Why does postpartum depression occur? What is postpartum depression? How is such a pathology diagnosed?

According to statistics, every second woman experiences emotional discomfort in the first postpartum period. Depressive states should not be perceived as whims or, moreover, not pay attention to your well-being, because the consequences of this disease can be serious.

What is postpartum depression

In the first months after the birth of a child (after a miscarriage), a young mother may develop serious illness– depression after childbirth. Pregnancy and childbirth are a difficult test for a woman’s body. Maternity leave, change in life priorities, prolonged painful condition after childbirth can lead to negative moods, changes in behavior, and psychological breakdowns. Against this background, postnatal depression may occur.

Symptoms of postpartum depression

In general, the symptoms are not very different from the blues (characterized by tearfulness, mood swings, irritability, sleep disturbance), but may be more acute and correspond to the indications of clinical depression. International diagnostic criteria(ICD-10) this diagnosis is established according to indicators. The development of the condition in intensity to clinical depression occurs on average within 6 weeks after birth. Consider that the signs postpartum depression may not appear immediately, but occur gradually.

How does postpartum depression manifest?

What is the manifestation of postpartum depression, what happens to a woman when the disease begins? You should be wary:

• depressed state: feeling of anxiety and emptiness, desire to cry for no reason, hopelessness;
• change of interests: apathy towards fulfilling duties and usual activities;
• loss of appetite and changes in weight (both weight loss and weight gain);
• insomnia, a woman cannot sleep, even when there is time, the child is sleeping;
• the appearance of slowness or restlessness, vanity, unusual for character and behavior;
• constant feeling fatigue;
• indecision in decision making, loss;
• feelings of inferiority, worthlessness, guilt;
• emerging thoughts of suicide, thoughts of harming the child may arise (this is not a real threat).

Why does postpartum depression occur?

Considering how depression manifests itself, it becomes clear that getting out of such a state is not easy. Not only the woman, but also the family suffers from this, especially since it can last long period. The causes of postpartum depression in women lie in a sharp change in hormonal levels. The release of hormones, insufficient support, care from men, relatives, or their excessive control and criticism are risk factors for the development of the disease. The form of depressive disorder is:

• mild (postpartum blues), which goes away in 2-3 weeks;
• moderate severity(postnatal depression), it can last up to a year;
• there is a severe form (postpartum psychosis).

Another reason for the manifestation of signs and symptoms of the disease during maternity leave is that a woman, having become a mother, begins to realize her age and identify herself with her own mother. Even childhood grievances, traumas, and conflicts on the part of parents can influence its occurrence. It is difficult to cope with this condition on your own; a woman needs the help of her family, and often a psychologist/psychotherapist.

How long does postpartum depression last?

Even if the disease does not develop in the first two months after childbirth, depression during maternity leave can manifest itself as main symptoms throughout the year. A young mother may simply miss the time when such symptoms begin to appear, attributing it to natural fatigue. Non-recognition of this disease, the attitude of others and the woman herself towards it, refusal to treat and fight it can lead to a transition to chronic form. The main reason that postpartum stress lasts for a very long time is untimely help.

How to Avoid Postpartum Depression

Most psychologists classify this disease as a family disease. A man can also suffer and experience emotional discomfort, especially if long term passes from the appearance of the first signs until the disease can be overcome. How to avoid, how to treat and how to get rid of a condition that threatens the family and can cause divorce?

Prevention of the disease and prevention of depression should begin much earlier than the first sign appears. It should begin during pregnancy, after going on maternity leave, especially if future mom belongs to a risk group (heredity, psychological instability, bipolar disorder). Attentive attitude on the part of the spouse and relatives can instill a sense of confidence, help to notice changes in behavior in time, carry out diagnostics and begin treatment for early stage. The interaction between spouses is important.

How to Diagnose Depression

The disease can begin gradually; as a rule, the diagnosis of postpartum depression is carried out by a pediatrician or its presence is determined by a gynecologist. To identify the disease, test questionnaires or a regular depression scale are used. Based on the dynamics of the indicator (growth or decline), a diagnosis is made. If it is suspected that a woman may be experiencing postnatal depression, weekly testing is necessary.

