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Understanding Postpartum Psychiatric Issues

Spring is fast approaching, with new beginnings. A time of birth and rebirth. A time associated with joy, but also a time to be aware of other forces.

Women have the unique quality of carrying and giving birth to the new hopes and dreams of the human species. This is a time that has both great expectations of hope and generous joy for everyone. These expectations, however, may be altered or only briefly experienced. The postpartum period can be influenced by many psychiatric problems. These include: “Baby Blues”, postpartum depression and postpartum psychosis.

During the postpartum period, up to 85% of women have some form of mood disorder. 10-15% of these women experience a more disabling and persistent form of mood disorder called postpartum depression or even psychosis.

The mildest form of postpartum dysfunction is the so-called “Baby Blues”. These usually consist of a week long mood lability with increased irritability, anxiety and tearfulness. Symptoms tend to peak around day 4 or 5 postpartum and gradually subside. Usually, this does not interfere with the care of children, the maternal bond or harm to the newborn.

Of a more serious nature is postpartum depression. This occurs in 10-15% of the general population.

The main phenomenological symptoms of this include: a depressed mood as manifested by: despair, lack of interest or joy – especially in the areas to do with childcare activities; feelings of emptiness, heightened anxiety, which may include obsessive concerns about the child’s health and well-being.

A previous history of depression, genetic predisposition towards depression, early postpartum problems or those who have depression during pregnancy represent those who have the highest risk.

The risk of the most concern is the mother’s loss of any interest in daily child care activities that can lead to having negative feelings towards the newborn. If it continues, it can progress to have negative or intrusive thoughts and fear to harm itself, its child or both. These tend to be more obsessional than actual urges to do real harm.

Other negative and qualitative changes may occur, i.e., increase or decrease in sleep and energy, uselessness and guilt without adequate reasons, changes in appetite up or down, significant decreases in concentration and restlessness .

The other main area of ​​concern postpartum is much less common, but much more serious – postpartum psychosis. Although some research shows that this can happen up to a year postpartum, most cases occur within a period of 2 weeks and up to 3 months postpartum. This disease presents the potential for many psychotic symptoms, namely hallucinations of any sensory organ, delusional false beliefs or illogical thoughts, sleep and appetite disturbances, agitation or anxiety at very high levels, episodic mania or delirium, thoughts or suicidal or homicidal actions.

Women at greater risk are those with a previous history of schizophrenia, bipolar disorder, other psychotic disorders or a history of a previous episode of the illness with another child.

Occasionally, women with postpartum psychosis, like other forms of psychotic illness, are not always the first to notice or may be unable or unwilling to communicate their experiences or fears. The need for help can be communicated by a support – ie family, friend or professional. This help should be through a trained professional.

What do you want to do?

Q. What causes postpartum depression?

A. Like other forms of depression, there is no single cause, but a combination of factors. These include genetic family histories, structural and chemical changes in brain function that lead to endocrine (hormonal) and immunological alterations. The significant increase in estrogen and progesterone during pregnancy is quickly followed by a significant decrease in about 24 hours. postpartum. A clear depressive factor. Thyroid hormones also follow this pattern. Life events experienced as stressors combine to cause symptoms and illness.

Q. What about the questions of motherhood itself?

A. These can clearly contribute. For example: postpartum physical fatigue from the course itself, as well as the interruption of sleep or deprivation of care for the newborn; stressors to be a “good mother”, loss of who or what you did or thought of yourself before, feeling less attractive, lack of free time and simply overwhelmed by all the challenges of a new child or children. Women who are depressed during pregnancy have a much greater risk of depression after giving birth.

Q. Can you just wait and let it pass?

A. Of course not. Postpartum depression and certainly psychosis are very serious psychiatric disorders that require psychiatric treatment as soon as possible. Some women are ashamed or embarrassed to feel these things at a time when they should feel happy. How will they be perceived – as unfit parents perhaps? Denial can happen.

Q. What can happen if women do not seek treatment?

A. Nothing good – either for mother or baby, i.e. Poor birth weight or prematurity, restlessness for both, poor sleep for both, lack of pre and postnatal care, substance abuse, poor mother-child bonding and simply unable to meet the needs. of your child. In psychosis, the risks of suicide/homicide can be.

Treatment for these problems are available from competent and experienced doctors. Medication is generally helpful and necessary. If these are necessary during pregnancy, the salient risks and benefits are evaluated and weighed. Various forms of psychotherapy and support groups are also very helpful. Rarely, hospitalization may be necessary. These interventions can be life saving for mother and baby.

All children should have the benefit of a healthy mother. All mothers deserve the opportunity to have rewarding pregnancy, birth and motherhood experiences. These diseases can insidiously deprive mother and child and cause serious harm. If there are concerns, symptoms or observations of care problems, seek a trained psychiatric care at once. Don’t just struggle in fear, shame or silence.

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