What is postpartum depression?
Postpartum depression is a mental illness characterized by prolonged signs of sadness, loss of interest in daily activities, anxiety, and irritability.
Postpartum depression affects between 10 and 15% of mothers, and can arise just before delivery and/or throughout the first year after delivery. However, it most often starts up to 4 months after delivery.
What are the main symptoms of postpartum depression?
Usually, the symptoms of postpartum depression last longer than 2 weeks and can be:
- decreased interest in or inability to perform daily tasks
- prolonged sadness, irritability, and easy crying
- Anxiety and agitation
- eating disorders (weight gain or loss)
- sleep disturbances (increased or decreased sleep)
- feelings of guilt or low self-esteem
- poor memory and difficulty concentrating
- Lack of energy and motivation
- Ideas of death or suicide
Along with these symptoms, it is common to have feelings such as:
- thinking about hurting yourself or your baby
- doubting your ability to take care of the child
- Feeling of distance from the baby
- Distance from people close to you
- feeling of not being satisfied/happy with the maternal function
- Changing the relationship with the partner
Is having episodes of sadness the same as having depression?
Nope. Postpartum depression has completely different characteristics, namely in the intensity and duration of symptoms, although it can originate from episodes of passing sadness (commonly known as "baby blues"). However, both conditions deserve evaluation, follow-up, and clinical treatment.
What can cause postpartum depression?
The cause of postpartum depression is unknown, and although hormonal changes are related to mood swings, the disease is due to a combination of several factors:
- Biological/Genetic
- Psychological
- Family
- Socioeconomic
How can this disease affect the relationship between mother and baby?
The process of pregnancy and postpartum are important events in women's lives, and in themselves represent risk factors for the development of psychological disorders. Postpartum depression can affect the relationship between mother and baby with a tendency to:
- Negative perception of the baby's behaviors
- anxiety about the baby's health
- emotional distancing, aloofness and lack of stimulation towards the baby
- decreased attention, sensitivity and empathy towards the baby
- decreased affective response, activity, and spontaneity from mother to baby
- non-adherence to follow-up to the child surveillance or vaccination program
- Excessive demand for health care
What are the risk factors for developing postpartum depression?
The likelihood of developing postpartum depression increases when there is:
- previous history of depression or postpartum depression (self-reported or family-related)
- Biological factors such as hormonal changes
- history of complicated childbirth and/or difficulty breastfeeding
- unwanted pregnancy
- lack of socio-familial and financial support (single mother or lack of support from her partner, young mother, work problems)
- history of physical or sexual abuse
- Fear of childbirth
- poor physical health (obesity, hypertension before or postpartum)
How is the disease diagnosed?
Diagnosis should be based on the time between delivery, the onset of symptoms, and the severity of symptoms. For this, a clinical evaluation is carried out, which can take place in a postpartum consultation, where the presence and persistence – a period of more than 2 weeks can be an indicator of the disease – of some of the symptoms mentioned above is evaluated. There are scales, such as the Edinburgh Postpartum Depression Scale, that can be used to screen for symptoms of postpartum depression.
Is it possible to prevent this disease?
If you think you have postpartum depression, talk to your doctor as soon as possible. Some strategies can help prevent the development of the disease, especially in the case of women with a history of episodes of depression:
- Before pregnancy: If you plan to become pregnant and have a history of depression, you should talk to your doctor to identify the symptoms
- During pregnancy and after childbirth: a medical evaluation, often accompanied by the completion of a questionnaire to screen for symptoms of depression, and according to the results, integration into support groups, psychological therapies or medication may be recommended
What is the treatment of postpartum depression?
Postpartum depression has a negative impact on the mother's health, the relationship with the baby, and the child's future development. Therefore, together with therapeutic, family and social support, it is important that depression is treated as soon as possible, helping to minimize the associated risks.
Thus, treatment of postpartum depression may include:
- taking medication
- Psychotherapy sessions with cognitive and behavioral therapy
- Psychosocial interventions: with the aim of increasing the individual's ability to exert greater control and power over their individual and social environment (such as prepartum preparation classes)