How to treat postpartum depression

Treatment of postpartum depression should begin with determining the stage of the disease. To survive normally light form depressive disorder, you need to visit a psychologist several times, it’s good if both spouses go to the doctor at the same time. In case of moderate depression, how to treat and what to do in order not to fall into depression, you need to seek help from a specialist. The treatment method may be as follows:

• Medication. Antidepressants and tablets are prescribed very carefully, especially during lactation, self-treatment unacceptable.
• Group or individual psychotherapy. Experienced specialist will teach you what to do, how to fight, and not provoke attacks and negative conditions.
• Home support, healthy image life. Treatment is much easier when a woman has sufficient support from loved ones.

How to deal with postpartum depression on your own

Many young mothers have no time to visit doctors. How to get rid of postpartum depression without visiting a psychologist; is it possible to fight this disease at home? The female body experiences three hormonal changes at once: after childbirth, the end of the period breastfeeding, renewal menstrual cycle, and if you add changes in appearance and weight, you get a full set of prerequisites for depression.

Postpartum syndrome needs to be treated, this can be done at home, following a few rules:

• Healthy sleep. Relax with your baby Homework endless, but health is the same.
• Hurry slowly. Don’t grab every job, you will become an ideal housewife, wife and mother a little later.
• Free time. Spend at least a little time a day on what you love: reading, your favorite movie, visiting girlfriends.
• Talk about your problems. Don't be shy to tell your husband what you don't like and what worries you. Divided in half, the problem will be half as big.
• Release tension.
• If you cannot cope on your own, consult a doctor, he will help you deal with this problem.

Video: Postnatal depression

Postpartum depression is a common problem for new mothers. Causes of depression, common methods of dealing with them.

What is postpartum depression

Some statistics. From 10 to 15% of mothers suffer from depression that appears after childbirth. The peak of the disorder occurs when the child is 6 months old. Most often, it fades away closer to the baby’s year. Another 10% notice depression only in the second year of the baby’s life.

What are the causes of postpartum depression?

• Physiological or physical reasons. Caused by malfunctions thyroid gland, as a result of which the production of progesterones and estrogens in the mother’s body decreases. This leads to a change in mental state (symptoms are similar to menopausal disorders and manifestations of premenstrual syndrome)
• Anamnestic information about predisposition to depressive states. Such data can be obtained from the results of monitoring a woman during pregnancy. Abuse alcoholic drinks And hereditary factor can lead to depression or even mental pathologies
• Social reasons. They are very individual and numerous for each individual mother. They directly depend on the woman’s environment, family structure, as well as physical and moral support from loved ones. Most common social reasons depressive syndrome young mothers are considered:
  • Inattention or misunderstanding on the part of the partner/husband
  • Financial dependence on parents or other relatives
  • Loss of loved ones
  • Career pause
  • A woman’s desire to conform to maternal ideals imposed by society
• Psychological reasons. There are several main similar factors influencing postpartum depressive syndrome:
  • Low resistance to stress
  • Emotional immaturity, infantilism
  • Tendency to hypochondria, suspiciousness
  • Low degree of self-esteem, tendency to self-blame
  • Tendency to depression
  • Negative type of thinking

Analysis of symptoms: how does postpartum depression manifest?

• Decadent mood. Prevails most of the day and lasts continuously for more than 2 weeks, regardless of external factors. Sadness, melancholy, taciturnity, depression - the main symptoms of a depressed mother
• Decreased interest in things that used to bring joy and excitement
• Decreased energy, increased fatigue. Slowness, reluctance to move (sometimes to the point of stupor)

• Feelings of guilt, self-flagellation (usually unfounded)
• Decreased self-esteem loss of self-confidence
• Drawing gloomy, pessimistic prospects in your thoughts
• Sleep and appetite disorders
• Thoughts of suicide (may be accompanied by attempted actions)

How to deal with postpartum depression: treatment methods

Psychotherapy

Drug treatment

Many women in the first days after the birth of a child experience feelings of anxiety, irritability, depression and apathy. Sudden mood swings, causeless tearfulness, increased vulnerability, fear of not being able to take care of the baby - all these are signs of so-called postpartum melancholy. This natural reaction for stress.

Before you continue reading, take a depression test (ed.)

The support and help of relatives will help the new mother get through this difficult period. If a woman for a long time is in a depressed state; indifference to the world around is replaced by a strong sense of guilt and deep despair; it is necessary to pay attention to the painful experiences in time. All of these may indicate postpartum depression.

