Postpartum emotional disturbances

Having a baby is a happy event for most women, but the biochemical, psychological and social changes that it entails make women more vulnerable to changes in their postpartum mood. These alterations reduce the level of health of the woman who has just had a child. We can divide postpartum emotional changes into three large groups: postpartum melancholy, postpartum depression, and postpartum psychosis.

Postpartum blues

70-80% of women on the second or third day after childbirth present the so-called postpartum blues or third-day depression that lasts between one and three weeks. These women feel weak, lonely and distressed, it is a mild form of depression. Postpartum melancholy is characterized by emotional lability, bouts of crying and sadness that do not reach sufficient intensity to require drug treatment, psychological treatment being very useful. The patients describe that they feel hurt very easily, that they get angry at any small incident and in some cases they lose interest in the baby. Most of the cases this syndrome is mild and transitory and will remit spontaneously without sequelae.

Depression

It is estimated that between 10 and 20% of women will have postpartum depression, but this incidence is very difficult to estimate since many women may be wary of showing their feelings. This entity is a disease that requires psychological and often medical treatment as well. Symptoms usually start before the sixth week postpartum and can last between 3 and 14 months. Women who have suffered from it previously have a 70% chance that it will also occur in subsequent deliveries. Women with postpartum depression generally have several of these symptoms:

• Laziness
• Fatigue
• Sadness
• Sleep and appetite disturbance
• Lack of concentration, confusion
• Memory loss
• Irritability towards partner and other children
• Guilty feeling
• Loss of livid
• Fear of self-harm or injury to the child
• Overprotection of the child, repeated visits to the specialist for estimating that he is always ill
• Intolerance towards the baby
• Anxious symptoms: intense anguish, fear, palpitations ...

Postpartum depression is a medical problem and you should not just wait to get out of it but seek help from specialists.

Risk factors for postpartum depression are:

• Previous postpartum depression
• Depression not related to pregnancy
• Severe premenstrual syndrome
• History of eating disorder
• Unwanted pregnancy
• Teen pregnancy
• Cultural uprooting
• Compromised socio-economic situation
• Psychosocial stress in the last 6 months

Postpartum psychosis:

It is an acute and serious disease that affects 1-2 / 1000 of postpartum women. The clinic usually begins in the second or third week after giving birth. The symptoms that are manifested are: affective lability, visual or auditory hallucinations, disorganized speech, sleep disorders. Self-injurious behaviors are more frequent and can even go as far as suicide.

The causes of postpartum emotional disturbances are multifactorial. One of the influencing factors is the abrupt decrease in sex hormones associated with pregnancy. This hormonal decrease is similar to what happens on the days of menstruation, which explains why women with mood swings marked by menstruation have a higher rate of melancholy or postpartum depression. These hormonal variations produce chemical changes in the brain that influence depression and in some cases there is a very frequent alteration of thyroid function postpartum. Patients with a history of depression will have a higher incidence rate after giving birth.

To this are added psychological factors since the woman needs an adaptation to the changes that take place in her body and in her life, and the idea of ​​the ideal mother can produce psychic confrontations in the new mother. Fatigue and interrupted sleep do not favor postpartum physical and mental recovery. Psychosocial factors play a very important role since the lack of both physical and emotional support increases the risk of postpartum depression. These variables are more pronounced in mothers of late or very early age, and according to their socioeconomic status. Maternal or fetal complications also imply an increase in the incidence of postpartum depression, on the other hand, good family support, with help both in housework and in caring for the child, decreases its appearance.

The treatment of these disorders must be done by specialized personnel. The treatment of choice is psychotherapy, both individually and in groups. Supportive measures have been shown to significantly reduce the incidence of postpartum emotional disorders and in most cases of postpartum melancholy they are sufficient as treatment. In cases where there is not enough improvement with psychological treatment, pharmacological treatment with antidepressants should be used. Depending on the antidepressant to be taken and the assessment of each case, breastfeeding will continue or artificial lactation will be indicated. In cases of postpartum psychosis with risk to the child or the mother, hospital admission should be indicated.