What is postpartum depression associated with? Postpartum depression: symptoms and prevention. Video: Yoga as the best means of getting out of a depressive state

Postpartum depression often occurs after the birth of a baby. The birth of a child is a bright emotional outburst, but the positive can quickly take on a complex coloration. Due to the processes occurring in the body of the woman in labor, as well as the family environment, in 10-15% of cases, postpartum depression occurs. This is a serious and dangerous condition, accompanied by growing despondency, which can radically change a woman's life in a negative direction. Therefore, it is extremely important in as soon as possible recognize the pathological process and take comprehensive measures to overcome the crisis.

Risk Factors for Anxiety

Postpartum depression is a complex psychopathological condition, which is characterized by a general negative mood of a woman, a sharp emotional lability and a decrease in attraction to a man and a child. Despite the study of the problem, the exact causes leading to the disease have not been established. The most well-known theory of monoamines, according to which the number of mediators of positive emotions serotonin and melatonin decreases in the body of a woman in labor. However, all the processes occurring in the nervous system, the theory is not able to explain. However, the factors provoking postnatal disorder are quite clearly defined.

These should include:

• violence in family;
• excessive influence of relatives on a woman;
• initial organic damage to the nervous system;
• genetic determination - the presence of any psychopathological diseases in close relatives;
• late formation of ovulation after childbirth;
• negative attitude from a man;
• inability to cope with increased obligations;
• low self-esteem.

More than 60% of all cases of postnatal mood depression are associated with previous depressive episodes during a lifetime. In the early years, it could be suicide attempts due to unhappy love or oppressive feelings due to poor school performance. Depression during pregnancy, especially after the 30-week period, often provokes the development of such episodes after childbirth.

Clinical manifestations of the disease state

According to WHO, symptoms postpartum depression occur within 7 weeks after the birth of the child. If the manifestations of the disease occur later, then such a disorder does not apply to postnatal. Classic signs of postpartum depression include:

• a sharp change in mood with a tendency to reduce the emotional background;
• tearfulness;
• reduced performance;
• apathy towards the child and the man;
• loss of appetite or even a complete aversion to food;
• pathological taste in the mouth;
• somatic complaints of constant discomfort in any part of the body, often headaches or dyspepsia;
• depressed facial expressions.

In some women, the appetite is not only preserved, but also sharply increased. Eating becomes more frequent and food cravings are bulimic. This is a kind of substitution form - getting the missing pleasures from food.

This form of depression is the most favorable, since the deficiency of monoamines is relatively quickly compensated. But in the future, it is possible to form the usual nervous breakdown due to dissatisfaction with their own appearance.

Initial signs of the disease

It is always important to know how a problem manifests itself at the very beginning of its development. The first sign of a painful condition is by no means sudden mood swings. Often a subtle symptom is a harbinger of a complex disorder. Postnatal depression is characterized by glycogeusia. It's a sweet, sugary taste in the mouth. It can occur already in the first days after the birth of the child. The probability of developing full-fledged postpartum depression in this case is more than 90%.

Another subtle symptom leading to a pathological nervous breakdown is a spotting discharge from the vagina. Ordinary lochia is typical for women in labor, but a small daily loss of blood negatively affects the emotional sphere. Coupled with family troubles associated with understandable reluctance intimacy, there is a feeling of hopelessness and uselessness, and further prospects seem vague. Only family support and iron deficiency medication will help protect against depression.

Features of the course of the disease state

How long postnatal depression lasts is hard to say. With rational help, the disease can be avoided, and the duration of the reduced mood background will be minimal. Officially, the diagnosis is considered established if the signs of an anxiety disorder persist for more than seven days. The following factors influence the duration of depression:

• family relationships;
• early psychocorrection;
• health of women and children;
• the presence of crazy ideas;
• the severity of the existing organic lesion of the nervous system;
• lactation.

With insufficient family support, lack of sexual intercourse, poor health of the baby, the level of “happy” hormones drops sharply. This provokes a long duration of depression and even a transition to chronic form. An equally negative role is played by the existing organic pathology of the brain and the associated delirium. In these cases, even suicide attempts are possible, which are usually not characteristic of postpartum depressive episodes.

Non-drug methods of dealing with the problem

You need to deal with depression. The question of how to get rid of the disease on your own is always acute in any family, since it is initially difficult to make a decision to contact a specialist. The main condition is to improve the quality of life and improve the family microclimate. The following will help in getting rid of depression:

• warm conversations with her husband;
• informal communication with relatives and friends - meetings, joint walks, even collective viewing of TV shows;
• regular sexual intimacy, bringing pleasure to both partners; folk methods- soothing herbs, contrast shower;
• extension of natural lactation.

The most important role in how to get out of postpartum depression is communication with loved ones. This is a kind of psychological training that helps to escape from the difficult postnatal life. If the mood continues to decline, the future outlook is not drug treatment associated exclusively with a specialist. It is necessary to contact a psychotherapist for individual or group sessions.

