Postpartum depression - a taboo subject - 'Because it's so ugly to be sad when everything is so beautiful."
Can one, quoting the movie "The Hours": "Capture a woman's entire life in one day?" - in other words - compress it like a Coca cola can and extract the essence...
In the case of individuals with postpartum depression, one
can compress a piece of their functioning and lost hope into a picture painted
by a weary mind.
Postpartum depression is suffering in solitude. It's a room,
where a mother or father, holding their child in their arms, gazes at the clock
with tears in their eyes.
Hours - the first... the second... another...and nervously
awaiting someone to appear at the door and relieve them from the current state
of mind and situation.
Postpartum depression is an illness, not a choice. It's not
about good or bad will. Sometimes it sneaks into the room with small steps,
sometimes it enters unannounced and turns the world upside down.
Depression is the inadequacy of experiences - the disconnect
between the beautiful picture painted in the eyes of observers and what the
woman or man is experiencing inside.
It's often the role of an actor to smile in front of the
public, because that's what's expected.
It's the thought of escaping, of running away as far as
possible from pretense, from lost illusions.
In today's post, we will delve into the topic of postpartum
depression.
Postpartum depression
is still a taboo topic because it's seen as "ugly" to be sad when
everything is so "beautiful," because it's not appropriate, because
it shouldn't affect our families.
If anyone doubts the
existence of postpartum depression or would like to have a better imagination
of how it can look like, I encourage watching the aforementioned Oscar-winning
film from 2002, "The Hours," as well as further reading.
Postpartum depression in numbers and on a timeline.
Postpartum depression affects around 10-20 percent of
mothers and 10-25 percent of fathers.
Its symptoms can appear as early as during pregnancy - most
commonly in the third trimester.
Depression may begin after childbirth and escalate over the
first 30 days.
We diagnose postpartum depression when its symptoms appear
within the first 3 months after childbirth.
Untreated postpartum depression can last up to 1 year.
It sometimes transitions into a state of chronic low mood
that doesn't meet the criteria for depression - dysthymia.
How does dysthymia look like - another movie, another set of images: "What's Eating Gilbert Grape?"
Chemistry of postpartum depression
The cause of postpartum depression in genetically
predisposed individuals is believed to be a decrease in the level of the
"happiness" neurotransmitter serotonin and overactivity of the
hormonal system associated with stress. In men, it is mentioned that there is a
decrease in testosterone levels and an increase in prolactin - the hormone of
motherhood, and cortisol - the stress hormone.
Postpartum depression is considered a hereditary disorder. It is worth finding out from one's own parent whether there was a tendency for mood lowering after childbirth.
Postpartum depression and baby blues... between pathology and norm.
Postpartum depression should be distinguished from
short-term mood lowering, commonly known as baby blues. Baby blues result from
hormonal changes occurring in a woman's body after childbirth. Baby blues occur
in up to 80 percent of women after childbirth. It most commonly appears between
the 2nd and 5th day after childbirth and typically resolves spontaneously
within 10 days after childbirth. Baby blues are characterized by irritability,
mood swings, tearfulness, anhedonia, and fatigue.
What can be recommended for baby blues?
How to recognize postpartum depression?
Tools for detecting depression - a test for self-completion or with the participation of a specialist
The gold standard diagnostic tool in many countries is the
Edinburgh Postnatal Depression Scale.
This is a short test - 10 questions, which can provide insight into whether someone may be dealing with postpartum depression or is at risk of experiencing it.
In many countries, this tool is used by midwives,
pediatricians, and gynecologists - towards the end of pregnancy, shortly after
childbirth, and at monthly intervals during baby check-ups.
The test is available for free on the internet.
For example, you can find it at this website:
Edinburgh Postnatal Depression Scale.
There is a test in English and Spanish to print with a key to interpreting medical tests. When taking the test, it is important to remember that a high score - indicating a high risk of postpartum depression - is a sign to consult a psychiatrist, who, after familia
rizing themselves with the situation, can provide guidance on how to restore well-being and overcome depression.
Postpartum depression - masked depression
Postpartum depression is often masked by the duty-bound facade, a "smile" stemming from the need to conform to the widely accepted image of The Perfect Mother.