Depression, unlike postpartum melancholia, is a severe emotional disorder and requires compulsory treatment. It can only be dealt with with the help of specialists.

Symptoms of postpartum depression

With depression, a woman’s condition only gets worse every day. The world seems gray and joyless. Lack of meaning in life and hope for the future are serious signs of postpartum depression.

The woman feels abandoned, left alone with her painful experiences and her child. Loneliness and social isolation only make depression worse.

Losing control over your emotions makes you feel helpless. An overwhelming feeling of powerlessness interferes with caring for the baby and doing household chores. An endless feeling of guilt has now become a constant companion. Being in the grip of despair and feeling like a “bad” mother, a woman is unable to give emotional warmth to her child. Warmth, which is vital for him. After all, the period of infancy is important stage formation of the baby’s psyche.

The consequences of maternal postpartum depression for a young child

Lack of maternal love, affection and warmth can lead to serious violations child's psyche. The emotional connection between mother and child gives him a sense of security, and the absence of this connection is always a tragedy for the baby.

Depression prevents a mother from feeling and emotionally responding to her child’s wants and needs. He feels rejected and unwanted when left alone with his fears and anxieties. Such isolation in the future can lead to serious personality disorders - pathological self-doubt, increased anxiety, fears and phobias, depressive disorders, difficulties in establishing close relationships, etc.

Causes of postpartum depression

A woman's life changes radically after the birth of a child. And no matter how much she prepares to become a mother, such changes are difficult to come to terms with. It’s hard to accept that life now entirely belongs to the child. A strong one arises internal conflict between the desire to be a good mother and your own desires and needs.

As a rule, women expect that maternal love, with which they will be overwhelmed immediately after the birth of a child, will solve the problems of adaptation to new conditions. But it takes some time to establish emotional contact with the baby.

The woman experiences disappointment, which turns into a feeling of guilt and shame for her inability to discover her attachment to the baby. And while the child is felt as a “stranger,” the woman suffers from remorse and feels like a bad mother.

Depressive state or others emotional disorders Women before pregnancy can also cause postpartum depression. Excessive vulnerability increased anxiety and self-doubt, instability of the nervous system make a woman vulnerable to depressive disorders.

Pregnancy and childbirth, being severe stress, deplete an already vulnerable psyche, which can lead to serious consequences. Therefore, a woman’s emotional well-being is the key to happy motherhood.

Treatment of postpartum depression

Popular on the site: How to avoid postpartum depression (editor's note)

Timely help from a psychologist will help you get rid of painful experiences, understand the causes of emotional distress and cope with depression. In a particularly serious condition, a woman needs to be monitored by a psychiatrist and take antidepressants.

Already during pregnancy, a woman prepares for the future role of a mother on a psychological level, as well as for all the difficulties that lie ahead during this period. After giving birth, many women experience fear of breastfeeding and caring for the baby. There may also be fear for the health of the newborn. However, very soon all fears are left behind, the woman calms down and gradually enters into the role of a mother. Unfortunately, this period does not end well for everyone. Some women develop a painful state of anxiety, unfounded by objective reasons. In medicine, this kind of change is called depression. In this article we will talk in more detail about this condition, the main causes and ways to prevent it.

What is postpartum depression?

This is a rather serious mental illness that develops exclusively in the postpartum period and is characterized by depressed mood and loss of former interests. This pathological condition most often occurs in the first or second week after the baby is born.

This type of depression has a direct connection with social, chemical, and psychological changes in a woman’s life. Fortunately, this pathology responds well to treatment.

The chemical changes observed in the body are explained by fluctuations in hormone levels after childbirth. However, experts have still not been able to find scientific evidence of the connection between hormones and depression itself. It is known that during pregnancy the level increases 10 times. After the baby is born, these indicators drop sharply, and after another three days they return to the level they were before pregnancy.

Along with hormonal changes, social and psychological transformations also influence the onset of depression.

Main reasons

It is not only possible, but also necessary to combat this condition. It’s even better to prevent signs of postpartum depression and prevent the development of serious mental disorders. Not all women who have given birth are susceptible to this condition: some were able to survive it very quickly and now, together with their child, enjoy every new day, while others experience daily bouts of irritation and anger, as a result it even comes to divorce. Why is this happening? To prevent the development of depression, it is important to know its causes and try, if possible, to avoid them. Provoking factors:

• Unwanted or difficult pregnancy.
• Problems with breastfeeding.
• Conflicts with the child’s father (infidelity, quarrels, scandals, separation).
• Upset nervous system even before the baby is born.
• Excessive physical activity.
• Financial problems.
• Lack of basic outside help.
• Unjustified expectations.