Medical methods of correction

It is absolutely unacceptable to experience a problem on your own with the ineffectiveness of home treatment. Depression and despondency will only progress, which will lead to dire consequences. With ongoing depression, medication is required, which is prescribed exclusively by a doctor. The basis of therapeutic correction is antidepressants and tranquilizers.

In parallel, vitamins, sleeping pills and drugs that stimulate the brain are prescribed. Usually the treatment process takes place at home, but in severe cases, especially with a suicide attempt or delusional disorders, hospitalization is indicated. Of course, natural feeding in such cases will have to be excluded.

Forecast and conclusion

In the presence of warm relations in the family, depression usually does not develop. But with the appearance of depression and a decrease in mood, the help of loved ones and alternative methods of treatment help to solve the problem. The prognosis in such a situation is extremely favorable: depression ends after a short time.

If the disease drags on, and the man does not take part in solving the problem, then fear, anxiety and general despondency increase. In this case, psychocorrection in the form of group or individual sessions will help.

If home methods are ineffective, you should consult a doctor. Even severe disorders with the presence of delirium and suicide attempts are fully compensated by medications. Therefore, later life can easily improve, and the prognosis will again be favorable. It will be doubtful only if there is a pronounced neurological deficit against the background of organic brain damage preceding pregnancy.

Postpartum depression is a common problem for new mothers. Causes of depression, common methods of dealing with them.

For several decades, modern doctors and psychotherapists have been concerned about the issue of postpartum depression in mothers, as well as the treatment of this pathology. Increasingly, the joy of motherhood in women is replaced by despondency, turning into despair. The anxiety of experts is caused by the increased number of suicides and mental disorders on the background of postpartum depression. Timely therapy can save the fragile psychological state of new mothers. To do this, you need to understand what postpartum depression is, as well as be able to recognize its symptoms.

What is postpartum depression

What is postpartum depression? It would seem - well, what, in fact, depression? Nearby, in the crib, a tiny touching bundle is sniffling, ahead are only bright and bright prospects. In fact, everything is somewhat more complicated and often after the first days of communication with the baby, the joy of the mother is replaced by other, stronger, but less positive feelings.
Postpartum depression is accompanied by a feeling of anxiety, devastation, and other signs that are dangerous for mental and physical health.

Some statistics. From the manifestations of depression, which manifested itself after childbirth, suffer from 10 to 15% of mothers. The peak of disorders falls on the period when the child is 6 months old. Most often, it fades away closer to the year of the crumbs. Another 10% notice depressive states in themselves only in the second year of a baby's life.

What are the causes of postpartum depression

So famous and dangerous postpartum depression - what are its causes? Depressed mom is usually caused by one of 4 types of factors:

• Physiological or physical causes. Caused by disorders in the thyroid gland, as a result of which the production of progesterone and estrogen decreases in the mother's body. This leads to a change in mental state (symptoms are similar to menopausal disorders and manifestations of premenstrual syndrome)
• Anamnestic information about the predisposition to depressive states. Such data can be obtained from the results of monitoring a woman during pregnancy. Abuse alcoholic drinks and a hereditary factor can lead to depressive states or even mental pathologies
• social reasons. Very individual and numerous in each particular mother. They directly depend on the woman's environment, family structure, as well as physical and moral support from loved ones. The most common social causes of depression in young mothers are:
  • Inattention or misunderstanding on the part of the partner/husband
  • Financial dependence on parents or other relatives
  • Loss of loved ones
  • Pause in career
  • A woman's desire to conform to maternal ideals imposed by society
• psychological reasons. There are several main similar factors affecting postpartum depressive syndrome:
  • Low resistance to stress
  • Emotional immaturity, infantilism
  • Tendency to hypochondria, suspiciousness
  • Low self-esteem, desire for self-blame
  • Tendency to depression
  • Negative type of thinking

Analysis of symptoms: how postpartum depression manifests itself

How does postpartum depression manifest itself?
As a rule, manifestations of depressive conditions begin after 2-4 months of communication with a newborn and can drag on for a period of several months to a year. Symptoms are most pronounced in the morning.
The main criteria for recognizing depression are:

• Decay mood. It dominates most of the day and lasts continuously for more than 2 weeks, regardless of external factors. Sadness, melancholy, laconicism, depression are the main symptoms of a mother in depression
• Decreased interest in things that used to bring joy and excitement
• Decreased energy, increased fatigue. Slowness, unwillingness to move (sometimes to the point of falling into a stupor)

Additional symptoms of postpartum depression include:

• Feelings of guilt, self-flagellation (usually unfounded)
• Decreased self-esteem loss of self-confidence
• Drawing in your mind a bleak, pessimistic outlook
• Sleep and appetite disorder
• Thoughts of suicide (may be accompanied by attempts to act)

How to deal with postpartum depression: treatment methods

In the light of all the above, relatives of a young mother will be interested in the question: how to deal with postpartum depression?
The main methods are 2: psychotherapy and drug treatment.

Psychotherapy

Effective in mild cases of postpartum depression. In working with a patient, a specialist can apply methods of autogenic relaxation, as well as conduct sessions of individual, family, marriage psychotherapy.
With mild mental disorders, these methods are usually enough to overcome their problems on their own, without taking special drugs. After the end of the main treatment course, it is recommended to conduct periodic maintenance sessions.

