Postpartum depression, a perfect storm

Perhaps she is one of those women who has come face to face with reality when, despite having maternal instinct, she has found herself lost and confused by the arrival of her baby. She may not even have felt that radiant happiness that she has been told so much about throughout her life. She calm: she probably nothing sick or pathological happens to her. Welcome to royal motherhood.

And, of course, congratulations if you are one of that group of mothers who are bursting. Seize the moment!

Much has been speculated and very little has been investigated about what happens to women during pregnancy and childbirth, although in recent years there has been a growing interest in knowing the neurobiological, psychological and contextual changes that come together during the perinatal stage.

Whirlwind of changes and emotions

First, scientific evidence shows the role of genetic and epigenetic factors during pregnancy and the changes experienced in the mother’s body and brain that prepare her to care for and bond with her future baby. One of the factors that contributes the most to this hatching has to do with the hormonal rush; hence those characteristic mood swings.

Secondly, during this period, the woman’s personality must be taken into account (for example, if she presents high neuroticism), her anxious attachment style, her expectations, shortcomings, desires and perceptions of reality, of herself. and of her future role as a mother.

No less important is the influence of the context, of stressful events that can arrive (a dismissal, a death, an illness, a breakup…) at the most inopportune moment. All these factors –biological, psychological and circumstantial– can undermine the mood of the pregnant woman.

A serious obstacle to parenting

But when we talk about postpartum depression, what exactly do we mean? It is a mental disorder that usually begins during pregnancy and emerges in the immediate weeks after delivery. One in ten women experiences this pathological state of mind, although the figure varies according to the socioeconomic context, with higher rates in countries with lower incomes.

The prevention of these alterations is of vital importance because it necessarily affects the mother and the calf. The situation of sadness and apathy entails tremendous difficulties to carry out the necessary and demanding care of a dependent baby 24 hours a day, seven days a week. Yes, raising does not have schedules or vacations and, of course, it is for life.

Although it seems obvious, it is not always taken into account that when a baby is born, so does the mother. This natural (and often turbulent) process of transition to motherhood, the so-called matrescence, is often silenced by the shame of not feeling the idealized happiness or by experiencing a life crisis.

“Baby blues” or depression?

More than a few women report that, far from being a period of fulfillment, they perceive it as a burden, a punishment or a barrier in their professional, social and personal development. This discomfort or dissonance can sometimes be mislabeled as postpartum depression.

Because what most women experience is a period of postpartum emotional discomfort or dysphoria known as baby blues. To an outsider, it could be mistaken for an affective disorder, but it’s quite different.

He baby blues It usually appears between the first and third week postpartum. It can manifest with fluctuations in mood or the desire to cry, but it does not produce relevant changes in self-esteem.

Although the woman does not sleep as before, she can do so according to the rhythm of the baby. The feeling of tiredness improves or disappears with rest and, above all, the mother is capable of feeling pleasure, joy and excitement.

On the contrary, depression usually begins to show signs during pregnancy and generates a low, sad, hopeless state of mind. The affected person has low self-esteem, may feel unsuccessful or incapable as a mother, and exhibits exaggerated guilt.

The depressed mother also suffers from insomnia and is unable to rest or reduce fatigue with naps or rest periods. And she, of course, loses the capacity for enjoyment or entertainment (anhedonia), a deficiency that is not reversed even with visits or stimuli that previously encouraged her.

It is also important to note that suicidal behaviors often go undetected during this period of “mandatory happiness.” However, recent studies show that between 5-14% of mothers claim to have suicidal ideas, and that the completed act is the first cause of death of women during the perinatal period in Western countries.

Risk factor’s

As mentioned, nine out of ten mothers do not develop this type of mental disorder. The risk factors that predispose to suffer it are, among others: personal or family history of mental disorder; lack of support from the partner, the family or the social environment; loss of previous pregnancies (unresolved bereavements, abortions); perception of complicated pregnancy; negative attitudes towards pregnancy; inappropriate coping strategies (for example, using drugs); stressful life situations (financial hardships, job dismissal, relationship problems…); and have suffered sexual abuse, mistreatment or violence.

Preventing this type of disorder is everyone’s responsibility. The next time you see a pregnant or recently delivered woman, ask without judging, see if she’s fixed, lend a hand, or make yourself available to her.

And of course, if you think she may be experiencing depression, take her to the health center so she can receive specialized help. Remember: Most women with postpartum depression who receive adequate treatment recover within months of starting treatment.

Teresa Bobes-Bascarán, Associate Professor in Health Sciences. FEA Clinical Psychology. SESPA. CYBERSAM. ISPA. INEUROPE, Oviedo University

This article was originally published on The Conversation. Read the original.