Some women fit this image perfectly, while others do not fit it at all.
Depression in individuals with a strong need for
self-presentation and a desire to maintain an image, coupled with limited
insight into their emotional states, can take on the characteristics of masked
depression.
Many women suffer from it for years.
Sometimes, they admit
after years, when their children are grown, that they suffered in secrecy.
Some women, in whom depression creeps in slowly and gradually intensifies, begin to treat their state of being as a normal element of life. They are unaware that things were different before and they felt differently.
It's as if they've been simmering in a depressive soup, like those frogs, on a low flame.
They forget that they once lived life to the fullest.
Motherhood is an end, but also the beginning of a new stage
in life. It's worth remembering that this stage can be "cool," and
you can feel "OK" being a mom or dad.
To recognize depression, one isolated symptom lasting for a short time is not enough. A compilation of symptoms and the fact that the state persists, like a stubborn stain, inclines towards specialist consultation. You can start with a consultation with a psychologist or go straight to meeting with a psychiatrist. If you have reservations about such consultations, report your suspicions to your primary care physician, gynecologist, or midwife - they will assist you and refer you accordingly.
Symptoms of postnatal (postpartum)
According to Beck's
Depressive Triad, depression is a state in which a person loses hope in
themselves and the surrounding reality, in the past and the future. They become
trapped - prisoners of the vision of the toxin of the mind disease. All
symptoms of depression stem from such thinking.
Moving from the
general to the specific, individuals with postnatal depression - both men and
women - often experience:
- Persistent feelings of sadness and depression or mood swings
- High tendency towards irritability, explosiveness - diagnostically, this will be a characteristic that is not constant for a given individual
- Persistent feelings of fatigue despite rest
- Problems with concentration and attention
- Sleep problems - excessive sleepiness or difficulty falling asleep
- Appetite problems - loss of appetite or comfort eating
- Decreased libido - lack of interest in sex
- Anhedonia - lack of joy from activities that used to bring pleasure
- Tendency to isolate and avoid contact with people, rejecting help and support from others
- Lack of satisfaction from interacting with the child, lack of joy from the child's developmental milestones
- Sensory integration disorders - problems tolerating loud noises, touch sensitivity, excessive reaction to light, movement, rotations
- Worrying - a very important and typical symptom of postnatal depression
- Worrying that one is not a good enough mother/father Feeling inadequate in caring for the child Feeling that one is not providing the child with everything they need Feeling that one is not cut out to be a mother/father Feeling like a failure, burdening everyone - thoughts like "it would be better if I weren't here" Worrying about one's own and the child's health - seeking and escalating somatic symptoms occurring in the child and oneself Feeling like one wants to escape - to get away from lost hopes and one's perceived incompetence.
One can escape by:
- Substance use, including behavioral addictions such as compulsive gaming or shopping addiction, and the pursuit of the perfect self-image and ideal home space as a perfect homemaker.
- Physically escaping from the child and problems - leaving for a seemingly simple errand and not coming back.
- Mentally escaping - passive suicidal thoughts like "I wish I could get sick and die" or active suicidal thoughts like "I want to take my own life in an active, self-directed way."
Factors contributing to the onset of postpartum depression include:
- Genetics - scientific research confirms familial predisposition to postpartum depression.
- Difficult childbirth - What does this mean?
- Traumatic memories from the delivery room - Rodzić po LudzkuFoundation International Confederation of Midwives
- Postpartum complications such as physical injuries, post-birth issues like urinary incontinence, and lack of adequate postpartum care for complications requiring specialist assistance.
"To put it mildly, a difficult childbirth" is still a taboo topic, so it's worth breaking the ice here. What postpartum depression and postpartum complications may look like - without taboos, straightforwardly, and with a glimmer of hope... that everything can end happily - I refer you to the interview:
Tatiana Okupnik: I Had Depression During Pregnancy | Ofeminin - YouTube (you can translate this video into English and other languages using this information - Subtitles Video Translate).
Other risk factors include...
- Lack of means to meet the needs of the baby and oneself - difficult financial situation. Loneliness - lack of support from a partner or others - being a single parent.
- Unplanned pregnancy.
