General considerations about postpartum depression

Discouragement, tiredness, and irritability are characteristic of the pregnancy and postpartum period. Regardless of the joy one feels with the arrival of a baby, some women may even experience sadness as a sign of the changes in their body, or even feelings of helplessness and insecurity in dealing with the child.

However, when this sadness evolves into postpartum depression, the care must be doubled because the condition can be harmful to both the newborn and the mother herself. Friends and family must be close to this woman, offering all the support possible, including helping to identify the symptoms.

In this text, we will talk about this important clinical condition that has affected many Brazilian women. With the lack of attention, postpartum depression can be easily confused with the normal gestation period or be seriously neglected. So, continue the text to learn more.

Understanding postpartum depression

Although much talked about in recent times, few people know what postpartum depression actually means. In the following topics you will learn a little more about the condition, including its causes, symptoms, and the possibility of a cure. Read on to understand.

What is postpartum depression?

Postpartum depression is a clinical condition that occurs after the birth of the baby and can appear up to the child's first year of life. The condition is characterized by depressive states, marked by feelings of intense sadness, reduced mood, pessimism, a negative view of things, decreased willingness to care for the baby, or exaggerated protection, among other symptoms.

In some cases, this clinical condition can evolve into postpartum psychosis, which is a much more serious condition and requires psychiatric treatment. But this evolution rarely happens. With specific care, postpartum depression is treated and the woman can go on undisturbed, with due attention to her baby.

What are its causes?

A number of causes can lead to postpartum depression, from physical factors, such as hormonal changes, characteristic of the puerperium period, to a history of mental illnesses and disorders. The quality and lifestyle of the woman can also influence the onset of the condition.

In general, the main causes of the clinical condition are: lack of a support network, unwanted pregnancy, isolation, depression before or during pregnancy, inadequate diet, hormone changes after birth, sleep deprivation, family history of depression, sedentary lifestyle, mental disorders, and social context.

It is important to emphasize that these are the main causes. As each woman is different from the other, unique factors can trigger the depressive condition.

The main symptoms of postpartum depression

Postpartum depression is similar to common depression. In this sense, the woman presents the same symptoms of a depressive condition. However, the big difference is that in the postpartum period there is a relationship with the baby, which can be affective or not. Therefore, the symptoms of depression can be neglected.

Thus, the woman may experience great fatigue, pessimism, recurrent crying, difficulty concentrating, changes in eating habits, lack of pleasure in taking care of the baby or doing daily activities, great sadness, among other symptoms. In more severe cases, the woman may present delirium, hallucinations, and suicidal thoughts.

Is postpartum depression curable?

Postpartum depression is curable, but it depends on the mother's positioning. With the proper treatment and the adoption of all medical prescriptions, the woman can get rid of the depressive condition and continue caring for her baby. It is important to keep in mind that the clinical picture is a condition that can and must come to an end.

In addition, for the woman's complete healing, without it being a prerequisite for this, it is good to have the presence of a support network. In other words, family and friends need to be by the mother's side to offer all possible help.

Important facts and information about postpartum depression

Postpartum depression is a clinical condition that affects some women. It is important to know more about this condition in order to refute some false information and face the condition with more tranquility. See relevant data in the topics below.

The statistics of postpartum depression

According to a survey conducted by the Oswaldo Cruz Foundation, in Brazil alone it is estimated that 25% of women have postpartum depression, which corresponds to the presence of the condition in one out of every four mothers.

However, with the increasing demands on women who sometimes need to divide themselves between work, home, other children, and the arrival of a new baby, depressive states can occur with any woman.

Taking into consideration the natural state of fragility and sensitivity, characteristic of the pregnancy period itself, the pregnant woman needs to receive all the support possible, especially after the birth of the child.

How soon it manifests itself after birth

With a diversity of symptoms, postpartum depression can appear up to the first year of the baby's life. During these 12 months, the woman can feel all the symptoms of depression or only some of them. It is important to also pay attention to the intensity of the symptoms felt during this period.

If after the child's first year of life, the mother begins to present symptoms of depression, the condition is not a consequence of pregnancy. In this case, treatment must be sought so that the condition does not interfere in other areas of the woman's life.

Is it possible that it occurs late?

It is important to be aware of the signs of postpartum depression, because the condition can occur late in life. In this case, the condition develops for 6, 8 months, or even up to 1 year after the birth of the child. The symptoms are characteristic of the condition, with the possibility of occurring in the same intensity as if it started in the puerperium.

It is essential that the woman receives full support from friends and family to deal with the situation, because until the child is one year old, the baby is still very connected to the mother, depending on her for everything. The choice of trained and supportive professionals is also essential.