Of course, not all reasons depend on the woman. They are often dictated by social and living conditions. However emotional condition a young mother’s life directly depends on her thoughts and daily mood, on her attitude towards life and others. This is why psychologists strongly recommend reducing everything negative emotions to a minimum.

Symptoms

How does postpartum depression manifest? How do you understand that you have this particular problem and not another disease? After all, this may be the most common fatigue from accumulated tasks, which often goes away on its own. Experts identify a number of signs indicating postpartum depression. If they appear, you should immediately consult a doctor. Only a specialist can confirm the presence of a problem such as postpartum depression.

• Symptom No. 1. A woman’s regular complaints of suffering due to loneliness and excessive fatigue. In addition, mommy may experience tearfulness, sharp changes moods, uncontrolled outbreaks anger. Already now, family and friends should sound the alarm, because this is how postpartum depression begins.
• Symptom No. 2 regarding the condition and health of the newborn. Very often a woman experiences this as a result of the most minor failure. Suicidal thoughts and a gloomy vision of the future may also appear.
• Symptom No. 3. Provocation conflict situations, daily tantrums, grumpiness. Relatives and friends, as a rule, have no idea about the main reasons for this behavior of a young mother. However, it is precisely this that indicates that postpartum depression is occurring.
• Symptom No. 4. Feelings of panic and anxiety, accompanied by strong heartbeat, loss of appetite, regular headaches, insomnia. Sometimes a woman has an irresistible desire to commit actions that are senseless, in the opinion of others. Simple conversations with a young mother most often end in serious scandals.

These are the symptoms that accompany depression after childbirth. If you find one or two of the above signs, there is no reason to worry, as it may be simple fatigue. If this figure goes off scale, it’s time to sound the alarm and immediately seek help from specialists.

Why is it so important to recognize a problem in a timely manner? The whole point is that prolonged depression after childbirth, which in some cases can last for months, often ends in psychosis without medical intervention. This condition is characterized by confusion, delusions, hallucinations, and complete inadequacy. Of course, here we can already talk about limiting the mother’s access to the baby.

What factors increase the likelihood of developing the disease?

There are several of them, and they all have a different nature:

1. Age. The earlier a woman becomes pregnant, the higher the risk.
2. Loneliness.
3. Lack of psychological support from family and friends.
4. Ambiguous perception of pregnancy.
5. Children. The more children you have, the higher your chance of developing depression with each subsequent pregnancy.

Types of postpartum depression

Experts identify three types of disorders of this nature, which develop exclusively after the birth of a child:

1. Postpartum blues. Every woman is familiar with this condition; it is normal reaction body to the changes that have occurred. A young mother's mood can change dramatically. Only now she feels the happiest in the world, and after a few minutes she begins to cry. The woman becomes irritable, intolerant, and agitated. According to experts, postpartum blues can last from several hours to a couple of weeks. This condition does not require specialized treatment, as it most often goes away on its own.
2. Postpartum depression. Symptoms characterizing this condition most often appear a few days after the baby is born. They are similar to the signs of postpartum blues (sadness, despair, irritability, anxiety), but they manifest themselves to a greater extent. During this period, a woman, as a rule, cannot perform the daily duties assigned to her. When this happens, you should immediately seek help from a psychologist. Despite the complexity of this disease, depression after childbirth is highly treatable. Moreover, modern medicine offers a variety of solutions to this problem, so that every woman can choose the most suitable option for herself.
3. Postpartum psychosis is the most serious mental illness diagnosed in new mothers. The disease appears unexpectedly and develops rapidly (during the first three months after birth). Initially, a woman loses her usual ability to distinguish real world from the invented, sound hallucinations arise. Other symptoms include insomnia, constant restlessness, anger at the world. When primary signs It is extremely important to seek help from a qualified physician. In some cases, hospitalization is even required, as there is a risk of harm not only to oneself, but also to the newborn.

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

Postpartum depression is considered a more serious problem than the usual blues. If young mothers who have overcome the blues have already managed to cope with all the difficulties and experience the joy of caring for their baby, then women with postpartum depression feel more and more unhappy and exhausted every day.

