How to deal with postpartum depression? Interesting psychiatry

Many people mistakenly believe that a joyful event never leads to depression. Official statistics say: from 10 to 15% of new mothers face serious psychological disorders that arise after childbirth (some sources put the figure at 40%). Unlike prenatal depression, postpartum depression is more common and carries a much greater danger.

According to scientists, this pathological condition negatively affects not only the mother, but also her baby. In severe cases, mothers mutilate their children and kill themselves. The long-term consequences of this disease are also quite serious. A child whose mother once suffered from postpartum depression has a greater risk of becoming an alcoholic in adulthood and developing many complexes against the background of low self-esteem.

Why does postpartum depression occur?

The development of this pathology is associated with the reaction of the psyche to physiological changes occurring in the body during childbirth, as well as after it. We are talking about blood loss, hormonal changes, lack of sleep, fatigue, a new regime, a shift in emphasis in the behavior of loved ones and relatives, fear of making a mistake, and lack of attention from the husband.

The following factors also play an important role:

— low socio-economic status; - difficult pregnancy; - negative events in life; - age over 40 years; — lack of professional education; - complete cessation of work before childbirth; - alcoholism, etc.

Depression or bad mood

It is important to distinguish depression as a mental illness from the banal blues that occurs in a young mother due to lack of sleep and isolation from the outside world in the first months of the baby’s life.

The decline in mood is compensated by meetings with loved ones and friends, sleep, and the opportunity to devote time to appearance and figure. But the main difference lies in the fact that the moping mother is happy with the child, she is happy in motherhood.

Signs of postpartum depression

Unfortunately, postpartum depression in most cases is not detected and treated. This is explained by the fact that young mothers extremely rarely realize that they are sick and even less often seek medical help. Typically, women with this pathology show signs such as anxiety, lack of strength, tearfulness, feelings of sadness and loneliness.

Patients complain of poor sleep, decreased appetite, and depressed mood. They often have ideas of self-deprecation. With some frequency, young mothers note remorse. A woman thinks that she is a bad mother, that she does not correspond to the ideal accepted in society. And because of this, a feeling of shame appears.

A typical sign of postpartum depression is denial of the disease and a woman’s reluctance to seek medical help. This is due to a deep sense of guilt. It occurs when overcoming difficulties associated with caring for a child. It is this feeling that underlies depression. Most mothers believe that taking care of the child is solely their responsibility. This takes a lot of physical and mental strength. The result is a feeling of helplessness, which is further intensified by isolation.

Professional help

A good way to combat postpartum depression is psychotherapy sessions. They help a woman increase her self-esteem, stimulate her to communicate with her baby, and restore interest in life. A specialist will tell you how to properly relax and take care of yourself, for example, recommend art therapy, meditation or yoga. Close relatives of the young mother are often invited to sessions, because without their support, healing is impossible.

In some cases, medication may be required, and this is not something to be afraid of. If you consulted a doctor, it only means that you are a thinking mother who cares about her well-being. First, you will need to take some tests - for example, a lack of thyroid hormones or estrogen can aggravate a depressive state. The doctor will adjust your hormonal levels and prescribe treatment with antidepressants. Many women are reluctant to take these medications for fear of addiction or the need to wean their baby. It is important to know that there are now mild medications that are compatible with breastfeeding, and the course of therapy usually lasts only a few weeks.

Ask your doctor to check the drug prescribed to you for compatibility with breastfeeding.

When does postpartum depression occur and how long does it last?

Symptoms of postpartum depression can appear 3, 9, and 15 months after the baby is born. Most often, a deterioration in a new mother’s mood occurs between the third and ninth months after birth. Initially, anxiety, irritability and depressed mood appear. These unpleasant sensations are accompanied by a gloomy vision of the future, a gray perception of the world around us, and an inability to carry out daily activities. Obsessive thoughts arise, which sometimes lead a woman to kill her children and/or commit suicide. The duration of postpartum depression depends on the woman herself. The sooner she seeks medical help, the faster the depression will be overcome.

Self-care

How can you help yourself cope with depression? Rest, rest and rest again as much as possible. Nature itself took care of this, because for the first few months the child sleeps a lot, and the mother can relax with him. Give yourself time to establish contact with your baby: carry him in your arms more often, kiss him, hug him, and breastfeed him. This helps to overcome the feeling of alienation if it appears. In the first weeks after birth, minimize visits from friends and family and focus on yourself and your newborn.

