Postpartum depression: what is it?

The post-partum depression occurs in the weeks after childbirth and is characterized by depressed mood, worthlessness, and physiological alterations.

Postpartum depression

The period of pregnancy and postpartum is a moment of great vulnerability for the woman. Since conception, in fact, a series of changes have occurred, not only external but above all internal. For this reason, pregnancy is considered an experience of "crisis," in which the woman will acquire a new psychic body.

Pregnancy and childbirth

The nine months of gestation, on the one hand, allow the future mother to prepare her physical space for the newborn in the real world. On the other hand, it allows her to reorganize her interior spaces, to create in her mind a space suitable for containing the idea of a child and herself as a parent.

Some women find it difficult to accept the pregnancy, experiencing mixed feelings of happiness, fear, concern for what awaits them. These reactions are actually shared by many women but are not always expressed in fear of feeling "different" and judged as inadequate. You must know how to "read" one's internal states because sadness, discomfort, and anxiety can turn into real symptoms of depression.

When the baby is born, things can become even more complicated, as the two new parents often find themselves unprepared in carrying out their new role. Furthermore, we know that for women, the postpartum is characterized by a rapid hormonal change, which can favor the onset of mood alteration, in most cases, transient. Only 10-15% of the general population experience clinically significant symptoms of postpartum depression. These symptoms are not temporary and can persist for several years. The interest found in postpartum depression is linked to the strong impact it has not only on the woman but also on the father and the child. But what are the symptoms, and how can you recognize them?

Symptoms of postpartum depression

To diagnose postpartum depression, at least five of the following symptoms must be identified for at least two weeks:

- depressed mood

- anhedonia (loss of pleasure)

- change in weight and appetite

- sleep disturbance

- asthenia (loss of energy)

- isolation

- feelings of guilt and worthlessness low self-esteem, helplessness and disvalue

- anxiety and related somatic characteristics

- loss of libido

- decrease in concentration

- recurring thoughts of death and suicide plans

- Psychomotor agitation or slowdown.

Symptoms in the language of mothers can be translated as follows

- Depressed mood, emotional lability, sadness, and loss of pleasure:

"Everything has lost its color."

"I would always cry."

"I don't want to see anyone."

"For a moment I feel great, and a moment later I'm back on the ground."

- Lack of energy, mental confusion, and difficulty concentrating:

"I'm so tired ..."

"All I do is a struggle."

"I can't make decisions."

"I'm confused, and I have a clouded manta."

- Sense of despair, inadequacy, and pessimistic thoughts, sometimes thoughts of death. Feeling worthless, guilty, and reproachful:

"I'm not able to do anything."

"Others are only interested in my baby, not how I feel."

"Why am I so bad now that I have this beautiful baby?"

"I just sat down, and the baby starts to cry again."

"Sometimes I think everyone would be much better if I weren't there anymore”

- Anxious symptoms, irritation:

"I feel alarmed."

"I feel I'm going to explode."

"I have palpitations, shortness of breath."

"I feel a lump in my throat."

- Neurovegetative function alteration (sleep, appetite, libido):

"I can't stand being touched."

"I wake up early."

"I have no appetite."

"I eat without a break."

Some women may have only a few of these symptoms without meeting the criteria for diagnosing postpartum depression. In fact, other disorders such as adaptation disorder with depressed mood can be treated.

 When the stress that the woman experiences in the period immediately after the birth of the baby is a quick reaction to the requests of the newborn or other family members, no diagnosis is made. In these cases, providing information, reassurance, and listening may suffice.

Other times, difficulties in concentrating, making decisions, and falling asleep can result from severe anxiety. Unless there is also a depressed mood, there is no mention of postpartum depression, but of an anxiety disorder that still needs specific treatment. It is good to remember, however, that the presence of a certain degree of anxiety in a depressive situation is a common feature of postpartum depression. 

When does postpartum depression occur?

The first symptoms can begin to manifest themselves already in the 3-4 week following the childbirth, manifesting clinically between the fourth and sixth month, with reports of cases even up to nine months. However, a mild transient emotional disorder that more than half of women suffer in the first days after giving birth and which resolves spontaneously within a week without particular consequences on the mother and the newborn.

When the mother or the people around her recognize the symptoms of postpartum depression or notice that the malaise persists for more than two weeks. It is good to contact a psychologist, who through an interview, specific tests, and clinical observation, can advises the best treatment path. One of the most effective treatments for postpartum depression is cognitive-behavioral (CBT). The sooner you intervene, the better the prognosis.

Treatment for postpartum depression

In addition to the attitude of warmth, support and welcome, it is important to contact a specialist who will take care of the mother through support or therapy appropriate to the specific case. For instance, cognitive-behavioral therapy provides for individual or group interventions to teach an alternative way of thinking and act.

The aim is to identify dysfunctional thoughts and the emotions consequent to them to introduce alternative thoughts that modify the patient's emotional state and behaviors.

The characteristics of this orientation are:

- practice and concreteness

- focus on solving concrete psychological problems centered on the "here and now"

- short term

- purpose orientation

- Active role: both the patient and the therapist play an active role, the therapist tries to teach the patient what is known about his problems and possible solutions to them.

The patient also works outside the therapeutic session to put into practice the strategies learned in therapy by carrying out the tasks that are assigned to him from time to time. Associated with cognitive-behavioral treatment, relaxation techniques such as progressive muscle relaxation by Jacobson are also very useful in the case of postpartum depression.

Author: Vicki Lezama