Postpartum depression can be seen in one out of every 5 women during the puerperium. It is important to be aware of the situation and seek support.
Women are at a significant risk for psychiatric disorders (anxiety disorders, obsessive-compulsive disorders, depression, psychosis) in the first year after giving birth. Since the incidence of these diseases is more dominant than the others, when postpartum psychiatric diseases are mentioned, postpartum depression is generally understood. The incidence of this disorder, which is also known as puerperal depression among the people, is between 5-20%.
Pregnancy is the most special period a woman goes through. During this period, many emotions are experienced intertwined. Excitement, happiness, impatience, curiosity, hope, sometimes despair… With the birth of the baby, a brand new process begins. Postpartum…
Postpartum; It is the time period in which the changes that occur in pregnancy slowly disappear, which medically refers to the first six-week period from birth. However, full recovery takes until the day the woman stops breastfeeding. During this period, some physical and mental changes occur in women. More than half of the postpartum women experience a period of anxiety called puerperal melancholy, maternal blues or baby blues, which starts a few days after birth and disappears by itself in a few weeks. Every healthy pregnant can go through this anxious period after giving birth. The incidence of postpartum sadness is between 50-70%.
In postpartum sadness; anxious mood, panic, feeling of not being able to keep up with everything are in the foreground. However, the mother tries to meet the needs of the baby in any case and there is no decrease in her interest in the baby. Postpartum sadness resolves on its own.
However a period of sadness and anxiety if it lasts longer than a month and if the mother finds it difficult even to fulfill the needs of the baby postpartum depression can be mentioned.
At this point, it is necessary to get support from an expert. The symptoms of postpartum depression are not different from depression in women who have not given birth, and it can be difficult to distinguish from maternal sadness in the first postpartum days.
In postpartum depression; lovelessness towards his family and opposite feelings towards his baby are more prominent. Other findings; mood depression, lack of interest in activities, appetite changes, fatigue, sleep disorders, difficulties in caring for the child, feelings of guilt, low self-confidence, difficulty concentrating, psychomotor retardation or agitation, and suicidal thoughts. Usually 2-8 days after birth. It starts within weeks and lasts at least 2 weeks and up to 1 year. It must be treated.
It is known that postpartum depression is more common in women with certain risk factors. These risk factors are unemployment of the woman or her husband, insufficient social support, marital problems, unexpected life events (death, separation, etc.), unplanned pregnancies, depression in previous pregnancies, not breastfeeding, pregnancy and birth experiences that ended in loss, concerns about early mother-infant separation and infant care. It is recommended that women with one or more risk factors be evaluated for postpartum depression 1 or 2 months after delivery.
Evaluation of every pregnant woman in terms of risk factors for postpartum depression by her doctor, who goes to regular pregnancy follow-ups, can be helpful in starting treatment with early diagnosis. Expert clinical psychologists are competent people in the field of treatment. With the evaluation interview and the necessary screening tests, they determine the situation and plan the treatment. Treatment of postpartum depression is almost 100% cured by psychotherapy. Rarely requires drug therapy.
Postpartum sadness and postpartum depression should not be confused with puerperal psychosis, which starts with the birth of the baby and appears suddenly and progresses with more severe symptoms. The incidence of puerperal psychosis is less than 1 in a thousand. This is a major inconvenience.
In postpartum psychosis there is a break from real life. Excessive emotional responses, shifts between extremes, flying in thoughts, hallucinations, and behaviors that will cause harm to oneself and the environment can be observed. If it is not noticed by the relatives and medical support is not started in a short time, the person may harm himself and his immediate surroundings, and very rarely the baby.
Mental syndromes seen in puerperium can sometimes be intertwined. Severe infant rejection can be seen in a mild postpartum depression. It is possible to encounter people around them, abandoning the baby to places of worship, beating, biting, strangling, burning, starving and depriving the baby, and even very rarely killing it.
Treatment in intertwined psychotic states is not easy. It may be necessary to hospitalize the postpartum and stop breastfeeding. Electroshock treatments that act faster than drug treatments can also be used.
Psychiatric problems may worsen in proportion to the severity of the underlying picture. The probability of recurrence also depends on the underlying disease. As puerperal syndromes may recur in every puerperium, their weight may be more or less. Pregnancy and puerperium periods of patients with previous puerperal syndromes should be followed closely, and their social environment should be warned.
What can be done in the Postpartum Period?
Almost half of postpartum syndromes are undiagnosed and therefore untreated. Since the mother thinks that the deteriorating mood begins with the birth of the baby, it may cause difficulties in communicating with her baby and adversely affect the behavioral and cognitive development of these children in the future.
Environmental support, especially spousal support, is very important in postpartum grief. The most important way for a mother to get rid of anxiety is to make her feel safe. Knowing that she is not alone and that she will be there for her husband and social circle in all her troubles is very comforting for the mother. The duty of the spouse is to patiently run to every request for help during this period.
During this period, it should be ensured that the mother does not look at anything other than breastfeeding. An older sister of the family should help with other baby-related tasks other than breastfeeding, such as changing the baby’s diaper, bathing, and putting him to sleep. The puerperant should not wake up with every cry. If other family members take care of the baby in small murmurs, the mother’s waking frequency decreases. Since the baby will not be silent in real hunger, then the mother should start breastfeeding and should only be busy with this job. The presence of a reliable older sister who takes care of the baby prevents the mother from waking up frequently with the worry of “Is my baby okay”.
After the baby’s belly drops, going for walks with the baby, meeting with friends at home or outside will reduce the troubles. It will be useful to chat with experienced mothers, read the articles on mother-baby blogs on the internet, and follow the information given by the experts. It should be ensured that the mother has time for herself besides her baby.
It would be right to seek medical help in cases of persistent anxiety that does not improve with these measures.