Get enough sleep and eat well, especially if you are breastfeeding: you need all the microelements and vitamins. Treat yourself to tasty and healthy food, because buckwheat and crackers do not contribute to a good mood. It is ideal if someone can help you with everyday life: go grocery shopping, cook food, clean the house.

6 tips to prevent postpartum depression:

Surround yourself only with beautiful things, choose those news sources and information channels that do not carry negativity, listen to good music. Try not to read bad books, watch horror films, or go to online forums where children’s problems and illnesses are discussed;
Don't burden yourself with all sorts of things. At the moment, the main thing is the child, and for him there is nothing more important than a happy and satisfied mother. Cleaning and work can easily wait;
Don't believe everything "good mothers" say on social media. In fact, there is no ideal, and photographs on the Internet do not convey the true state of affairs. You don’t have to look up to them, because you don’t know how they really live;
Add light and air! Walk more often in the morning and during the day, ventilate the apartment, do not sit in the dark. You can buy a beautiful new lamp or set of candles for your home;
Avoid communicating with those who do not support you, accuse you, or are generally unpleasant to you. You can choose your social circle yourself: leave only good people in it;
Find an ally - someone you can talk to about your condition and who will definitely support you. For example, this could be a friend who also went through postpartum depression and understands exactly how you feel.

Remember that you and your baby come first now. By any means you need to achieve harmony with yourself and start enjoying motherhood. The postpartum period is the best time to learn to love yourself. Believe me, this will benefit not only the newborn, but the whole family.

Depression after childbirth: symptoms

The disease has an individual “face” for each woman, manifesting itself as a combination of signs:

Frequent mood changes
Chronic fatigue and apathy
Tearfulness, frequent tantrums
Decreased vitality
Changes in appetite, both in the direction of increase and in the form of refusal to eat
Sleep problems: insomnia or constant sleepiness
A sharp decrease in self-esteem, dissatisfaction with oneself and a chronic feeling of guilt towards the child (with reluctance or lack of strength to change the situation)
Headaches, abdominal pain, deterioration in health

Risk factors

Postpartum depression can happen to any woman. But there are factors that increase the risk:

depression in the past (during pregnancy or at any other time in life)
presence of severe premenstrual syndrome
mental illness in the family
postpartum depression after a previous pregnancy
history of depression in relatives
severe stress (even not related to pregnancy)
changes that require an adjustment period, such as returning to work
multiple pregnancy
premature birth
caring for a child with special needs or health problems
difficulties with breastfeeding
problems with your partner
lack of sufficient support from loved ones
financial difficulties
bipolar disorder

If you have already experienced postpartum depression, tell your pregnancy doctor right away. If you have any of the risk factors, tell your doctor about it during pregnancy or immediately after giving birth.

If your doctor decides that you are at risk, here is what they can do:

Watch for the first signs to appear
Ask you to complete a depression questionnaire (such as the Edinburgh Postnatal Depression Scale) during pregnancy and after birth
Encourage you to attend support group meetings or seek psychological counseling
Prescribe antidepressants
Recommend a course of psychotherapy immediately after childbirth

St. Petersburg State Budgetary Healthcare Institution "Nikolaevskaya Hospital"

March 14, 2018

“Features of a woman’s psycho-emotional state after childbirth.

How to prevent postpartum depression?

Prepared by: medical psychologist at the antenatal clinic Glebova N.A.

Childbirth is a very powerful physiological process. Naturally, it affects both the physical and psychological state of a woman. According to statistics, 80% of women in labor experience “postpartum blues” or “sadness syndrome” (or “blues” syndrome) and this percentage tends to increase. Let's take a closer look at the emotional state after childbirth.

The emotional uplift and euphoria that occurs immediately after the birth of a child, in most women, by 2-3 days after birth, is replaced by low mood, sadness, uncertainty, confusion, and emotional discomfort. A woman-mother may experience an inexplicable desire to cry, depression and even irritation. The cause of this condition after childbirth is not reliably known, but there are versions of its occurrence. Firstly, rapid and powerful changes in hormonal levels in the last weeks of pregnancy and especially after childbirth cannot but affect a woman’s mood. “Hormonal shock” is a biological factor in the development of anxiety. Secondly, for women who have become mothers for the first time, the new role of “mother” brings a lot of anxiety and anxiety . In addition, after long months of pregnancy have passed, and the expectant mother has become accustomed to her condition, after childbirth there is even a feeling of losing something important and dear. Thirdly, the cause of tension may be physical fatigue. Constant lack of sleep caused by the baby's schedule and household responsibilities can throw a woman out of psychological balance. Fourthly, a dysfunctional family environment (conflict and discord in a married couple, lack of support from loved ones and a sense of “family happiness” or a serious illness of a family member) can aggravate a woman’s state of stress and lead to depression.