- Difficult baby - A child with problems and difficulties in the early stages of life, known as High Need Babies - exceptional children with exceptional needs - such as those born prematurely with disruptions in the sensory sphere, excessive crying, colicky abdominal pain, feeding difficulties, problems with regulating circadian rhythms - everyone else sleeps, but they demand activity.
- Previous miscarriages and stillbirths - unresolved grief - Support groups for parents after miscarriage | Poroniłam.pl (poronilam.pl).
- The birth of a child with disabilities, especially in cases where there was no prior knowledge of the possibility of such a condition - film on the topic - "Five Women" with subtitles - YouTube.
- Lack of healthy parenting models from home - plunging into the whirlwind of motherhood without preparation, without an ingrained program for being a healthy parent.
- Psychological problems and difficulties before pregnancy that were not addressed with psychotherapy before childbirth, such as personality disorders, perfectionism.
- Mood disorders and other conditions before pregnancy and childbirth - a VERY important factor - more about depression and bipolar disorder, anxiety disorders, eating disorders.
- Somatic burdens and disabilities in a parent - dealing with diabetes, thyroid disorders, obesity, etc. A film showing that despite lack of full mobility, one can become a happy parent - though it requires support and teamwork from both parents. -
- Life stressors are also important.
- Being on the autism spectrum is another significant factor.
Mothers on the autism spectrum are predisposed to mood
disorders after childbirth. This is due to the changes brought by the child,
the need to synchronize on communication channels, and the overload of sensory
stimuli from the child - overload of the nervous system. Not enough is said
about the autism spectrum. Supporting mothers on the autism spectrum and for
those interested in the topic, I refer you to:
Autism spectrum - Asperger's syndrome, autism - what's up
with that? (oczamipsychiatryterapeuty.blogspot.com)
More about women and girls on the autism spectrum - Tony Attwood Youtube.
Who suffers? Mother? Child? Father? Everyone?
Postpartum depression is a disease of the entire family
system.
Depression that appears in the mother during pregnancy
affects the developing child in the womb.
Depression is like a tornado of stress hormones. Children
bombarded with stress hormones in the womb develop to be smaller, more
susceptible to mood disorders and anxiety, and more likely to have sensory
integration disorders. Depression during pregnancy contributes to complications
during pregnancy and postpartum complications.
Mothers with postpartum depression have less drive to care for both the newborn and older siblings.
Caregivers of young children with
depression are less responsive to the child's behavior and needs, often
neglecting their own needs.
Postpartum depression affects the entire family system.
Families with depression often struggle to transition to the next stage of
family life - the phase of family life with a young child.
Due to biological markers of depression - decreased libido
and sleep disturbances - fatigue - depression in one partner negatively affects
the quality of building a relationship with the partner.
A major problem is outbursts of anger and irritability,
which suffocate household relationships. It is important to remember that
depression speaks in these moments, not the person.
Maternal depression suppresses a child's desire to explore the world. The overall depressive infrastructure affects the formation of abnormal attachment styles to close individuals in the child. Attachment styles are the foundation of patterns in adult interpersonal relationships.
Male depression
Men who suspect they have mood disorders, including
postpartum depression, are directed to an article describing the specifics of
male depression, with recommendations on how to proceed.
Can it end happily?Treatment and therapy
Postpartum depression is a disease that can and should be
treated. If left untreated, it can last a very long time... even up to a year.
As mentioned above, it can transition into a chronic state - dysthymia.
It's worth it...
Treatment of depression during pregnancy and after
childbirth
The primary way to cope with postpartum depression - both during pregnancy and after childbirth - is therapy, with suggested cognitive-behavioral and integrative, humanistic approaches. In cases of higher necessity, interventions such as pharmacotherapy and as a final step electroconvulsive therapy are employed. Contrary to common belief, electroconvulsive therapy is an effective and safe method for fighting depression during pregnancy and after childbirth. From experience, I can add that it's usually used as a last resort or when other methods of help fail. It's a procedure that requires additional consent and is performed under general anesthesia.
In conclusion:
You are not alone.
Celebrities about depression, including postpartum depression
Celebrities on dealing with depression .
You are hungry for knowledge
Books on postpartum depression.
If after reading the
post, you feel that you need help, take action, because it's worth it... :)
See you in the next post