Is there a relationship between postpartum depression and premature babies?

Women who have had premature babies may face periods of insecurity and a high level of stress. They may feel unable to take care of the child. But still, this state does not mean that they will develop postpartum depression. It is just a common behavior of every mother.

With a humane and responsible medical team, the mother who has had premature babies will receive all the guidance to take care of her child. Tips and guidelines will be passed on so that this woman can be calmer, reassured, and secure. That is why it is very important that the choice of professionals be well made.

Is there a relationship between postpartum depression and the type of delivery?

There is no relationship between postpartum depression and the type of delivery performed. Whether it is a cesarean, normal, or humanized, any woman can experience the clinical condition. The only thing that can happen is that the woman creates expectations with one type of delivery and at the moment of giving birth, it is not possible to perform it.

For a calm birth, the mother can talk to her doctor and expose her expectations of the moment, but understanding that an emergency change can occur and she must remain calm about it.

Gestational depression and baby blues

Postpartum depression can be easily confused with gestational depression and the baby blues phase. To correctly identify the symptoms of each period, it is important to know the difference between them.

Gestational or prepartum depression

Gestational depression is the medical term for what is known as prepartum depression, a period when a woman becomes more emotionally fragile during pregnancy. In this phase, the pregnant woman feels the same symptoms of a depression while pregnant with the child, that is, she faces pessimism, negative view of things, changes in appetite and sleep, sadness, among others.

Even in some cases, what is observed as postpartum depression is actually a continuation of gestational depression. The mother already presented a depressive condition during pregnancy, but it was neglected because they thought the condition was normal. By believing that changes in appetite and sleep, tiredness and insecurity are absolutely normal during pregnancy, the depressive condition may go unnoticed.

Baby Blues

As soon as the child is born, the female body begins to face some changes generated by the variation in hormones. This transformation takes place in the phase called puerperium, a period after childbirth that lasts 40 days, also known as quarantine or lull. After 40 days, these changes begin to show a decline.

In the first two weeks of the puerperium, a woman can develop the baby blues, which is a temporary stage of intense sensitivity, fatigue, and fragility. At this time, the woman needs full support so that she can recover. The baby blues lasts a maximum of 15 days, and if it goes beyond that, postpartum depression can set in.

The difference between postpartum depression and baby blues

Regardless of how one experiences pregnancy and the puerperium, every woman faces changes in her body, whether in her hormones or emotional aspects. Because of this, postpartum depression can be easily confused with the baby blues. After all, both present sensitivity, fatigue, and fragility, with significant loss of energy.

However, the big difference between the two phenomena is in the intensity and timing of the symptoms. While in the baby blues the woman becomes sensitive, but does not lose her joy and desire to take care of the baby, in postpartum depression the mother presents fatigue, lack of pleasure, frequent crying, sadness, and discouragement in great intensity.

Also, even if the baby blues come on strongly, the period comes to an end within 15 days. If it goes beyond that, it is necessary to be careful because it can be the beginning of a depressive state.

Diagnosis and prevention of postpartum depression

As a clinical condition, postpartum depression has diagnosis and prevention. It is very important that early identification is done to avoid worsening of the condition. Read on to learn how to diagnose and prevent it.

Identifying the problem

Before identifying the signs of postpartum depression, it is important to keep in mind that, regardless of the clinical condition, it is to be expected that after pregnancy, a woman will face fatigue, a state of irritability, and a lot of sensitivity.

After all, in the first days of the puerperium the mother feels all the changes and alterations in her body. However, in the depressive state, it is very difficult to be happy about the birth of the baby.

The woman is unable to bond with the newborn, or she may be so protective that she won't let anyone near the newborn, not even family members. In addition, she feels all the symptoms of depression.

The diagnosis

The diagnosis is made in the same way as a common depression. The diagnosing physician, i.e. the psychiatrist, evaluates the intensity and persistence of the symptoms, which must occur for more than 15 days.

To configure postpartum depression, the woman must present anhedonia, which is a decrease or total loss of interest in daily activities, depressed mood, and at least 4 symptoms of a depression. Remembering always that these signs must be constant for more than two weeks.

In addition, the professional may also request the completion of a depression screening questionnaire and blood tests to identify the presence of any abnormal hormone changes.

Prevention

The best way to prevent postpartum depression is to be alert to the first signs of the condition. As soon as you notice the presence of any symptoms, your doctor should be notified. Women who are under treatment for some psychological disorder should also notify their doctor to take the necessary steps.

Another attitude that can be taken as prevention is to talk to obstetricians, friends, family members, and mothers to get tips on how to better prepare for the pregnancy period.