Psychologists also note that typological personality traits and a woman’s age aggravate her emotional state in the postpartum period:

In the “risk group” are women-mothers under the age of 18 years. and above 35l.
Emotionally unstable type (excitable, spontaneous, impulsive).
An anxious personality type with increased sensitivity and suspiciousness (increased sensitivity to external influences).
Emotionally immature, women with infantile traits who cannot withstand life's blows.
Rigid, straightforward, hyper-responsible women with hypernormative attitudes (make “.

An unfavorable obstetric and gynecological history, reluctance to have a child, or the severity of the child’s condition (for example, identified pathology or peculiarities in the baby’s health) also create the ground for the occurrence of postpartum depression.

Deterioration in mood after childbirth should be distinguished from postpartum depression . Immediately after childbirth, against the background of hormonal changes, the mood of the mother in labor worsens and “postnatal sadness” occurs with the presence of depressive reactions - they are not so deep, short and reversible - in approximately the first two to three weeks to 1 month of the child’s life. This “ postpartum blues” is manifested by a woman’s tearfulness, feelings of depression, insecurity, fear, and self-doubt.

Postpartum depression itself begins at 3-4 months of a child’s life and lasts up to six months or more. Symptoms of postpartum depression include: a feeling of constant, deep melancholy , inability to enjoy the child and life in general, lack of interest in caring for the baby, decreased appetite, increased anxiety, insomnia.

If mood swings usually do not have a very strong effect on overall well-being and pass rather quickly, then postpartum depression affects the entire body and can last a very long time . Anxiety, depression, fatigue, irritability, panic attacks, a feeling of unreality, poor sleep, loss of appetite and libido, helplessness in household chores, loss of love for your child - all these are signs of fairly common postpartum depression. And its consequence is that a woman ceases to experience the joy of her own motherhood, stops taking care of her appearance, avoids communication, and may even become addicted to medications or alcohol.

So, there are three types of postpartum crises :

“postpartum blues” (melancholy) , which appears during the first few days after childbirth, when you want to cry, there is a feeling of depression, insecurity, fear, self-doubt - support and help from a close circle is needed;
mild degree of depression , which is accompanied by sadness, attacks of helplessness, loneliness, fear - consultation with a psychologist is necessary;
chronic depression : characterized by severe nervousness, a feeling of inferiority, constant attacks of anxiety and fear, when ordinary activities seem completely unbearable. The mood is low, there is no joy in life. A woman often refuses food, libido decreases; seeks privacy, refuses to breastfeed. Sleep disturbance (insomnia or nightmares). Such depression can persist for a whole year, and sometimes even three or four years. A variant of postpartum depression may develop, reminiscent of manic-depressive disorder (states of excitement, euphoria and fussiness are replaced by passivity, lethargy, melancholy, apathy). Of course, in this case, the help of a psychotherapist or psychiatrist is necessary.

Modern medicine today views depression as a natural reaction of the body to childbirth and motherhood. Therefore, a young mother should be mentally prepared in advance for the fact that after the birth of a child, her feelings may become somewhat unstable and rapidly change in different directions: from joy to despair and vice versa. You should also warn your relatives about this so that they do not perceive this condition solely as the whims of a spoiled lady and help the woman get through this period as easily and quickly as possible.

What should a woman do to prevent postpartum depression? Advice for women in labor:

