Perinatal depression: causes, symptoms and tips for overcoming it.

During pregnancy, some expectant mothers may feel deeply sad.

Pregnancy is a period marked by illusions, but also by suffering.. Some mothers experience, shortly before or after childbirth, what is known as perinatal depression (PND).

This form of depression, which can be particularly tragic for both mother and child, is a peculiar manifestation that requires a different treatment from major depression, as it has its own characteristics. We explain the keys to understand it and review the most effective treatments.

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Perinatal depression, more than just postpartum.

For some time now, psychologists have broadened the definition of what used to be labeled as postpartum-onset depression.

We know that depression can begin a few months before delivery and that it is the same phenomenon that will haunt the mother's mood for a year after giving birth.

Clinical description

Perinatal depression includes any minor or major depressive episode occurring during pregnancy or within 12 months after childbirth.. There is some uncertainty regarding the incidence of the disorder. Several studies agree on prevalence rates ranging from 10-15%. However, when excluding studies where the diagnosis is based on self-report only, rates of 6.5% to 12.9% are reached. This is a global phenomenon, not exclusive to Western society.

Symptoms

Suffering mothers feel extremely guilty, some even hate their child. They feel alone and overwhelmed, they need help and do not know how to ask for it. They are filled with ruminative thoughts, sticky beliefs that are very difficult to get rid of and that severely hinder their lives.

Women with perinatal depression are in a period of role transition, from wife to mother, which is difficult to cope with.which is difficult to cope with. Likewise, difficulties in communication with a partner can further aggravate the feeling of being completely alone.

The seriousness of the disorder is not limited to how disabling it can be for the sufferer. Maternal perinatal depression is associated with a higher incidence of excessive crying in the child, colic, sleep problems, temperament difficulties, poorer self-regulation and more indicators of stress. It is also associated with negative mother-child interactions, including detachment, withdrawal, intrusiveness and hostility as well as poorer infant interpersonal functioning, insecure attachment and elevated rates of behavioral and emotional problems.

The main risk factor for perinatal depression is inadequate social support. The danger is increased by different deficiencies in social support such as:

• Not having someone similar to talk openly with.
• Not having friends or close relationships.
• Not receiving support without having to ask for it.
• Feeling socially isolated.

Treatment and advice

A very common feature of perinatal depression is that mothers feel ashamed of suffering from depression, so much so that they do not ask for help. This is why it is especially important to normalize depression, it is especially important to normalize perinatal depression.. 

Anyone can suffer an emotional upheaval, especially during such a difficult period as pregnancy and the enormous change it entails in family life. The arrival of a child always marks a before and an after.

Psychoeducation and activation

The first stone in overcoming perinatal depression is laid when the mother understands what is happening to her and why it is happening. Once this is done, she can start planning a whole series of activities that will get her going and make her feel useful again.

2. Learning to be a mother

One of the main concerns of mothers with perinatal depression is not measuring up and being a "bad mother.". The truth is that no mother magically learns, and some people may find it harder than others. In addition to addressing these thoughts, it will be vitally important for mothers to learn to feel comfortable interacting with their baby.

A good way to achieve this may be to attend workshops that teach you how to play with your baby, how to handle difficult situations (incessant crying, tantrums, etc.) or feeding problems. Support groups can be of great help in proposing alternative behaviors that promote an optimal relationship with the baby.

3. Working with the social support network and communication

Because perinatal depression is a markedly social disorder, it is vital to identify communication patterns that are not working. It will be necessary for both mother and father to learn to relate to each other and to communicate what they think in a clear and non-accusatory way. If we can do this, we will achieve two things: the mother will be able to ask for and receive help, and she will stop feeling completely alone and overwhelmed.

Support groups are a very important network in this regard.. Being able to talk to other mothers who are going through the same process, share your own experiences and receive advice from other women will make you feel supported and better prepared to face motherhood.

4. Role transitions

Motherhood is difficult to incorporate. The change of role can mean the loss of personal meaning, going from working woman to simply mother.

It will be very important to recover those activities that were part of the mother's identity. Identify those reinforcers that existed before the baby, such as the feeling of doing a good job or enjoying an evening with friends, and find opportunities within the new routine to incorporate them again.

Also, there may be a conflict between long-term goals (e.g., between family and work). Sometimes it will be necessary to rethink the goals and restructure them to make them both harmonious and realistic.

5. Attacking maladaptive thoughts

As in any emotional disorder we will have to work by means of cognitive techniques the thoughts that instead of helpinganchor people in the depths of depression.

Mothers should learn to identify in which situations they appear and acquire strategies to anticipate them or know how to neutralize them when they appear with more adaptive thoughts and adjusted to reality.

In addition, it is especially important to acquire the habit of thinking about problems only if it is to solve them. It is very easy to get stuck in the emotional discomfort caused by worries, but the only way to get out of this quicksand is to take distance and remind oneself that when faced with a problem there is no other way out than to look for a solution.