In addition, considering the changes that the arrival of a baby causes, people in the same household should talk to define each other's role, especially during the sleeping period when the baby wakes up at dawn to feed.

How to help someone who is suffering from postpartum depression

Welcoming is the key word to help a woman who is suffering from postpartum depression. She needs to be heard in her complaints and understood when she is not completely happy with the baby. Judgment and criticism should not exist, because some may blame themselves for the current state and make the situation even worse.

Help with household chores and child care is also fundamental to help this woman. Remember that, besides the clinical picture, the postpartum period generates a natural fatigue in the female body. Therefore, the mother needs to rest so that she can have enough energy for her baby.

The levels of postpartum depression

Postpartum depression presents some levels, with specific symptoms. It is fundamental to pay attention to the level in which the woman is, because this will directly impact the type of treatment that should be adhered to. There are three levels of the condition, mild, moderate, and severe.

In mild and moderate cases, the woman becomes a little more sensitive, with feelings of sadness and fatigue, but without major compromises to her activities. Therapy and medication are enough to improve the condition.

Symptoms such as hallucinations, delusions, lack of connection with people and the baby, changes in thinking, the desire to harm oneself and others, and sleep disturbances are very common.

The difference between postpartum depression and ordinary depression

Both postpartum depression and common depression have similar characteristics to each other. The only difference is that the clinical condition after the birth of the baby, occurs exactly at this stage and there is the presence of the mother's bond with the child.

In addition, the woman may find it very difficult to care for the baby or develop overprotection. Common depression can occur at any stage of life and due to multiple factors.

The fact is that the presence of the clinical picture before pregnancy can contribute to the emergence of postpartum depression, but it is not a rule, because pregnancy is a time of many representations, which for some women can mean a phase of great joy.

The treatment of postpartum depression and the use of medications

The absence of treatment for postpartum depression can bring harm to the baby, especially in the most severe cases of the clinical picture. At the first signs of depression, the doctor should be sought out to initiate care. See below for more information on this.

The treatment

Postpartum depression is treatable, but it will depend on the doctor's guidance and the level of the clinical condition. The more severe the case, the more intense the care will have to be.

But in general, women with depression after pregnancy can undergo medication interventions, with medical prescription, participation in support groups and psychotherapy.

In the case of using medicines, the mother does not need to worry, because nowadays there are medicines that do not harm the child, either during pregnancy or while breastfeeding. In any case, the woman's treatment is fundamental to guarantee the baby's protection and health.

Are medications safe for the fetus?

Fortunately, with the advance of medicine, nowadays there are many medications that are safe for the fetus. They do not alter the motor or psychological development of the child. The medications used for the treatment of depressive conditions must be specific. Whether for postpartum or common depression, the doctor must be consulted to make the prescription.

Years ago, electroshock treatment was used as the choice for mothers. However, due to the intensity of this type of intervention, it is only used in more severe cases, where there is a risk of suicide. After all, such cases require a much quicker response.

Can medications taken while breastfeeding harm the baby?

In the womb the baby does not make any respiratory effort; therefore, medications for depression have no effect on the development of the fetus. However, after the child is born, the sedative effect of the medications can pass into the milk and be ingested by the baby.

For this reason, it is important to use specific antidepressants with low transferability to the mother's milk. Also, the whole scheme must be discussed between the doctor and the mother.

In addition, it is recommended that after taking medication for postpartum depression, the woman wait at least two hours to collect milk. This reduces the baby's exposure to the antidepressant agent.

Is the use of medication always essential to treat postpartum depression?

If a case of postpartum depression is not caused by a family or personal history of the condition, the use of medication is indispensable to treat the condition, because if not treated, the condition can evolve or leave residues that can interfere in other areas of life. Always remembering that medication must be prescribed by a psychiatrist.

However, if the woman already presented depressive conditions or comes from a stressful social context, it is very important not to miss the psychological treatment. It is in therapy, where the conflicts, questions, and insecurities that affect not only the relationship with the baby, but also other sectors of life, will be placed.

If you identify the symptoms of postpartum depression, do not hesitate to seek help!

One of the main points in treating postpartum depression is to identify the symptoms as early as possible and to get medical care. Even if you are alone, without the help of important people, keep in mind that you can count on the support of professionals, who are trained and experienced for this.

With so many demands and misrepresentations of women in society, it is almost impossible not to feel overwhelmed, tired, or even discouraged with life.

Both pregnancy and the baby's birth period are a challenge for women, where sensitivity and fragility must be naturalized. So, take care of yourself, but without guilt.