Spring is coming soon, with new beginnings. A time of birth and rebirth. A time associated with joy, but also a time to be attentive to other forces.

Women have the unique quality of carrying and giving birth to the new hopes and dreams of the human species. This is a time that holds great expectations of hope and abundant joy for all. However, these expectations may be modified or experienced only briefly. The postpartum period can be influenced by various psychiatric problems. These include: “Baby Blues”, Postpartum Depression, and Postpartum Psychosis.

During the postpartum period, up to 85% of women experience some type of mood disorder. Between 10 and 15% of these women experience a more disabling and persistent form of mood disorder called postpartum depression or even psychosis.

The mildest form of postpartum dysfunction is the so-called “baby blues.” They typically consist of a week-long period of weak mood with increased irritability, anxiety, and crying. Symptoms tend to peak around day 4 or 5 after delivery and gradually subside. Generally, this does not interfere with childcare, maternal bonding, or harm to the newborn.

Of a more serious nature is postpartum depression. This occurs in 10-15% of the general population.

The main phenomenological symptoms of this include: a depressed mood manifested by: hopelessness, lack of interest or joy, especially in areas related to the daily activities of caring for children; feelings of emptiness, increased anxiety, which may include obsessive concerns about the baby’s health and well-being.

A previous history of depression, genetic predisposition to depression, previous postpartum problems, or those who experience depression during pregnancy represent those most at risk.

The most worrisome risk is the mother’s loss of interest in daily childcare activities, which can progress to negative feelings towards the newborn. If this continues, you may progress to negative or intrusive thoughts and fears of harming yourself, your child, or both. These tend to be more obsessive than the actual urges to do actual harm.

Other negative and qualitative changes can occur, i.e. increase or decrease in sleep and energy, worthlessness and guilt without adequate reason, variations in appetite up or down, significant decreases in concentration and restlessness.

The other main area of ​​postpartum concern is much less common, but much more serious: postpartum psychosis. Although some research shows this can occur up to a year after delivery, most cases occur within 2 weeks and up to 3 months after delivery. This disease presents with the potential for many psychotic symptoms, i.e. hallucinations of any sense organ, erroneous delusional beliefs or illogical thoughts, sleep and appetite disturbances, very high levels of agitation or anxiety, episodic mania or delirium, thoughts or suicidal or homicidal actions.

Women at highest risk are those with a history of schizophrenia, bipolar disorder, other psychotic disorders, or a history of a previous episode of the illness with another child.

Occasionally, women with postpartum psychosis, like other forms of psychotic illness, are not always the first to notice or are unable or unwilling to communicate their experiences or fears. The need for help may need to be communicated by a support person, that is, a family member, a friend or a professional. This help must be through a trained professional.

What to do?

Q. What causes postpartum depression?

FOR. Like other forms of depression, there is no single cause, but rather a combination of factors. These include genetic family histories, structural and chemical changes in brain function that lead to endocrine (hormonal) and immune disturbances. Significant increases in estrogen and progesterone during pregnancy are precipitously followed by significant decreases in approximately 24 hours. postpartum. A clear depressing factor. Thyroid hormones also follow this pattern. Life events experienced as stressors combine to cause symptoms and illness.

Q. What about the demands of motherhood itself?

FOR. These can clearly contribute. For example: postpartum physical fatigue due to delivery itself, as well as interruption or deprivation of sleep in the care of the newborn; stressors about being a “good mother”, losing who or what she did or thought of herself before, feeling less attractive, lack of free time, and just simply overwhelmed with all the challenges of a new baby or babies. Women who are depressed during pregnancy have a much higher risk of depression after giving birth.

Q. Can you wait for it to happen and let it go?

FOR. Definitely not. Postpartum depression and certainly psychosis are very serious psychiatric disorders that require psychiatric treatment as soon as possible. Some women are ashamed or embarrassed to feel these things at a time when they are supposed to feel happy. How will they be perceived, perhaps as unfit parents? Denial can occur.

Q. What can happen if women don’t seek treatment?

FOR. Nothing good, neither for the mother nor for the child, that is, poor birth weight or prematurity, restlessness for both, lack of sleep for both, missed prenatal and postnatal care, substance abuse, poor bonding between mother and child and simply not being able to meet your child’s needs. In psychosis, suicide / homicide risks can occur.

Treatment for these problems is available from competent and experienced doctors. Medication is often helpful and necessary. If they are needed during pregnancy, the main risks and benefits are evaluated and weighed. Various psychotherapy modalities and support groups are also very helpful. In rare cases, hospitalization may be necessary. These interventions can save the lives of both mother and child.

All children should have the benefit of a healthy and loving mother. All mothers deserve the opportunity for rewarding pregnancies, births, and maternal experiences. These diseases can insidiously deprive mother and child and cause serious harm. If there are concerns, symptoms, or careful observation of problems, seek trained psychiatric care immediately. Don’t fight alone in fear, shame, or silence.