Definition
For the new mother, the birth of the child can provoke a cascade of intense and contrasting emotions, ranging from excitement and joy, to attacks of anger and anxiety, but it can also result in something that is not expected, like the postpartum depression.
Postpartum depression is not a weakness or a character defect. Sometimes it is simply a complication of childbirth. If you experience post-natal depression, timely treatment can be helpful to keep your symptoms controlled and be able to fully enjoy your baby.
Symptoms
To learn more: Symptoms Postpartum Depression
The symptoms are different and depend on the type of postpartum depression.
The symptoms of the so-called baby blues, which last only a few days up to a maximum of one or two weeks, may include:
- Mood swings
- Anxiety
- Sadness
- Irritability
- Cry
- Declines in concentration
- Sleep disorders
When you experience a real postpartum depression, the symptoms may be similar to those of baby blues, but of greater intensity and longer duration, such as to sometimes interfere with the ability to take care of the child, 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 bonding to your child
- Isolation from family and friends
- Thoughts of getting hurt or hurting the child
Postpartum depression, if left untreated, can last for months or longer.
If post-natal depression evolves into post-natal psychosis or if after the birth of the child you go directly to a post-natal psychosis (a rare condition, but if it occurs in the first two weeks after the birth), the symptoms are even more strict 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 child, you may be reluctant or embarrassed to talk about your mood. However, it is important to call your doctor if the signs and symptoms of depression show some of these characteristics:
- They don't disappear after two weeks
- Deterioration
- They make it difficult for the new mother to take care of her child
- Thoughts of self-harm or hurting the child arise
If you suspect that postpartum psychosis is developing, you should consult your doctor immediately. There is no need to wait and hope that the condition improves on its own, since - if neglected - postpartum psychosis can lead to life-threatening thoughts or behavior.
Causes
There is no single cause responsible for post-natal depression; both physical factors, lifestyle and emotional state can play a favorable role in the development of the pathology.
- Physical changes: after the birth of your child, a dramatic drop in hormone levels (estrogen and progesterone) can contribute to post-natal depression. Other hormones produced by the thyroid gland can decrease dramatically, leaving a feeling of fatigue, laziness and depression. Changes in blood volume, pressure, the 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 the correct rest is lacking and you are overwhelmed by sleep, even small daily problems can be difficult to solve. Thus, one may be concerned about one's abilities to take care of the newborn; one can feel less attractive or struggling with one's sense of identity; one can experience the sensation of having lost control of one's life. All these factors can lead to post-natal depression.
- Lifestyle influence: a demanding child or the presence of older siblings, breastfeeding difficulties, financial problems and lack of support from partners or other loved ones can lead to post-natal depression.
Risk factors
Postpartum depression can occur after the birth of each child, not only after the first child. The risk increases if:
- He has a history of depression behind him, both during a previous pregnancy and at other times in his life
- Stressful events occurred during the past year, such as pregnancy complications, illness or job loss
- Problems arose in the relationship with your partner
- You are going through a period of financial problems
- Pregnancy has not been scheduled or is unwanted
The risk of developing postpartum psychosis is higher in women who have bipolar disorders.
Complications
If not treated, post-natal depression can interfere with the mother-child bond and cause serious family problems. The children of mothers who have not readily treated post-natal depression will most likely have behavioral problems, such as difficulty sleeping and eating, anger attacks and hyperactivity. Furthermore it is possible that these children may experience delays in language development.
Post-treatment 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 the risk that the woman may develop major depression in the future.
Deepening: what to do before going to the doctor and what to expect from a medical examination
In the case where there are symptoms suggestive of a post-natal depression it is useful:
- Write down each symptom experienced and how long it has manifested
- Write down all medical problems, including other physical problems and the mental conditions that have been diagnosed. Tell your doctor if you have already experienced some type of depression or another mental disorder in the past
- Make a list of all the medicines you take, including over-the-counter medications, vitamins and supplements
- Find a trusted friend or family member to go to on a first date so you can be helped in discussing all the written points
- Write down the questions you would like to ask the doctor
Among the questions commonly asked to the doctor are:
- What is the diagnosis and what is the most appropriate type of treatment for the case
- Ask what are the side effects of the treatment proposed to us
- How and after how long after the start of treatment, an improvement in the condition is expected
- Is that safe if you are breastfeeding?