Medical treatment

Lack of results from psychotherapy or insufficient effect after 1.5-2 months, become the reason for drug treatment of postpartum depression. As a rule, psychotropic drugs are prescribed for this purpose - antidepressants, antipsychotics or tranquilizers.
Mild and moderate depressive states are treated with Negrustin, Deprim forte or Delarium. These medicines contain an antidepressant plant origin obtained from the extract of St. John's wort.
Taking antidepressants can negatively affect the quality breast milk. But sometimes the treatment of prolonged depression in the mother justifies the possible risk. Alternative ways to solve the problem would be to transfer the baby to artificial feeding or taking medications that are safe for the baby (eg, sertraline).
Usually, an improvement in the condition of a young mother is observed already 2-4 weeks after the start of treatment. To consolidate the positive effect of medication, it is recommended to take a few more weeks.

The hardest part is over - you have successfully undergone childbirth and are now at home, and the baby is sleeping soundly in her crib. Your husband is crazy about happiness and loves you even more. Relatives and friends fill up with congratulations and gifts. In a word, live and be happy. And you want to cry. You feel anxiety coming from nowhere. It seems as if something is about to happen, and everything good will dissolve like a dream. Don't be scared, you're not the only one this is happening to. All women experience such sensations in the first few days after childbirth.

However, in ~50% of women, such a depressed state drags on and already ceases to resemble ordinary sadness or experience. This condition is called postpartum depression. In women, it can manifest itself to a lesser or greater extent, briefly or drag on for many months. Postpartum depression occurs in 50% of women, in 13% it is severe.

postpartum depression- a painful condition of a woman after childbirth, characterized by a depressed mood, tearfulness, unwillingness to see her child, reversible mental disorders. In most cases, PD is not too pronounced, but in severe cases, the mother may even have a desire to kill herself or the child. Such women require treatment in special institutions.

Video #1: About Postpartum Depression

Signs and causes of depression

All of the above exhausts a woman and makes her irritable. There is an inner emptiness and indifference to everything that previously gave pleasure and delight. A woman becomes indifferent and indifferent to her husband, it may seem to her that love for him has passed. Moreover, all the men in the world become disgusted with her.

Apathy reaches such a degree that it is manifested by indifference to the child, unwillingness to care for him, up to hostility.

Causes:

• a sharp hormonal change that occurs during and after childbirth;
• psychological unpreparedness for motherhood or unwillingness to do so;
• physical exhaustion of the body, fatigue, overstrain, difficult childbirth, material or family trouble;
• hereditary, age (after 40 years) or personal predisposition to depressive states.

Everything else can be accompanied by somatic symptoms.

Somatic symptoms:

• common headaches or migraines;
• increased heart rate, dizziness;
• indigestion (loss of appetite, constipation);
• neuralgia;
• skin itching;
• insomnia, nightmares, suicidal thoughts, desire to harm yourself or the newborn;
• violations menstrual cycle or disappearance of menstruation, frigidity.

Video #2

Psychologist Anna Galepova talks about postpartum depression, anxiety, fears for the child:

Fighting depression

With a mild degree of postpartum depression, you can get rid of it yourself. The most important thing is a woman's understanding that this condition is temporary and that a certain self-adjustment is needed to get rid of this condition.

1. Remind yourself often that a miracle has happened in your life that many can only dream of. Remember what you had to go through for this miracle to happen. Thank God (fate) for the fact that everything went well, everyone is alive and well. Feel the peculiarity of your position, then the household routine will repent for you as a trifle of life.
2. Think about how your baby needs your love now, when he is helpless in a new world for him. Take the baby in your arms more often, stroke him, talk affectionately. Tactile contact, breastfeeding contribute to the production of "happiness hormones" that will help you fully experience the joy of motherhood, tenderness and love for the baby.
3. Whatever the circumstances, try to understand that you are not alone now. A person has appeared in the world whose well-being depends on you.
4. If possible, be sure to allow yourself to be alone with yourself. Each person must have a personal life and personal time, otherwise he loses his individuality and falls into depression. Give yourself a day off when your husband is at home. Many women are initially afraid to leave babies with their fathers - sort it out in yourself. An increased sense of responsibility will only drive you into more depression. Pick up your phone and go shopping, to the cinema or to the hairdresser. If it's tight, they'll call you. Even breastfeeding should not interfere with a full life, a breast pump is your good assistant in this matter ().
5. Don't be ashamed overweight is a temporary natural phenomenon. Extra pounds will leave you within a year, especially if you are breastfeeding, because the fat accumulated during pregnancy goes into milk ().
6. Get enough sleep. Do not take on all the worries, leave some of them for your husband, grandmother, grandfather or nanny. You must have an assistant. If you feel tired, choose rest over cleaning and cooking.
7. Do not listen to those who give you advice to go on a weight loss diet or eliminate a bunch of foods from your diet, for fear of allergies in your child. If you are a nursing mother, eat whatever you want and how much you want, excluding obvious allergens. Right now you need to fully eat and gain strength after stress ().
8. The closest person to you is your husband. Do not move away from him in silent mystery. Men do not understand the emotional state of a woman. Talk to him and tell him specifically what is happening to you, what you feel, what you think, ask for help. For your trust, he will only be grateful to you.
9. Don't wallow in loneliness. Communicate with other mothers, talk heart to heart. Surely, you will meet women with the same problems. Perhaps one of them managed to solve them, or you will become like-minded people in this struggle. In any case, this will be a support for you.
10. Many relaxation and meditative techniques (aromatherapy, bath, massage) teach how to cope with depression on your own. At first, newborns sleep a lot, so you will have time to relax, read, or simply do nothing.