Sometimes a woman, even before the baby is born, struggles with a depressive state, and childbirth only aggravates the previously existing problem.

In some cases, symptoms of this mental illness appear months after the baby is born. Initially, the young mother experiences exclusively positive emotions and pleasure from communicating with the child, but after a certain period of time all these troubles begin to exhaust, and the woman herself feels unhappy and depressed.

How long does postpartum depression last? This depends not only on the mother herself, but also on her environment. Very often, a woman is in no hurry to seek qualified help from a psychologist, believing that the problem will solve itself. Sometimes representatives of the fair sex are simply afraid to seek support due to complete disappointment in themselves and constant worry for the health of the child.

Of course, this attitude only makes the situation worse. You shouldn't be embarrassed to ask for help. First of all, psychologists recommend talking to loved ones and talking about all your worries. If they agree to take on some of the housework, mom will have time to rest and even consult with specialists.

What should the treatment be?

How to get rid of postpartum depression? This is the question most often asked by relatives and friends of women who have had to face this problem. First of all, you should seek qualified help. Trying to help a young mother on your own is not recommended, as in some cases a consultation is required medicines and psychological consultations. Self-medication can only aggravate the current situation, which will lead to the development of postpartum psychosis.

Depending on the type and complexity, depression is treated either on an outpatient basis or in an inpatient setting. The decision on the latter option is made solely on the basis of identifying the risk of suicidal tendencies and severity general condition. Modern medicine offers several treatment options:

As a rule, the use of the above drugs implies a complete refusal to breastfeed, since these drugs can harm the baby. It is important to note that any medications should be taken only after consulting a doctor. When postpartum depression passes, the drugs are gradually withdrawn and the woman returns to her usual life.

What should my husband do?

Psychologists recommend that family and friends help young mothers who are faced with a problem such as postpartum depression. The causes of this disease, as is known, often lie in lack of rest. A husband can help his wife by taking on a number of responsibilities around the house and meeting the physical needs of the newborn. It is no secret that this kind of disorder is less often diagnosed in those couples where husbands initially took an active part in common family affairs.

Invaluable support for a woman is also the fact that her husband is ready to listen to all her experiences and concerns and encourage her. It is recommended to avoid sharp criticism and condemnation.

Complications

TO unpleasant consequences The following can be included:

• Prolonged depression (more than one year).
• Suicide attempts.

In addition to medical complications, quite severe social consequences are possible. First of all, this is the breakdown of the family. Indeed, constant changes in a woman’s mood, dissatisfaction with her own life, increased irritability - all these factors often push both spouses to divorce. In addition, some women, in a fit of despair, decide to abandon the child. As a rule, this kind of situation is common among single mothers.

Prevention

How to avoid postpartum depression? Exact causes this state still remain unexplored. This is why experts cannot offer effective measures its prevention.

However, psychologists name a number of activities that, to one degree or another, help reduce the likelihood of depression:

Conclusion

In this article, we explained what postpartum depression is in women. The symptoms and causes of this condition may vary in each case. It is important to remember that depression is, first of all, a rather serious illness. It is not the young mother’s fault that she has to suffer so much. That is why a woman cannot simply pull herself together and cope with the problem. After all, no person can overcome the flu by force of will, diabetes or heart attack.

On the other hand, the attention of her husband and family helps a woman feel truly loved. It will be much easier for her to find free time for relaxation or hobby. This kind of care helps quick recovery young mother and her return to the family.

During pregnancy, the woman had a lot of worries, but now the birth is over, and it would seem that she needs to calm down, take care of her recently born child and enjoy her new life. But some women experience specific changes after childbirth brain activity and the functioning of the nervous system, leading to disruption state of mind and loss of peace, constant depression and anxiety. Often similar condition anxiety flows into postpartum depression - this medical term, serious pathology, and should not be perceived as a young woman’s way of shirking her responsibilities.

Postpartum depression as a social problem

Due to personality traits, the influence of various external factors or health problems, the birth of a child does not always become an emotionally bright and joyful event for a woman. Acquiring a new social status, many mothers experience, instead of joy and tenderness, the enjoyment of motherhood constant worries, anxiety and . Continuous tension, worries, fears and poor health turn into a depressive state. This is medically called postpartum depression.

