Postpartum Depression. Causes, Symptoms, Treatment

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Birth of a child is a great joy and at the same time a stressful event for the whole family. The period of pregnancy, childbirth and the first 9-12 months after the birth of a child is a crisis period. This crisis is associated with a sharp and radical change in the rhythm and way of life. The married couple cannot continue to function as a dyad and are forced to accept the reality of the triad - the triangular relationship.

Usually, during a crisis period, all unresolved conflicts and contradictions are exacerbated, both regarding marital relationships and intrapersonal anxieties, fears and fears. Most families can successfully overcome this crisis, but 10-15% of women develop postpartum depression.

The period of pregnancy and childbirth for the expectant mother is the period of birth of her maternal identity. During this period, regression occurs (a return to one's childhood to one's childhood experience and childhood experiences) and identification with one's mother in her maternal role. If the relationship with your own mother turns out to be unsatisfactory, this always complicates the psychological and emotional state of the future woman in labor. During pregnancy, a woman experiences a greater lack of love, and the feeling of loneliness is exacerbated. There is a great need for support from her husband and her own mother.

Causes of postpartum depression:

There is a widespread belief that postpartum depression is due to hormonal disruption, but current clinical studies have not revealed a significant relationship. Psychoanalytic studies reliably and convincingly show us the correlation of the development of postpartum depression with psychological factors.

The process of childbirth itself, as a rule, is a stressful event for the woman in labor. It can be subjectively experienced as the loss of a child as a part of himself, the loss of a sense of fullness. But the main difficulty lies in the fact that life after childbirth changes in key ways.

Disappointing reality is replacing idealized notions of motherhood. There is an intrusion of the child into the mental life of the mother, his exactingness is revealed. The desire to take care of the child turns into a duty, it becomes difficult for the mother to endure the cries and tears of the child, she feels like an incompetent mother, unable to calm her child. Without good support from the inner circle, the young mother soon falls into postpartum depression.

A vicious circle is formed: The child perceives the depressed mother as a “dead mother” and tries to revive her, stir her up, wake her up, and draw more attention to herself. The child's screams and demands are felt as unbearable, since the mother's inner "container" is overflowing with negative emotions and is unable to absorb the child's anxieties and rage in order to process them inside herself and thereby calm the child. The mother begins to feel guilty because of the feeling of her incompetence and sinks even more into an apathetic and depressive state, emotionally moving away from the child. The child reacts to this with even greater demands and negativism (a negative reaction to formal care without desire and without a feeling of love). The mother becomes angry with the baby, suppressing her anger. Awareness of anger reinforces feelings of guilt. The vicious circle is closed, and the contact between mother and baby is broken.

Also, the causes of postpartum depression include:

A lack of love and an overabundance of hatred from the invasion of the child's needs into the mother's inner world. The prohibition on the manifestation of anger towards the child leads to "reactive education" - hypertrophied feelings of love, anxiety and care, behind which there is an unconscious hatred. This kind of psychic structure, which allows the manifestation of "love" without love, leads to a rapid depletion of the mother's nervous system.

In a normally functioning family, the anger that arises between the mother and the child and the child and the mother must be borne and tolerated by the man, the head of the family. But often a man is not psychologically ready for the birth of a child, he is offended by the lack of attention and sex on the part of his wife. This often leads to his self-elimination, resentment, and sometimes to adultery. This kind of detached, sabotaging position of the husband is a strong provoking factor in the development of postpartum depression.

Another factor that provokes the development of depression after childbirth is the internal prohibition of a woman to fantasize. Let's clarify this issue a little. If a child cries in the room for a long time, and there is no way to calm him down, the absolute norm of psychological health will be the fantasy: "Throw him out the window", but love stops this action. If there is a deficit of love, then either the child really flies out the window, and these are real cases of psychotic manifestation of postpartum depression, or the mother, not allowing herself to get angry, tries with all her last might to be an ideal mother and defends herself from her negative feelings with "reactive education" which we wrote above, and then she begins to have a headache, psychosomatic symptoms are connected, and rapid exhaustion sets in, leading to an aggravation of the course of postpartum depression.

The symptoms of postpartum depression are:

- Chronic fatigue, irritability, developing into apathy.

- Sadness, sadness, tearfulness, insomnia, impaired appetite.

- Anxiety, panic, obsessive thoughts and obsessive actions. (When the mother goes to the crib 10 times an hour to check if her baby is still breathing).

- Feeling of emptiness and meaninglessness, depressed mood and feelings of intense loneliness.

- Feelings of guilt, self-reproach and self-deprecation, remorse and shame.

- Feeling of own helplessness and incompetence.

- Gloomy vision of the future.