When you need specialist help

What to do if all this does not relieve depression, and you no longer understand how to get out of this state? It may be worth contacting a specialist. It is better if it is a perinatal psychologist or a psychotherapist. First, it will be necessary to remove the anxiety state, fears. The doctor will help you relax, normalize your mood, return to the natural perception of life. Different techniques can be applied: NLP, psychoanalysis, hypnosis or others, depending on the skills of the specialist and the factors that caused postpartum depression.

Further, the psychotherapist may suggest that you undergo sessions of family, cognitive psychotherapy, during which internal family problems, children's complexes, resentment and everything that can again return you to a depressive state after some time.

The treatment is fixed by analyzing negative scenarios and changing the life attitudes and views of a woman on problems.

In severe cases of depression, a woman is prescribed antidepressants or anti-anxiety medications. But due to their high toxicity, they are taken in exceptional cases. If it is impossible to refuse medications, breastfeeding has to be sacrificed.

Prevention

Prevention of depression consists in informing a pregnant woman about possible changes in her emotional state after childbirth.

In most cases, a woman, understanding the cause of a depressive mood, is able to control her emotional background herself and get out of this state after some time. The support of loved ones and spouse during pregnancy is important. Healthy, warm relationships in the family are the key to a successful postpartum period for a woman. Especially women should be closely monitored, whose status is already burdened by depressive episodes or some kind of trouble.

When does it pass

Women are wondering how long postpartum depression lasts, because it is easier to cope with any condition knowing its timing.

A mild form of depression can be observed for only a couple of months, but it can drag on for six months. Severe depression without treatment can last for years.

But when depression passes, everyone can breathe a sigh of relief. After all, the happiness of the family directly depends on whether the woman is happy. Having overcome this condition, many women then remember with a smile all their whims, tears and obsessive thoughts, and forget what they went through. No one is immune from illness, the support of loved ones and a psychotherapist will speed up recovery.

Video stories

Lecture

Postpartum depression: myth or reality?

Is postpartum depression really a difficult state of body and spirit, or is it just an invention of hysterical mothers who do not know how to control themselves? What are the causes of postpartum depression and how to avoid it?

Content

Most of the women in last dates pregnancy experience anxiety. Unstable mood intensifies on the eve of childbirth and after the birth of a child. The nervous state often develops into a prolonged depression of varying severity and can be big problem not only for the mother and her child, but also for the environment.

What is postpartum depression

Many mothers after childbirth experience fear of the first feeding of the baby, they are worried about whether they will be able to care for the baby. Often a woman has a fear for the health of the child, but very soon the fears are left behind. Unfortunately, not all of this period ends quickly and safely. Some women do not stop experiencing fears even a few months after the birth of a child. In medicine, a painful state of anxiety, which is unreasonably objective reasons, is called depression.

This is a serious mental pathology, which is formed only in the postpartum period. Depression after childbirth is distinguished by the loss of former interests, a depressed mood that occurs already in the first week after childbirth, and only grows over time. This disease is directly related to psychological, social and hormonal changes in the life of a lady.

Causes

Postpartum depression in women occurs for a variety of reasons. To date, doctors do not have a unified theory on this matter. All available causes are divided into two groups: socio-psychological and biological. The most proven is hereditary predisposition. If one of the woman's genetic relatives had depressive disorders, then the pathology can be inherited and manifest itself when certain life circumstances coincide.

The socio-psychological group explains the postpartum anxiety of a woman by the peculiarity of her personality, communication problems in adulthood, the psychology of growing up, and the level of stress resistance. Psychotherapists distinguish two bases of a person's well-being: physiological and psychological. The first include the following causes of depression:

• postpartum imbalance of chemical elements;
• malfunctions of the thyroid gland;
• hormonal changes;
• side effects from taking certain medications;
• infectious diseases;
• long-term chronic diseases.

More often, psychosis occurs due to psychosomatic disorders. The main psychological causes of postpartum depression in women:

• problems with breastfeeding;
• fatigue from lack of sleep;
• pain after difficult childbirth;
• increased degree of responsibility;
• changes in the figure;
• lack of finance;
• partner problems.