The older generation, and sometimes the woman’s husband, may take serious symptoms for a whim, whims or character traits, fatigue, and do not attach importance to what is happening, do not sound the alarm and do not force the mother to see a doctor. And then all this can lead to tragedy both in relation to the life and health of the child, and the young mother herself, right up to

It is important that relatives and the woman herself know that postpartum depression is a serious psycho-somatic disorder that requires attention and control, and sometimes active drug treatment. For most mothers, this disorder has a short duration and a favorable outcome, but for some it requires close attention and consultation with a doctor.

note

If changes in the psycho-emotional background and negative moods last more than 5-7 days, there is every reason to suspect depressive disorders. If the mother shows negativism, detachment or indifference towards the desired and long-awaited child, it is important to immediately seek help.

How long does postpartum depression last?

Without proper help, such a condition can drag on for a long time. long months, seriously affecting the quality of life and attitude towards the child. A mother with a similar disorder experiences apathy with loss of interest in any manifestations of life. Over time, the manifestations may smooth out, but the course of depression itself becomes chronic.

The biggest difficulty for success in treatment is the fact that the woman is not ready to admit her problem and take any action to eliminate it. At the same time, her family and husband silently agree with her decision and also do nothing about what is happening.

Statistics on the frequency of occurrence of this disorder are inexorable - every fifth mother who recently gave birth suffers from various manifestations depressive disorders during the first two years after birth. Psychological and emotional disorders after childbirth are typical for approximately 60-70% of women, but severe degrees, problems that are dangerous for others, oneself and the child are typical for 2-3%, and not everyone goes to the doctor with them.

Who suffers from such problems?

According to experts, postpartum depression is included in the category of major depressive disorders due to the similarity of symptoms, manifestations and consequences.

Interesting fact!Postpartum depression can haunt not only the mother, but also the father of the child. Although the psyche of men is relatively more stable, the birth of children can also negatively affect their emotional background, but for them this condition usually lasts relatively short time, and the symptoms are not so clearly expressed.

Such conditions in a father are associated with a change in his usual life and the imposition of new obligations, a high degree of responsibility not only for himself, but also for his wife and baby, who depend on him. This is their new role, which not all men are ready to happily accept. In men, depressive manifestations can be both active and passive. With active ones, aggression and irritability are manifested, while with passive ones, isolation and detachment from the situation are typical.

Types of postpartum depressive disorders

Not every psychological state of a woman after the birth of a baby can be attributed to depressive disorders, and attacks of apathy or melancholic mood, which occur occasionally in each of us, do not require concern or immediate treatment. However, there are also situations in which it is important to consult a doctor and seek help, and sometimes even hospital treatment:

Causes of depressive disorders after childbirth

Even among those women whose children were very desired and long-awaited, postpartum depression is quite possible, and approximately every fifth mother has some signs of it. There is no single reason for the formation of such a disorder, but often a whole complex of provoking and irritating factors, negative events and states. Often, both mental and physical negative factors influence simultaneously, which lead to an exacerbation of depressive moods and neuroses.

Purely physiological factors

Childbirth is a serious test for female body, including emotional ones. Woman experiencing severe pain, the balance of hormones changes dramatically, which leads to the fact that organs and systems, body tissues, as well as the nervous system work in a special mode. This creates physical ailments in the first days and in the future, creates fatigue and ailments, which makes it difficult to combine this with full-time caring for the baby and constant household chores.

Surgery may have an effect. Moreover, among women who gave birth quickly, there are usually more problems with emotions and psyche than among those who gave birth themselves. This is due to hormonal changes and fluctuations in hormone levels. During the natural birth of a baby, due to oxytocin, a hormone that performs leading functions in childbirth, the sensation of pain is dulled and lactation then improves faster. This eliminates some of the factors that provoke postpartum depression, and when caesarean section the body's restructuring is not so fast, which leads to disruption of the natural balance of hormones.

Initial problems with breastfeeding, physical difficulties with breasts and milk deficiency can also influence the formation of depression. This creates a conflict in the head between the mother's desires and capabilities regarding what she can give to the baby.

Psychological reasons

Often after childbirth, especially if it did not go exactly according to the expected scenario, completely unpleasant feelings and emotions may arise, as well as a feeling of guilt that the image of ideal parents was not fully realized.

