Postpartum depression: how to recognise the first symptoms and overcome it
Postpartum depression, also called postpartum depression, puerperal depression and abbreviated DPP, is a disorder that affects, with varying levels of severity, between 8 and 12% of new mothers: in Italy it can be estimated that out of 576,659 births a year at least 46,000 women may suffer from DPP (ISTAT data 2008)
PLD represents a public health problem of considerable importance, considering the subjective suffering of the woman and her family members, as well as the limitations and direct and indirect costs due to the impairment of her personal, social and occupational functioning.
When do the first symptoms of postpartum depression appear?
Postpartum depression has a variable onset; it generally begins between the 6th and 12th week after the birth of the child.
Recognising the symptoms of postpartum depression
The woman feels sad for no reason, irritable, easy to cry, not up to the tasks ahead of her.
Moreover, a recurring feeling among new mothers, who are faced with this problem, is shame mixed with guilt.
In common feeling, it is taken for granted that a new mother must be happy at all times.
This is a false myth.
The fear of being considered an inadequate mother, fuelled by unrealistic expectations, can lead women to feel guilty and unwilling to seek help, forgetting that it takes time to adjust to motherhood.
It is good to remember: one is not born a parent, one becomes one.
Causes of postpartum depression
The causes of postnatal depression are not yet fully known.
However, certain risk factors listed in the scientific literature are certain:
- having suffered anxiety or depression during pregnancy
- having suffered from anxiety and depression previously, even before pregnancy;
- familiarity with psychiatric disorders (i.e. having close family members who suffer from them);
- experiencing or having recently experienced very stressful situations, such as bereavement, separation, loss of job;
- experiencing a condition of poor family or social support, with precarious emotional relationships and lack of social networks to refer to in case of difficulty;
- economic difficulties or precariousness;
- suffer from premenstrual syndrome or premenstrual dysphoric disorder;
- suffer from thyroid function disorders;
- having had recourse to assisted fertilisation techniques.
The relationship between mother and child is affected
The disorder also interferes with the woman’s ability to establish an interchange of behaviour and emotions with her child.
In fact, 67% of depressed mothers report difficulties in interaction and attachment.
Interchange has been recognised as essential for an effective mother-child relationship, capable of preventing long-term consequences on the child’s cognitive, social and emotional development.
Postpartum depression and postpartum psychosis
PPD must be distinguished from so-called postpartum psychosis, also known as puerperal psychosis, a very rare disorder that is more severe in its manifestations.
Women suffering from it present states of great confusion and agitation, severe mood and behavioural changes, often hallucinations and delusions.
These states are very rare.
Postpartum depression and baby blues
PPD should also be distinguished from a rather common reaction, called ‘baby blues’ (‘blues’ means melancholy), characterised by an indefinable feeling of melancholy, sadness, irritability and restlessness, which peaks 3-4 days after the birth and tends to fade within a few days, generally within the first 10-15 days after the birth.
Its onset is mainly due to the drastic hormonal change in the hours following childbirth (drop in oestrogen and progesterone) and the physical and mental exhaustion caused by labour and childbirth and can occur in over 70% of mothers.
Postpartum depression, on the other hand, presents more intense and long-lasting symptoms.
How to overcome postpartum depression?
If you realise that time is passing and symptoms such as sadness, anxiety, apathy, sleep disturbances and so on do not subside, the best thing to do is to talk to a doctor, perhaps in health facilities in the area, such as psychosocial centres or counselling centres.
The doctor will advise what to do, depending on the seriousness of the situation.
Sometimes, just talking to someone will improve the situation.
Many anxieties and fears are magnified by keeping them hidden, because you think you are the only one experiencing them, when in fact they are quite common.
There are three main levels of intervention possibilities:
A) Self-help
If the symptoms are really very mild, if it is baby blues or little more, there is no need to do anything specific, but certainly some small steps are of great importance:
Do not hide the discomfort, but talk about it with your partner, family, friends;
Try to get as much rest as possible: tiredness is a strong ally of depression;
Try to eat a healthy diet and do some physical activity, perhaps outdoors.
B) Psychotherapy
There are various types of psychotherapy that can help cope with and overcome postnatal depression, either alone or in combination with pharmacological treatment.
These include, in particular, cognitive-behavioural therapy.
C) Drug therapy
There is no point in hiding it: depression in general is still regarded as a ‘minor’ disorder, something not to worry too much about, and drugs specifically for this disorder are often viewed with suspicion, especially when it comes to administering them during delicate phases of life, such as pregnancy or breastfeeding.
If someone has a heart ache, everyone worries and recommends taking this or that drug.
If, on the other hand, someone suffers from a mood disorder, we do not worry, we minimise, we neglect.
Instead, the disorder must be addressed, with the available tools, which include medication.
These include, for example, antidepressants and anti-anxiety drugs: some formulations are also safe during breastfeeding and can be taken with confidence.
Remedies and protective factors against postpartum depression
Certain strategies can be protective factors against the onset of depression.
They may not prevent it altogether, but they can mitigate it, or help women cope better by giving them strength and support.
Let us see what they are:
- The possibility of good rest in the first few weeks after giving birth. We know it well: with a newborn baby at home, the first thing to jump is the sleep rhythm, but the mother must try to get as much sleep as possible, for example by resting when the baby is resting. It can help, in this regard, to ask family members for help with small domestic tasks, and to limit visits from relatives and friends in the first few days after returning home.
- An adequate, balanced diet with food rich in omega-3 fatty acids (fish, walnuts, flaxseed oil) and low in stimulants such as alcohol and coffee.
- A good supply of vitamin D: a healthy life in the open air is enough to stock up on it, but if necessary ask your doctor to check the dosage with a blood test to assess whether supplementation is needed.
- A good relationship with the partner, who in the very first weeks after the birth has the delicate and beautiful task of supporting the mother and not leaving her alone while she ‘learns’ her new job.
- A good network of family and friends, who for example can offer valuable help with housework.
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