Remember that the onset of motherhood will require you to review your entire lifestyle , as a result of which you will simply have to adapt (for example, you may not have time to watch TV).
Try to determine your priorities and don’t try to keep the house in the same condition ; you simply don’t have enough strength to maintain impeccable cleanliness. Reassure yourself that the chaos that has reigned in your once-so-tidy home is a temporary phenomenon.
Don't forget that you just need to find time to be alone with yourself , wander around the shops, visit a friend or go to a beauty salon in order to find balance and connection with the world around you. Therefore, do not hesitate to at least occasionally ask your loved ones to babysit your child and do not take into account what people think of you.
Distribute responsibilities in the family , involve your spouse in helping to care for the child and do not forget to praise him.
Rest is no less important for you after childbirth. Try setting specific hours for rest , preferably during the day . If you don't want to sleep, just relax, close your eyes and don't communicate with anyone at this time. Drink a cup of mint or chamomile tea. These herbs have calming properties. And also watch your diet.
While your child is sleeping, read a good book . Reading is one of the best ways to avoid stress. Rent a comedy cassette. Laughter is a great stress reliever.
Turn off your phone and take a hot bath with aromatic oils . Turn on some nice music and ask your husband to give you the massage you need to relieve muscle tension and improve your mood. And in order to enhance relaxation, add a few drops of aromatic oil to the massage oil. Ylang-ylang, sandalwood, lemon, orange, lavender and chamomile oils have calming properties.
Find time to do gymnastics. It has already been proven that if you do gymnastics during depression, your emotional state improves much faster. And regular gymnastics reduces tension, fatigue, aggressiveness and depression, gives vigor and lifts your spirits. In addition, exercise distracts you from everyday worries. By doing them, you will be able to forget about your problems at least for a while.
Breastfeed your baby, hold him in your arms often, talk to him and smile.
Share your experiences with your close circle, maintain emotional contact with them, find support and approval in them.
If you cannot cope with depressive reactions, then seek help from a psychologist or psychotherapist.

Dear women! Remember that a child needs a happy mother, whose nerves are in perfect order, and who is generally happy with her life. Before and after birth, the baby subtly senses your mood, rejoices and gets upset with you. When a mother feels bad, her child also feels bad; the more anxious the mother, the more anxious the baby will be. The mother-child dyad will be reliable if the woman knows how to properly care not only for the child, but also for herself.

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Here are some possible treatment options:

Self-medication
To begin with, you can try self-medication, without contacting a psychologist, to make sure whether it will help or not. Try discussing with your partner the issues that are bothering you, or seek help from another family member or friend. Let them offer possible options for help, talk with you, allow you to do what you love. So, you will feel new strength and get on the right path.
Rest whenever possible and sleep when your baby sleeps. It will take some time for your baby to establish a “normal” sleep schedule, initially he will sleep a lot during the day and very little at night, so rest whenever possible, this way you can feel good when the baby is awake. Psychologists are of the same opinion; sleep will do you good.
Making sure you eat right is also important. Even if you don't have enough time to prepare healthy food while your baby is very small, remember that nutrition should be as healthy as possible. Instead of a candy bar, opt for a banana, and instead of a muffin, eat a protein bar.
Despite the lack of time, exercise. If the weather is nice, your baby will probably enjoy relaxing in the stroller while you walk around the area. Alternatively, it's a good idea to do yoga while your baby is napping.
Psychotherapy
If you have tried all the ways to help yourself, but have not found the optimal solution, and your health has not improved, try contacting a psychologist. The specialist will recommend an alternative course to solve the problem and help overcome difficulties. You will tell the psychologist about what worries you and understand what prospects await you.
Your psychologist may be able to arrange treatment using cognitive behavioral therapy. This is one of the types of therapy, the essence of which is to reprogram the brain, you will learn to react differently to difficult situations, and you will make important decisions more quickly.
For example, in a situation where you hear your baby crying, you feel angry, stressed or frustrated and find it difficult to understand and accept these feelings. With the help of a psychologist, you will be able to rediscover this world for yourself, you will understand that the child is otherwise unable to tell you what is bothering him, which is why he cries. He has no intention of causing you trouble. He needs something, and this is the only way he can express his needs.
Drug treatment
Sometimes depression is the result of a chemical imbalance, trying to influence the external signs will lead to nothing until you attack from within, because this is the only way you can feel better. This is where medications come in handy.
A psychiatrist may suggest treatment in combination with therapy so that you can attack the problem from different angles. He will prescribe medications to help you feel less anxious or sad. If you are breastfeeding and are concerned about the effects of taking medications on your baby, so that he does not get harmful substances through his milk, your psychiatrist will recommend a medication that is considered safe for use during lactation.

Diagnostic features

Before you figure out what to do with postpartum depression, you should correctly diagnose and identify the variant of the disease.

In our clinic for these purposes we use:

Clinical and anamnestic analysis. The doctor examines and interviews the patient, finds out all the nuances of the development of disorders, establishes the causes and leading symptoms.
Psychodiagnostics using the Edinburgh scale, tests and questionnaires.
Laboratory diagnostics. In addition to clinical tests, the doctor may prescribe hormones and other endocrinological tests.