Did you know that the majority of new mothers may experience a period of so-called “baby blues,” sometimes lasting up to ten days? Often peaking during the fourth day, this syndrome may include irritability, weeping, sadness, anxiety and confusion. This mood disturbance is transient, does not affect functioning, and resolves spontaneously. It is attributed in great measure to hormonal changes.
When the mood disturbance is more pervasive and lasts longer, it may be classified as “postpartum depression.” Postpartum depression is diagnosed in about 13 percent (one of every eight) of women after delivery. In the United States alone, this means about a half-million women every year. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), an episode of depression is considered to have postpartum onset if it manifests within four weeks after delivery. For research purposes, an onset within three months is usually adhered to. Some practitioners may diagnose this condition even prior to giving birth. Often, it qualifies as a “major” depression.
While in some cases they may co-exist, it is important to differentiate between postpartum depression and postnatal posttraumatic stress disorder (PTSD), as treatment may differ.
Major depression is diagnosed when several symptoms are present, including a decrease in interest or pleasure in activities that were previously enjoyed or a depressed mood. In addition, various symptoms of dysregulation must be present for most of the day over a minimum period of two weeks or longer. These include sleep disturbance, changes in appetite, and cognitive changes, such as a predominance of negative cognitions and attendant feelings (“I am worthless,” accompanied by despair or guilt) and difficulty concentrating. Consequently, it may be difficult to make decisions. There may also be suicidal ideation or recurrent thoughts of death. Clearly, it is important to seek timely professional help.
The rapid decline of reproductive hormone levels after delivery.
Birth trauma – an event or series of events experienced as traumatic during labor or childbirth, including a medical trauma (e.g., unplanned emergency C-section.)
The following symptoms of postnatal post traumatic stress disorder (PTSD) may co-exist with post partum depression:
Various self-administered questionnaires may assist the clinician in determining the need for further professional attention. One such scale is the Edinburgh Postnatal Depression Scale. Another might be a PTSD Checklist. A high score should be followed up by a clinical interview designed to review the symptoms and establish a diagnosis.
Treatment may include psycho-education and participation in a support group comprising other women dealing with similar issues, individual psychotherapy, couples therapy and in some cases, anti-depressant medication (with special attention given to its potential impact on the fetus and/or breast-feeding infant).
Osmond, M. (2001). Behind the smile: My journey out of postpartum depression. Warner Books.
National Women’s Health Information Center (http://www.4woman.gov)
Postpartum Support International (http://www.chss. iup.edu/postpartum)
Depression after Delivery (http://www.depressionafterdelivery.com).
What is Birth Trauma? (https://www.birthtraumaassociation.org.uk/for-parents/what-is-birth-trauma)
פיכולוגית קלינית ומטפלת בטראומה (SEP). בעלת תואר ראשון ושני בפסיכולוגיה מטעם אונ' בר-אילן ותואר שלישי בפסיכולוגיה קלינית מטעם ביה"ס לפסיכולוגיה מקצועית בסן דייגו.