- How long should therapy continue?
- What lifestyle changes could help us manage the symptoms?
- How often should a check-up be done?
- If in the future you can encounter other mental illnesses
- Can postpartum depression re-occur even if other children are wanted?
- Is there a way to prevent it if you have other children?
- Are there any websites or information material from which you can inform us?
Therapy
Therapy varies based on the severity of depression and individual needs.
If you are in a so-called phase of baby blues, generally this will disappear on your own within a few days, up to a maximum of two weeks. In the meantime, it is necessary to 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.
Post-natal depression itself is often treated through proper counseling and therapy. As for counseling, it can be helpful to talk about your malaise with a psychiatrist, a psychologist or another person who carries out a profession in the field of mental health. Through specialist advice, you can find a better way to cope with your feelings, solve problems and achieve realistic goals. Sometimes even family or couple therapy can help.
Another possible solution derives from the use of antidepressant drugs, which are generally prescribed in case of post-natal depression. If you are still breastfeeding, it is important to know that any type of medication is administered, it will also go into breast milk. However, some antidepressants can also be used during breastfeeding because they present a very low risk of causing adverse effects to the baby. Obviously it is important to talk to your doctor to discuss the possible risks and benefits associated with the use of specific antidepressants.
The other path that can be taken includes hormonal therapy. The pharmacological contribution of estrogens could counteract the rapid decline of the natural counterpart that accompanies the birth of the child, thus alleviating the signs and symptoms of post-natal depression to which some women go. However, research on the actual effectiveness 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 you are facing.
An adequate post-natal depression therapy allows you to recover from this disorder in a few months. Obviously, in some cases the therapy lasts a little longer, the important thing is to continue it until you start feeling better and it is the doctor himself who advises you. An early discontinuation of therapy may in fact cause relapses.
The treatment of post-natal psychosis is more difficult. In fact, it requires immediate hospitalization in a hospital. Once the safety of the patient is assured, she can be given a series of drugs, such as antidepressants, antipsychotics and mood stabilizers, to control the signs and symptoms. An anticonvulsant therapy is sometimes prescribed, during which small electric shocks of low intensity are applied to the brain to produce the same brain waves that occur during an epileptic attack. The chemical changes that occur following the application of electric current can reduce the symptoms of depression, especially when other treatments have been ineffective or when immediate results are desired.
The treatment of postpartum psychosis can call into question the mother's ability to breastfeed her baby. In fact, separation from the small 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 Post-Partum Depression »
Lifestyle and home remedies
Post-natal depression is generally not a condition that can be treated on its own, but nevertheless something concrete can be done for oneself that helps to build one's own therapeutic plan and make healing faster, such as:
- Choose a healthy lifestyle. This includes regular physical activity, such as a walk with your child to include in daily activities. Eat healthy foods in a healthy way and avoid alcohol;
- Set realistic expectations without putting pressure on yourself for everything you have to do. Reduce your expectations about the existence of a perfect family life. Do what you can, leaving the rest. Ask for help when you need it.
- Take the time you need for yourself. If it feels like the world is against us, learning to carve out your own space, such as getting dressed, leaving home, visiting a friend or planning a little time alone with your partner.
- Respond positively. When you find yourself in a negative situation, focus your mind on a positive thought. Even if an unwanted situation does not change, you can change the way you think and behave accordingly: a short course of behavioral therapy can help you learn how to do this.
- Avoid insulation. Talking to your partner, your family and your friends about your state of mind and your feelings. Ask other mothers about their experience. Ask your doctor for information about possible local support that includes group therapy for new mothers or women who have suffered post-natal depression.
- Remember that the best way to take care of your child is to take care of yourself too.