The consequences of postpartum depression:

For the mother:

- Prolonged postpartum depression without treatment can develop into a chronic form of depression. This leads to the destruction of self-esteem, a feeling of fragility of one's own "I", emotional dependence on the approval of one's actions by others. In the future, against the background of postpartum depression, other psychopathological conditions may develop, such as anxiety-phobic personality disorder, panic attacks, etc.

For a baby:

- It's no secret that a child both in utero and after birth feels all the emotions of his mother. It is hypothesized that he experiences these emotions as his own. The emotional state of the mother has a huge impact on the mental and emotional development of the child. The child of a depressed mother, as a rule, becomes lethargic, self-absorbed, or, on the contrary, hyperactive and hyperexcitable.

The emotions of a child, which he gets used to experiencing in the first year of his life, become the basic foundation of the emotional structure of his personality in adulthood. That is, if a child is accustomed to feeling despair, apathy, meaninglessness and hopelessness in the first year of his life, it is highly likely that these sensations and feelings will remain with him throughout his life and will be expressed in the form of various psychological disorders, up to and including attempts suicide.

It is also important to note that as a result of postpartum depression of the mother, contact with the child is broken, which leads to the formation of childish negativism and the development of a rejecting and devaluating position, which is expressed in the attitude: "Everything is bad anyway!"

What prevents you from seeking help from a psychologist?

The main difficulty lies in the fact that postpartum depression often goes unnoticed by medical personnel, and a woman is left alone in her painful condition. It is often impossible to turn to a psychologist for help on your own because of the feeling of guilt and shame from the feeling of one's own incompetence, as well as because of immersion in an apathetic state, bordering on moral and physical exhaustion.

Often obstacles to turning to a psychologist are prejudice against psychological help (I can't cope with it anyway, no one can help me), lack of free time (there is no one to leave the child with, leaving the child increases the feeling of guilt) and lack of financial resources. To some extent, the way out of the situation of lack of time and the inability to leave the child is psychotherapy via Skype. Practice shows that in the case of postpartum depression, this help is possible, effective and urgently needed.

Often, postpartum depression is also not recognized because some of its types are not similar to the manifestations of depression in its usual sense.

Types of postpartum depression:

- Mental or thought depression. (Apathy, dark thoughts, feelings of loneliness and emptiness, guilt and feelings of incompetence)

- Phobic depression (Fear of harming the child by one's own actions, strong anxiety for the child, panic fear that something will happen to the child).

- Obsessive depression. (Obsessive hyper-care for the child, constant obsessive care and hygiene).

Of course, it is best not to bring yourself to the state of manifestation of all the symptoms of postpartum depression, but to prevent its development. Modern psychoanalytic research has identified risk factors for which the development of postpartum depression is likely to occur:

Risk factors:

- Depressive state experienced earlier.

- Low self-esteem.

- Bad relationship with your own mother at the moment, lack of support.

- Difficult relationship with the mother in childhood. (Risk of reactivating and acting out aspects of early childhood distress.)

- The presence of traumatic moments in the history of his early childhood (hospitalizations, early separation from his mother, depression of the mother during pregnancy and after childbirth). In this case, there is a high risk of repeating a negative scenario.

- Unsatisfactory relationship with her husband. Marital conflicts, lack of understanding and support.

- The desire to receive approval, the idealization of pregnancy and motherhood, the desire to be an ideal mother for your child. (This attitude will inevitably lead to frustration and feelings of incompetence. For the child, you just need to be a good enough mother.)

- Fear of attachment and dependence.

If you find these symptoms in yourself, then it is best to consult a psychologist for advice, without waiting for the development of postpartum depression.

Psychotherapy for postpartum depression

The main goal of psychotherapy for postpartum depression is to help the mother regain confidence that she is a “good enough mother” for her child and can cope with it. This kind of psychotherapy is often supportive in nature and aims to find and actualize the internal and external resources of motherhood. In the course of psychotherapy, aspects of the maternal role and maternal identity are touched upon. The supportive function of psychotherapy also consists in listening (containing) those feelings and emotions that the depressed mother is overwhelmed with and with which she has no one to share. Thanks to the containment (withstanding, digestion) of the mother's complex emotions, the psychoanalyst frees her own container and restores her function of emotional acceptance and reassurance of her child.

- Long-term psychoanalytic psychotherapy for postpartum depression can be aimed at working with loneliness, working through childhood traumas and childhood deficits of the mother, as well as helping in the formation of her maternal identity.

- Short-term psychoanalytic psychotherapy in psychotherapeutic counseling is mainly aimed at working out feelings of guilt, supporting self-esteem, resolving marital conflicts and establishing contact between spouses, creating a supportive environment and affirming the parental role.

It is important to note that psychotherapy for postpartum depression is most effective when it begins in the first three months after childbirth, and when it comes to short-term psychotherapeutic counseling, then it is important to say that it is desirable that this should be at least 10 meetings within three months.