Forms

Specialists divide postpartum mental disorders into three forms. They are formed only after the birth of a newborn baby. Among them:

• neurotic. It is manifested by irritability, frequent mood swings. The woman has a heightened dislike for the people around her. Sometimes she is exposed panic attacks, which are accompanied by profuse sweating, tachycardia, high blood pressure.
• postpartum psychosis. Severe form of depression. Manifested by delirium, hallucinations, which are embodied in aggression directed at the child. It is more common in women in labor with bipolar disorder (manic-depressive psychosis). This pathology is treated in a hospital under the supervision of a psychiatrist.
• Protracted postnatal depression. The disease begins as a spleen associated with postpartum difficulties. A woman tries to be a good mother, but any problem (for example, the inability to swaddle a baby) leads to panic. Over time, the condition worsens, the blues develops into despair, prolonged depression.

Symptoms

The first signs of postpartum depression are emotional exhaustion and loss of strength. A woman feels an enduring depression that intensifies in the morning and evening. Thoughts about the absence of the meaning of life increasingly arise in the head, a guilt complex develops in front of the child, especially if he has health problems. The woman in labor increases emotional sensitivity, expressed in excessive tearfulness with or without it. This condition begins immediately after childbirth and can last from several weeks to several months..

You should not run these symptoms, as they can very quickly turn into serious psycho-emotional problems. Conditions in which a woman needs to see a doctor:

• changeable mood;
• short-term memory loss;
• constant fatigue;
• tearfulness;
• increase or decrease in appetite;
• sleep disorders;
• constant feeling of guilt;
• apathy;
• indifference;
• migraine;
• intestinal disorders;
• hypochondria.

Complications

Postpartum syndrome, like any other disease, does not always pass without a trace. A long-term depressed state of a woman in labor adversely affects the baby and spouse. Children who are fed by mothers who are in melancholy are prone to increased excitability or abnormal passivity. During the first year of life, a child may not show bright, intense emotions at all. Such babies have inactivity, insufficient concentration of attention, and a late onset of the formation of speech skills.

Men are also dissatisfied with the depressive behavior of their spouses, and some even consider this pathological condition to be a whim. They try to restore their sex life, which is not achieved. Ignoring this issue introduces men into a depressive disorder, which poses a threat to the partnership as a whole. Postpartum depression can lead to severe consequences for the woman and her family:

• suicide attempts;
• exacerbation of depression requiring hospitalization;
• attempted infanticide;
• inability to restore relations between spouses.

How to deal with postpartum depression on your own

With a mild degree of postpartum disorder, you can get rid of it yourself. The main thing for a woman is to realize that this is a temporary condition, and a positive self-adjustment will give a quick relief from depression:

1. Remember more often that a miracle happened in your life. Feel the peculiarity of the situation, then the household routine will cease to cause negative emotions.
2. Consider that your child is helpless in this world, and most of all needs your love. Breastfeeding, tactile contact contributes to the production of hormones of happiness, so take your baby in your arms, gently talk to him as often as possible.
3. Be sure to take time to be alone with yourself. Each person must have personal time, otherwise he loses his individuality. Take a day off, go to the hairdresser, go shopping or go to the movies. Even the period of lactation should not prevent a woman from living a full life.
4. Do not be ashamed of extra pounds - this is a temporary phenomenon. Do not listen to those who will give advice to go on a diet or eliminate any favorite foods from the diet. In times of stress, you need to fully eat, gain strength.
5. Engage in relaxing, meditative techniques. Take time to relax (bath, massage, aromatherapy).

Treatment

If you cannot cope with the disease on your own, then with further development signs of a depressive state, you need to visit a psychologist or psychotherapist. The specialist will give recommendations for correcting behavior. Methods for treating depression are prescribed individually. The most effective therapeutic methods:

• NLP. Neurolinguistic programming techniques allow you to unlock the reserves of human strength. An NLP specialist will help the woman in labor to realize the true values ​​and needs, formulate the desired goals and show the way how to achieve them. If the treatment is based on experiencing a negative experience, then the doctor does not tease the woman's psyche, but teaches new behavior, forms positive attitudes.
• Psychoanalytic techniques. Doctors work through childhood memories. If the patient's mother had depression after her birth, then the woman's need for emotional contact was not fulfilled, so she repeats her negative experience in adulthood.
• hypnotic method. Hypnotherapy is effective in the initial stages of a pathological condition. Hypnosis will quickly relieve depressive symptoms. As a rule, a woman's well-being improves after 2-3 sessions. After the course of treatment, she experiences the whole gamut of positive emotions.

Drug treatment is prescribed for a severe form of the disease, when the above methods do not help get out of a depressive state. The following groups of drugs are prescribed:

• Antidepressants. Correct the work of the brain disturbed by depression (Imipramine, Pirlindol).
• tranquilizers. Reduce the speed of mental reactions, have a sedative, hypnotic effect (Nitrazepam, Tofisopam).
• Antipsychotics. Strong psychotropic drugs, the action of which is aimed at treatment bipolar disorder(Aminazine, Haloperidol).