Children are not always born with perfect health, and everything in the maternity hospital goes according to the books, and then the expectations and reality in the mother’s head diverge, which leads to a psychological imbalance. Sometimes there is no time to fully restore physical strength after childbirth, not to mention the emotional and moral costs.

Often, feelings of guilt and dissatisfaction with oneself can be formed due to other reasons:

In addition, depression is typical for those mothers whose children were born with developmental abnormalities, serious problems and require special care and rehabilitation. The mother subconsciously feels guilty towards the baby for the fact that he was born special, and worries about his life only aggravate depressive moods.

note

According to statistics, depression is more typical for young mothers and those over 35 years of age who have problems communicating with their own mother, spouse, or those women who previously, before pregnancy, had emotional and psychological problems.

Symptoms of postpartum depression

Depression in the postpartum period does not begin in one day, it gradually increases in severity and severity of symptoms, and its first manifestations become noticeable a few weeks after returning from the hospital. These include such alarm bells as:

It is not necessary that all of the listed manifestations must appear in the presence of depression; three or more in various combinations are quite enough, and for the last point, one is enough to seek help from a psychotherapist or psychiatrist.

Depression often develops in women due to the fact that their rosy expectations from motherhood and their own feelings run counter to the ideas and thoughts that they had before and during pregnancy. This is quite normal, but not all women can realize and accept the “imperfection” of their motherhood. Many women think that they will immediately, in the first minutes of the birth of a child, have maternal feelings, and they will immediately get used to the role of a mother. But in reality, connections between the baby and his mother are established gradually, over several months.

You should not reproach and scold yourself for various emotions regarding the baby, sometimes they can be negative, we are all living people. There may also be a feeling of disappointment, irritation, fatigue, especially when mixed with constant lack of sleep and lack of time. Experiences can be fertile ground for the formation of complexes and the development of depression, especially if the mother takes only full responsibility for the family and the baby. Don't give up outside help, you need to take care of yourself and give yourself rest, this will not make any woman a bad mother, and will not result in physical and emotional exhaustion.

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The pre-depressive state is complemented by isolation from the previous social circle and the outside world, constant sitting at home and concentrating only on motherhood, you need to remember yourself as a woman, spouse, friend and also pay attention to these areas of life.

Critical periods of depression after the birth of a baby

Psychologists identify certain critical periods, during which all emotions and experiences are the strongest and dangerous by transition to depression.

The emotional background will be most intense in the period from the fourth to the ninth month of the baby’s life, when the feeling of irritability and dissatisfaction and the feeling of continuous anxiety will increase.

This is the first critical period when postpartum depression is likely.

The second period, when late symptoms are possible, is considered to be a period of nine to 15 months, when pessimism about the future and the disappearance of the desire to do even basic housework are possible due to isolation from society and concentration on the worries of the baby. Often the situation will be aggravated by the fact that the mother is not aware of her problems and does not want to make any attempts to correct the situation.

How is such a pathology diagnosed?

Unlike somatic pathologies, where in addition to complaints, you can rely on analysis data and additional research, in diagnosing pathologies related to the mental sphere, there is only a detailed questioning and heart-to-heart conversation, as well as some information that can be obtained from relatives. Therefore, in identifying depression after childbirth, a special role is played by clarifying anamnesis data (the life history of a woman, her family and data on her pathologies and diseases).

note

An important note to possible problems there will be the fact that there was depression among the closest relatives or the patient herself before pregnancy. It is a known fact that in half a percent of cases, depression tends to relapse or worsen due to changes in life, including motherhood . A single episode of depression in the past increases the likelihood of it recurring by 50%.

IN diagnostic process additionally use such methods as:

• Hamilton Rating Scale for Depression Identification and Severity
• Examination and questioning, identification and careful recording of all mother’s complaints
• Laboratory diagnostic methods to exclude somatic pathologies
• Screening studies, smears, cultures to exclude infections, including hidden ones, which can lead to constant fatigue and stress.

If there are signs of depression during pregnancy, or if there is a history of depression, diagnosis is needed already in the first weeks after birth.

note

It is important to distinguish depressive manifestations from postpartum infections; against the background of them, development is possible; therefore, in the clinic, obvious mental disorders require urgent hospitalization and differential diagnosis With necessary treatment within the hospital.

It must also be remembered that psychosis postpartum period may be a special phenomenon psychiatric diagnosis– bipolar disorder with affective attacks (previously this condition was called manic-depressive disorder).

