Pregnancy and Childbirth can be a stressful and a life changing event, hence it is important to be aware of maternal mental health issues and disorders associated with it.
Most of Maternal Mental Health disorders are not limited to Depression, Anxiety and Psychosis.
BABY BLUES:
Almost 50% – 75% of Women suffer from Baby blues, following Delivery in which women might experience frequent crying spells for no apparent reason, mood swings, sadness and excessive worry about self or child- care and parenting. They don’t usually last more than few days and usually resolves by self, but if it extends beyond 2 weeks then it can be considered as a Postpartum depression.
Postpartum Depression:
Postpartum depression can affect almost 15-20% women following childbirth and can range in severity from mild to severe. It can prolong and complicate child care as it can last for almost a year or beyond if left untreated. The symptoms generally include feeling sad, crying spells, overwhelmed, irritable, excess guilt, anxiety, feeling exhausted, and inability to care for self or the baby. There can be higher risk of harming self or thoughts of suicide which might require emergency intervention and treatment.
Postpartum depression is often underdiagnosed and passed off as baby blues until it worsens and compromises the mother and the baby. Hence it is absolutely important to detect it early and treat.
Postpartum Psychosis:
Another important Maternal Mental health disorder that needs awareness is Postpartum psychosis. This requires emergency intervention as there is a high risk of harm to self or the baby. The symptoms may include severe agitation, confusion, paranoia, feeling of shame, lack of sleep, having hallucination or delusions, hyperactivity or rapid speech. The severity might worsen if left untreated and usually can happen within 2 weeks of child birth and can last for few weeks to months. Although rare it can affect 1 in 1000 women. It requires immediate hospitalization and treatment and should be considered as an emergency.
Other maternal mental health disorders can include Postpartum anxiety, Postpartum OCD, in certain rare cases PTSD. Any psychological symptoms that develop within few days or within 6 months of childbirth can be considered as a postpartum complication.
Child loss after birth, still birth, or late medical abortions can lead of Grief reaction which can lead to complicated grief or PTSD, hence it is important to seek help if symptoms are not improving.
Risk factors of Postpartum depression and psychosis include:
Previous history of depression or other mental health issues
Family history of mental health disorders or postpartum depression
Premenstrual dysphoric disorder
Lack of social support, financial burden
Young age of pregnancy <20 yrs or single parent
Complications during pregnancy
Having child with special needs or medical complications.
Treatment options:
Once the problems are noticed its very important to seek professional help.
Talk to someone- anyone you feel comfortable with, partners, family members and express the concerns and allow yourself to rest. Parenting concerns can be shared with friends or family, maintaining social contact is vital and join support groups if needed.
The treatments options include Medications like antidepressants, antianxiety, antipsychotics and other medications, Therapy like talking therapies – including CBT, IPT, supportive group therapies and so on. It is always better to combine Medication with therapies as studies have proven it is more effective than individual treatment.
Lifestyle changes like eating well, physical routine, getting adequate rest, family or friends support are all important parts of treating maternal mental disorders. Get help for daily household work to reduce the burden of managing family and house, hence keeping more focus on yourself and the baby.
Earliest detection of better often result in better treatment and earlier recovery.
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DR. ASGAR ALAM
Psychiatry
Aster Clinic, Discovery Gardens (Zen Cluster)