The most common treatment for postpartum mental disorders is complex therapy with antidepressants, psychotherapeutic sessions and folk recipes. Medications are prescribed in the form of tablets (oral administration) or as an injection solution (intramuscular or intravenous administration). Effective sedative medicines that can be bought at a pharmacy (in consultation with a doctor):

• Nervochel. Homeopathic remedy with a sedative effect. With increased nervous excitability, you need to dissolve 1 tablet 3 times / day for 2-3 weeks. Contraindications for admission: children under 3 years of age, hypersensitivity to the components.
• Alora. Combined medicine of plant origin, non-addictive. It has a sedative, anticonvulsant, analgesic effect. To reduce mental stress, take 1 tablet 3 times / day for 10-14 days (if there is no individual dosage). Caution should be exercised in taking the drug to people with diseases of the gastrointestinal tract.

How to avoid postpartum depression

If you know about the possibility of a postpartum mental disorder, then you can prepare for it. Prevention should begin during pregnancy. To prevent depression, you need to:

• create a warm microclimate in the family;
• visit a family psychologist;
• strengthen immunity through proper nutrition available exercise, daily walks in the fresh air;
• avoid overwork;
• learn to increase stress resistance (positive attitude, self-control, emotion management).

Video

During pregnancy, the woman had many worries, but now the birth is over, and it would seem that she needs to calm down, take care of her recently born child and enjoy a new life. But in some women, after childbirth, specific changes in brain activity and the functioning of the nervous system occur, leading to a violation of the state of mind and loss of peace, constant depression and anxiety. Often this state of anxiety flows into postpartum depression - this is a medical term, a serious pathology, and should not be taken as a way for a young woman to shirk her duties.

Postpartum depression as a social problem

Due to the nature of the character, the influence of various external factors or health problems, the birth of a child does not always become an emotionally bright and joyful event for a woman. Acquiring a new social status, many mothers experience constant experiences, anxieties, and instead of joy and tenderness, enjoying motherhood. Continuous tension, worries, fears and poor health turn into a depressive state. This is referred to in medicine as postpartum depression.

The older generation, and sometimes the woman's husband, can take serious symptoms for a whim, whims or character traits, fatigue, and do not attach importance to what is happening, do not sound the alarm and do not force the mother to see a doctor. And then all this can lead to tragedy both in relation to the life and health of the child, and the youngest mother up to

It is important that relatives and the woman herself know that postpartum depression is a serious psycho-somatic disorder that requires attention and control, and sometimes active medication. For most mothers, such a disorder has a short course and a favorable outcome, but for some it requires close attention and consultation with a doctor.

note

If the change in the psycho-emotional background and negative moods last more than 5-7 days, there is every reason to suspect depressive disorders. If the mother shows negativism, detachment or indifference towards the desired and long-awaited child, it is important to immediately seek help.

How long does postpartum depression last?

Such a condition without full assistance can drag on for many months, seriously affecting the quality of life and attitude towards the child. A mother with a similar disorder develops apathy with a loss of interest in any manifestations of life. Over time, the manifestations can be smoothed out, but at the same time, the course of depression itself becomes chronic.

The biggest difficulty for success in treatment is the fact that a woman is not ready to admit her problem and take any action to eliminate it. At the same time, relatives and spouse silently agree with her decision and also do nothing about what is happening.

The statistics on the frequency of occurrence of such a disorder is relentless - every fifth mother who has recently given birth suffers from various manifestations of depressive disorders during the first two years from the moment of birth. Psychological and emotional disorders after childbirth are typical for about 60-70% of women, but severe problems that are dangerous for others, for herself and the child are typical for 2-3%, and not everyone goes to the doctor with them.

Who suffers from such problems?

According to experts, postpartum depression is included in the category of major depressive disorders, due to the similarity of symptoms, manifestations and consequences.

Interesting fact!Postpartum depression can haunt not only the mother, but also the father of the child. Although the psyche of men is relatively more stable, the birth of children can also negatively affect their emotional background, but they usually have such a state for a relatively short time, and the symptoms are not so pronounced.

Such states in the father are associated with a change in habitual life and new obligations, a high degree of responsibility not only for himself, but also for his spouse and baby, who depend on him. This is their new role, which not all men are ready to accept with joy. In men, depressive manifestations can be both active and passive. With active ones, aggression with irritability is manifested, while with passive ones, isolation and detachment from the situation are typical.

Varieties of postpartum depressive disorders

Far from any psychological state of a woman after the birth of a baby can be attributed to depressive disorders, and bouts of apathy or a melancholic mood that occasionally occurs in each of us does not require anxiety and immediate treatment. However, there are also situations in which it is important to consult a doctor and seek help, and sometimes even inpatient treatment:

Causes of depression after childbirth

Even among those women whose children were very desired and long-awaited, postpartum depression is quite possible, and about one in five mothers have one or another of its signs. There is no single reason for the formation of such a disorder, but often a whole complex of provoking and irritating factors, negative events and conditions acts simultaneously. Often, both mental and physical negative factors simultaneously influence, which lead to an exacerbation of depressive moods and neuroses.

purely physiological factors

The birth act is a serious test for female body, including the emotional one. A woman experiences severe pain, the balance of hormones changes dramatically, which leads to the fact that organs and systems, body tissues work in a special mode, as well as nervous system. This forms ailments of the physical plane in the first days and in the future, forms fatigue and ailments, which makes it difficult to combine this with full-fledged care for the baby and constant household chores.