Je, ulijua kwamba wengi wa akina mama wapya wanaweza kupatwa na kipindi kinachoitwa "mwenye huzuni ya mtoto", ambacho nyakati nyingine huchukua hadi siku kumi? Mara nyingi hufikia kilele chake katika siku ya nne, ugonjwa huu waweza kutia ndani kukasirika, kulia, huzuni, wasiwasi na kuchanganyikiwa. Uharibifu huu wa hisia ni wa muda mfupi, hauathiri utendaji, na hutoweka kihalisi. Inasemekana kwamba tatizo hilo husababishwa na mabadiliko ya homoni. "Kama tatizo la hisia ni kubwa zaidi na linaendelea kwa muda mrefu, linaweza kuainishwa kuwa ""ushukaji wa moyo baada ya kujifungua."" kushuka moyo baada ya kujifungua hutambuliwa kwa karibu asilimia 13 (mmoja kati ya wanane) ya wanawake baada ya kujifungua." Katika Marekani pekee, hii inamaanisha karibu wanawake milioni nusu kila mwaka. Kulingana na DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), ugonjwa wa kushuka moyo huanza baada ya kujifungua ikiwa huanza ndani ya wiki nne baada ya kujifungua. Kwa madhumuni ya utafiti, mwanzo ndani ya miezi mitatu kwa kawaida hufuatwa. Wataalamu fulani wa afya wanaweza kugundua hali hiyo hata kabla ya kuzaa. Mara nyingi, ugonjwa huo huitwa mshuko wa moyo "mkubwa". Ingawa katika baadhi ya kesi zinaweza kuishi pamoja, ni muhimu kutofautisha kati ya unyogovu wa baada ya kujifungua na ugonjwa wa mkazo wa baada ya kujifungua (PTSD), kwani matibabu yanaweza kutofautiana. Ugonjwa wa kushuka moyo huchunguzwa wakati dalili kadhaa zinapokuwapo, ikiwa ni pamoja na kupungua kwa kupendezwa au kufurahia shughuli ambazo hapo awali zilipendwa au hali ya kushuka moyo. Kwa kuongezea, dalili mbalimbali za dysregulation lazima ziwepo kwa sehemu kubwa ya siku kwa kipindi cha chini cha wiki mbili au zaidi. Hizi ni pamoja na usumbufu wa usingizi, mabadiliko katika hamu ya kula, na mabadiliko ya utambuzi, kama vile utawala wa utambuzi hasi na hisia za mhudumu (mimi si wa thamani, pamoja na kukata tamaa au hatia) na ugumu wa kuzingatia. Kwa hiyo, huenda ikawa vigumu kufanya maamuzi. Pia huenda ukawa na mawazo ya kujiua au mawazo ya kifo yanayorudiwa-rudiwa. Ni wazi kwamba ni muhimu kutafuta msaada wa kitaalamu kwa wakati unaofaa. Kupungua kwa kiwango cha homoni za uzazi baada ya kujifungua Matatizo ya kuzaliwa <unk> tukio au mfululizo wa matukio yaliyopatikana kama ya kuumiza wakati wa kazi ya uzazi au kuzaliwa, ikiwa ni pamoja na majeraha ya matibabu (kwa mfano, sehemu ya C ya dharura isiyo na mpango.) Dalili za chini za ugonjwa wa post-traumatic stress disorder (PTSD) zinaweza kuonekana wakati wa ujauzito na kuonekana kwa dalili za postpartum, na kwa sababu ya hali ya chini ya afya, inaweza kuathiri uwezo wa matibabu ya matibabu. Kiwango kimoja kama hicho ni Kiwango cha Edinburgh cha Mshuko wa Kihisia Baada ya Kuzaa. Mfano mwingine ni orodha ya PTSD. Alama ya juu inapaswa kufuatiwa na mahojiano ya kliniki iliyoundwa kukagua dalili na kuanzisha utambuzi. Matibabu yanaweza kujumuisha elimu ya kisaikolojia na ushiriki katika kikundi cha msaada kilichojumuisha wanawake wengine wanaoshughulika na masuala kama hayo, matibabu ya kisaikolojia ya mtu binafsi, matibabu ya wanandoa na katika hali fulani, dawa za kupambana na unyogovu (kwa kuzingatia athari zake za uwezekano kwa kiinitete na au mtoto anayenyonyesha). Osmond, M. (2001). Nyuma ya tabasamu: Safari Yangu ya Kutoka Katika Mshuko wa Kiakili Baada ya Kuzaa. Vitabu vya Warner. Kituo cha Kitaifa cha Habari za Afya ya Wanawake (www.womensupport.gov) Ugonjwa wa kushuka moyo baada ya kujifungua (Depression after delivery) Mshtuko wa Kuzaliwa ni Nini? (https: www.birthtraumaassociation.org.uk) kwa wazazi (what-is-birth-trauma) Nawaona ni wa kwanza na wa pili katika kisaikolojia, na wa tatu katika kisaikolojia, na wa tatu katika kisaikolojia, na wa tatu katika kisaikolojia, na wa tatu katika kisaikolojia.