Pregnancy and childbirth is a joyous time for new mothers but some women may struggle with their mental health as the transitions towards motherhood is not easy, especially for the first time mothers. It includes so many overwhelming biological, physical, social and emotional changes that many females experience wide range of overwhelming emotions such as anticipation, excitement, happiness, fulfilment as well as anxiety, frustration, confusion, sadness and guilt during pregnancy and postpartum period, which makes them vulnerable to various psychiatric disorders.
It is really important to understand the mental and emotional health of new mothers, which often goes unnoticed and unprioritised in the society as the focus goes towards the newborn child and other activities rather than the mother. During this period, about 85% of women experience some type of mood disturbance, some are mild while some are moderate to severe and develop more significant symptoms of depression and anxiety.
Types and symptoms:
In an interview with HT Lifestyle, Dr Shilpi Saraswat, Clinical – Psychologist at Sakra World Hospital in Bengaluru, divided postpartum psychiatric disorders into three categories -
1. Maternity blues or baby blues - It includes the mild range of intensity of symptoms and it may resolve in a few days to a week, has few negative sequala, usually requires only reassurance with incidence 300-750 per 1000 mothers globally. It includes symptoms like sadness, mood changes, tearfulness, anxiety, irritability, frustration, anger.
2. Postpartum Depression - It can start soon after childbirth and estimated as 100-150 per 1000 birth. It can predispose to chronic or recurrent depression which may affect the mother child relationship, child growth and development. Children of mother of postpartum depression have greater cognitive behaviour, intrapersonal problems compared with the child of non depressive mothers. It can be mild to severe. It includes the symptoms like depressed mood, crying spells, loss of interest in usual activities, lack of interest in meeting people, feeling of guilt and worthlessness, fatigue, lack of energy, sleep disturbance, change in appetite, poor attention and concentration and suicidal thoughts.
{{/usCountry}}2. Postpartum Depression - It can start soon after childbirth and estimated as 100-150 per 1000 birth. It can predispose to chronic or recurrent depression which may affect the mother child relationship, child growth and development. Children of mother of postpartum depression have greater cognitive behaviour, intrapersonal problems compared with the child of non depressive mothers. It can be mild to severe. It includes the symptoms like depressed mood, crying spells, loss of interest in usual activities, lack of interest in meeting people, feeling of guilt and worthlessness, fatigue, lack of energy, sleep disturbance, change in appetite, poor attention and concentration and suicidal thoughts.
{{/usCountry}}3. Postpartum psychosis - It is a severe disorder. Global prevalence is 0.89-2.6 per 1000 birth and it begins within four weeks of postpartum and requires hospitalization.
Causes:
1. Rapid shift in hormonal environment.
2. Lack of social & Family support
3. psychiatric history
4. marital discord
Who is at risk?
According to Dr Shilpi Saraswat, women who could be at risk include those with
- Previous episode of PPD
- Depression or anxiety during pregnancy
- History of psychiatric illness
- Recent stressful life event
- Inadequate social support
- Problems in marriage
Treatment:
Dr Shilpi Saraswat advised
- proper screening on time
- medications
- finding medical cause for mood disturbance(thyroid dysfunction & anemia) must be excluded.
- Psychoeducation and psychotherapies (like cognitive behaviour therapy, intrapersonal therapy, dialectical behaviour therapy, supportive psychotherapy)
- family and social support
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