Operation may be affected. Moreover, among women who gave birth quickly, there are usually more problems in relation to emotions and the psyche than those who gave birth themselves. This is due to hormonal changes and fluctuations in hormone levels. With the natural birth of crumbs, due to oxytocin, a hormone that performs leading functions in childbirth, the sensation of pain is dulled and lactation is then established faster. Thus, some of the factors that provoke postpartum depression are eliminated, and when caesarean section the restructuring of the body is not so fast, which leads to a violation of the natural balance of hormones.

Influence the formation of depression can and initial problems with the establishment breastfeeding, physical difficulties with breasts and milk deficiency, . This creates a conflict in the head between the desires and possibilities of the mother regarding what she can give the baby.

Reasons for the psychological plan

Often after childbirth, especially if they did not go exactly according to the scenario that was expected, there may be completely unhappy feelings and emotions, as well as a feeling of guilt that the image of ideal parents was not fully realized.

Children are not always born with perfect health, and everything in the maternity hospital goes by the books, and then the expectations with reality in the mother’s head diverge, which leads to psychological imbalance. Sometimes there is no time to fully restore physical strength after childbirth, not to mention the emotional and moral costs.

Often, a sense of guilt and dissatisfaction with oneself can be formed due to other reasons:

In addition, depression is typical for those mothers whose children were born with developmental anomalies, serious problems and require special care and rehabilitation. The mother subconsciously feels guilty before the baby for the fact that he was born special, and worries about his life only exacerbate depressive moods.

note

According to statistics, depression is more typical for young mothers and older ones, after 35 years of age, who have problems communicating with their own mother, spouse, or those women who previously, before pregnancy, had emotional and psychological problems.

Symptoms of postpartum depression

Depression in the postpartum period does not begin in one day, it gradually increases in severity and severity of symptoms, and its first manifestations become noticeable after a few weeks after returning from the hospital. These include such alarming "calls" as:

Not necessarily, in the presence of depression, all of the listed manifestations should appear, three or more in various combinations are already enough, and for the last point - it is enough for one to seek help from a psychotherapist or psychiatrist.

Often, depression is formed in women due to the fact that their bright expectations from motherhood and their own feelings run counter to those ideas and thoughts that were before pregnancy and during it. This is quite normal, but not all women can realize and accept for themselves the “non-ideal” of their motherhood. Many women think that they will immediately, in the first minutes of the birth of a child, have maternal feelings, and they will immediately get used to the role of a mother. But in reality, the relationship between the baby and his mother is being established gradually, over several months.

You should not reproach and scold yourself for various emotions in relation to the crumbs, sometimes they can be negative, we are all living people. A feeling of disappointment, irritability, fatigue is also possible, especially when mixed with constant lack of sleep and lack of time. Experiences can be fertile ground for the formation of complexes and the development of depression, especially if the mother takes only one full responsibility for the family and the baby. You should not refuse outside help, you need to take care of yourself and give yourself a rest, this will not make a single woman a bad mother, and physical and emotional exhaustion will not form.

note

The pre-depressive state is supplemented by isolation from the former social circle and the outside world, constant sitting at home and concentrating only on motherhood, you need to remember yourself as a woman, spouse, girlfriend and also pay attention to these areas of life.

Critical periods of depression after the birth of a baby

Psychologists distinguish certain critical periods, during which all emotions and experiences are the strongest and most dangerous by turning into depression.

The most intense will be the emotional background in the period from the fourth to the ninth month of the baby's life, when the feeling of irritability and discontent, the feeling of continuous anxiety will increase.

This is the first critical period when postpartum depression is likely.

The second period when its late symptoms are possible is the period of nine to 15 months, when pessimism about the future and the disappearance of the desire to perform even elementary household chores are possible due to isolation from society and concentration on the worries of the crumbs. Often the situation will be aggravated by the fact that the mother is not aware of her problems and does not want to make any attempts to correct the situation.

How is this pathology diagnosed?

Unlike somatic pathologies, where, in addition to complaints, one can rely on data from analyzes and additional studies, in the diagnosis of pathologies related to the mental sphere there is only a detailed questioning and heart-to-heart conversation, as well as some information that can be obtained from relatives. Therefore, in identifying depression after childbirth special role plays the clarification of the anamnesis data (the history of the life of a woman, her family and data on her pathologies and diseases).

note

An important indication of possible problems there will be the fact that there were depressions among the closest relatives or the patient herself before the onset of pregnancy. It is a known fact that in half of the percent of cases, depression tends to relapse or exacerbate against the background of changes in life, including motherhood. . A single episode of depression in the past increases the likelihood of its recurrence by 50%.

In the diagnostic process, additional methods are used, such as:

• Hamilton Rating Scale for Detection and Severity of Depression
• Examination and questioning, identification and careful recording of all complaints of the mother
• Laboratory diagnostic methods to exclude somatic pathologies
• Screening studies, smears, cultures to exclude infections, including hidden ones, which can lead to constant fatigue and stress.