It is usually expected by mothers with mental illness or against the background of schizophrenia, which were simply not previously diagnosed. Unlike classic depression, postpartum psychoses appear a couple of weeks after the birth of the baby, they start as severe depression with the manifestations listed above and various psychiatric symptoms– manias, hallucinations, phobias, delusional thoughts and ideas. Therefore, with the early start of such manifestations, the mother needs consultation not with a psychotherapist, but with a psychiatrist and a thorough examination, otherwise she may be dangerous for the child, herself and others.

How is postpartum depression treated?

When a diagnosis of depression is made, a treatment plan will be drawn up based on its severity, developmental characteristics and leading syndromes, as well as what methods are available for treatment. Thus, nursing mothers should not take certain medications that may affect the baby.

The main goal of treatment is to reduce or completely eliminate the symptoms of depression and its progression, to help the mother restore lost social connections and bring her mental condition to a stable one, preventing recurrent episodes of depression.

note

Mothers are placed in a hospital for treatment extremely rarely, only if depression combines psychosis, severe somatic disorders and suicide attempts.

Applicable in treatment:

• Psychological correction (cognitive techniques, consultations)
• Psychotherapy in group and individually
• Family help and environmental support (family psychotherapy).

Such techniques will be effective and applicable if you are aware of your situation and diagnosis, desire for treatment and correction, motivation and the mood for a long course of treatment. In addition, psychotherapy is needed for those women for whom antidepressants and other medications are contraindicated due to various circumstances.

Drug correction of maternal depression

Depression often means medicinal correction, without which the symptoms do not disappear. It is usually based on hormonal drugs(estrogens) and a course selected in such a way that they do not affect lactation. Indications for use psychotropic drugs are determined individually and only by a psychiatrist based on the severity of symptoms and the degree of danger of consequences. Indications for them will be affective manifestations, suicidal tendencies and thoughts, anxiety and obsessive fears with sleep and somatic function disorders.

note

All medications taken during lactation and treatment of mothers are carried out only as prescribed by a doctor and only strictly under his supervision. No self-medication in cases of depression and psychosis is unacceptable, including various folk methods!

If necessary, prescribing antidepressants is based on several principles:

For therapy to produce significant results, treatment must be started in a timely manner, at the first alarming manifestations, and don’t be embarrassed to see a doctor.

Depression is a disease like many others, there is nothing shameful or illegal about it.

Often its manifestations can be noticeable even in pregnant women, and early stages it is well treated using soft and gentle means and techniques, and a full course of psychotherapy and medications quickly and gently relieves symptoms, restoring the joy of life and the enjoyment of motherhood. Herbal and sedatives, which do not have serious side effects or contraindications, they can be used in women at risk from pregnancy to prevent postpartum depressive disorders.

Selection of antidepressants after childbirth

It is worth repeating that antidepressant drugs should be selected only in conjunction with a doctor, excluding toxic effects on the baby and suppression of lactation.

If the patient suffers from anxiety and agitation ( strong excitement, fussiness), a group of drugs that have sedative effects(Amitriptyline, Pirlindol and others).

If depression and depression predominate among the symptoms, drugs with stimulating effects are needed (Paroxetine, Citalopam and others).

The drug is taken with the minimum possible therapeutic dose, gradually adding it until a lasting clinical effect occurs. A woman is treated at this dose for approximately 4-6 weeks until her condition improves, both subjectively and based on an external examination. As remission or persistent clinical effect occurs, the drug is not abruptly discontinued due to the possibility of exacerbation, but the dose is gradually reduced once a week with gradual withdrawal over the course of a month.

If the condition has improved, but has not completely recovered, the course of treatment is continued for another 1-2 months, and the results are assessed every 4-5 weeks. If there is no improvement on the Hamilton scale by 50% or more, then a revision of the treatment regimen is needed due to its ineffectiveness with the selection of other drugs.

Why is postpartum depression dangerous?

Without treatment, manifestations of depression drag on for a year or more, and can progress and lead to more serious symptoms. mental disorders. In addition, without treatment, depression can lead to tragic consequences:

• Attempts to harm the baby or relatives
• Development of psychosis
• Progression of depression
• Violation of family relationships, its disintegration
• Violations mental development child, negative influence on his psyche, his mother’s behavior and the methods of her upbringing.