthy foods and avoid alcohol.
- Set realistic expectations without putting pressure on yourself for everything you have to do. Downsizing one's expectations about the existence of a perfect family life. Do what you can, leaving the rest alone. Ask for help when you need it.
- Take the time for yourself. If it feels like the world is against us, learn how to carve out your own space, such as getting dressed, leaving the house, visiting a friend, or planning some alone time with your partner.
- Respond positively. When in a negative situation, focus your mind on a positive thought. Even if an unwanted situation doesn't change, you can change the way you think and behave accordingly - a short course in behavioral therapy can help you learn how to do this.
- Avoid isolation. Talk to your partner, family and friends about your state of mind and feelings. Ask other mothers about their experience. Ask your doctor about the existence of possible local support that includes group therapy for new mothers or women who have suffered from post-partum depression.
- Remember that the best way to take care of your baby is to take care of yourself too.