If there are signs of depression during pregnancy, or if there is a history of depression, diagnosis is needed already in the first weeks after childbirth.

note

It is important to distinguish depressive manifestations from postpartum infections, against the background of which development is possible, therefore, in the clinic of obvious mental disorders, urgent hospitalization and differential diagnosis with the necessary treatment within the hospital are needed.

It must also be remembered that psychosis postpartum period may be a phenomenon of a special psychiatric diagnosis - bipolar disorder with affective attacks (previously this condition was called manic-depressive disorder).

It is usually expected in mothers with mental illness or against the background of schizophrenia, which had simply not been diagnosed before. Unlike classical depression, postpartum psychosis manifests itself a couple of weeks after the birth of the crumbs, they start as severe depression with the manifestations listed above and various psychiatric symptoms - mania, hallucinations, phobias, delusional thoughts and ideas. Therefore, with an early start of such manifestations, the mother needs a consultation not with a psychotherapist, but with a psychiatrist and a thorough examination, otherwise she can be dangerous for the child, herself and others.

How is postpartum depression treated?

When depression is diagnosed, a treatment plan will be based on its severity, developmental characteristics, and leading syndromes, as well as on what methods are available for treatment. So, some medications that can affect the baby are not applicable to nursing mothers.

The main goal in treatment is to reduce or completely eliminate the symptoms of depression and its progression, to help the mother restore lost social ties and bring her mental state to a stable one, preventing recurrent episodes of depression.

note

In a hospital for treatment, mothers are placed extremely rarely, only if depression combines psychoses, severe somatic disorders and suicidal attempts.

In the treatment are applicable:

• Psychological correction (cognitive methods, consultations)
• Psychotherapy in a group and individually
• Family support and support of the environment (family psychotherapy).

Such methods will be effective and applicable in case of awareness of one's situation and diagnosis, desire for treatment and correction, motivation and mood for a long course of treatment. In addition, psychotherapy is needed for those women in whom antidepressants and other medications are contraindicated due to various circumstances.

Medical treatment of maternal depression

Often depression involves medication correction, without which the symptoms are not eliminated. It is usually based on hormonal preparations(estrogens) and a course selected in such a way that they do not affect lactation. Indications for taking psychotropic drugs are determined individually and only by a psychiatrist based on the severity of symptoms and the degree of danger of consequences. Indications for them will be affective manifestations, suicidal tendencies and thoughts, anxiety and obsessive fears with sleep disorders and somatic functions.

note

The intake of all drugs against the background of lactation and the treatment of mothers is carried out only as prescribed by the doctor and only strictly under his supervision. No self-treatment in cases of depression and psychosis is unacceptable, including various folk methods!

If necessary, the appointment of antidepressants proceed from several principles:

In order for the therapy to give pronounced results, treatment must be started in a timely manner, at the first alarming manifestations, and you should not be shy about contacting a doctor.

Depression is a disease like many others, there is nothing shameful or illegal in it.

Often, its manifestations can be noticeable even in pregnant women, and in the early stages it is well treated with mild and gentle means and techniques, and a full course of psychotherapy and medication quickly and gently relieves symptoms, returning the joy of life and the enjoyment of motherhood. Often, herbal and sedative remedies that do not have serious side effects can help. side effects and contraindications, they can be used in women at risk from the period of pregnancy for the prevention of postpartum depressive disorders.

Choosing antidepressants after childbirth

It is worth repeating that antidepressant drugs should be selected only in conjunction with a doctor, excluding toxic effects on the baby and suppression of lactation.

If the patient suffers from anxiety and agitation (strong agitation, fussiness), a group of drugs with sedative effects (Amitriptyline, Pirlindol and others) is applicable to her.

If depression and depression predominate among the symptoms, drugs with stimulating effects (Paroxetine, Citalopam and others) are needed.

The drug is taken from the lowest possible therapeutic dose, gradually adding it to a stable clinical effect. At a similar dose, a woman is kept for about 4-6 weeks until her condition improves, both subjectively and on the basis of an external examination. As a remission or a persistent clinical effect, the drug is not abruptly canceled due to the possibility of exacerbation, but the dose is gradually reduced once a week with a smooth withdrawal throughout the month.

If the condition has improved, but has not fully recovered, the course of treatment is continued for another 1-2 months, and the results are evaluated every 4-5 weeks. If there is no improvement on the Hamilton scale by 50% or more, then a revision of the treatment regimen is necessary due to its ineffectiveness with the selection of other drugs.

How dangerous is postpartum depression?

Without treatment, the manifestations of depression are delayed for a period of a year or more, can progress and lead to more serious mental disorders. In addition, without treatment, depression can lead to tragic consequences:

• Attempts to harm the baby or relatives
• The development of psychosis
• Progression of depression
• Violation of relations in the family, its disintegration
• Violations mental development child, negative influence on his psyche, the behavior of his mother and the methods of her upbringing.