DSM-5, the most recent guideline for the description and diagnosis of mental illnesses, lists postpartum depression as a potential challenge for new moms.
Since it has been recognized that a cluster of mood disorders may begin in pregnancy, rather than being confined to the months after delivery, the term “post partum” has been replaced with “peripartum.”
What Sets Postpartum Depression Apart From The “Baby Blues”?
Okay, but what is it about, exactly? Is it a temporary, relatively “normal,” condition, or does it need urgent care?
The article will gradually reveal the answers to these questions, but first we must establish a premise to differentiate postpartum depression from the “baby blues,” a condition of low mood, tears, melancholy, and physiological symptoms that affects many mothers (as many as 60-70%) in the days following childbirth.
Linked to the rapid hormonal shifts that occur in women after giving birth, it goes away on its own within a few days (at most a couple of weeks).
However, postpartum depression often manifests itself weeks or months after delivery and affects anywhere from 10 to 15 percent of new mothers. Let’s work to clarify its components.
Postpartum Depression Symptoms
Postpartum depression is defined by the presence of at least five of the following symptoms, all of which must be present at the same time and last for at least 15 days.
- Negative emotions, sadness
- Weariness throughout the day Loss of interest and the absence of pleasurable experiences
- Disinterest in the kid
- Restlessness, agitation
- Disruptions in sleeping and eating patterns
- Negative thoughts about oneself or feelings of remorse
- Lowered concentration levels
- Constant depressing and suicidal thoughts
- Irrational and excessive worry over the child’s care or wellbeing that has no rationale
Postpartum Depression’s Root Causes
A postpartum depression episode’s beginning is likely influenced by a number of factors.
It’s reasonable to assume that hormonal shifts and the exhaustion associated with giving birth, which may be a painful experience in and of itself, have a role.
Factors of a psychological, interpersonal, and societal nature are also important.
The most important psychological element is determining whether the woman has a history of depression or severe anxiety issues; if so, she is more likely to have depressive troubles in the postpartum period.
Other significant psychological, relational, and social factors include having a difficult birth, experiencing stressful events in the months leading up to the birth, being a single mother, having financial difficulties, being in a disadvantaged social situation, having a tense relationship with one’s partner, not having a strong support system, having a difficult experience with hospital staff, and having postpartum complications with either the mother or the baby.
Although these characteristics increase a person’s susceptibility to developing postpartum depression, they in no way guarantee that someone will suffer from the condition.
We may also remark that, while being normal and physiological processes, pregnancy and labor are nonetheless a burden for a woman’s body and mind and, like other stressful events, put a person’s equilibrium under strain.
There may be less of a negative reaction to stress if the equilibrium is healthy and consistent.
On the other hand, if a mother’s physical or mental health is already somewhat compromised, a life-changing event like giving birth can have the effect of exacerbating any existing discrepancies.
Previous history of major depressive or anxious episodes is a strong indicator of future postpartum depression. To draw a comparison, one might say that labor and delivery are similar to a severe storm, which is only a natural occurrence—powerful, yes, but not harmful; no home is typically flooded during a storm.
But if our roof has any preexisting flaws, holes, or excessive wear, the water might seep in, flood the home, or even bring the roof down entirely.
To be able to consider and monitor as significant even more or less strong depressive episodes that occur during pregnancy, by intervening promptly and accompanying the woman immediately with specific support, it will be possible to avoid carrying on the problem for to long after childbirth, the term has also been renamed to “peripartum” depression to reflect the connection with psychological factors of the person prior to childbirth.
Behavioral Traits Of Postpartum Depression In Females
In the context of Brief Strategic Therapy, the term “attempted solutions” refers to any and all attempts to address an issue that fail to do so and, in doing doing, contribute to maintaining the status quo of the problem, if not exacerbating it.
Let’s take a look at the most common coping mechanisms used by women experiencing postpartum depression.
Avoiding The Real Issue / Denial
If successful, this strategy will prevent people around the affected kid from realizing the severity of the situation at hand, leading them to dismiss any signs of distress as the result of the child’s natural fatigue or of his or her erratic sleep schedule.
In fact, the societal expectation that a new mother should feel nothing but joy at the arrival of her child may lead the woman experiencing postpartum depression to hide or downplay her symptoms.
Regarding itself but mostly to the requirements of the youngster, that exhaustion is natural and will eventually fade.
Since her feelings are so at odds with her expectations, the distraught mother may attempt to hide her true emotions out of shame and guilt.
This obviously doesn’t work, and in fact makes things worse, since the more the mother withdraws into herself and refuses to welcome the feelings she’s feeling, the more intense those emotions will grow, and the longer it will be before she can begin to intervene on the genuine depression issue.
Delegating the child’s care is an attempted solution often implemented by those suffering from postpartum depression, both as a solution to calm the anxiety and sense of inadequacy related to the fear of not being able to take proper care of the little one, and as a result of a sense
Both mothers and dads have a propensity to hand over responsibility for their children to other family members, fathers, grandparents, or a nanny for both the little and major duties (a walk, a bath, a moment of play), especially as the severity of the disease increases (eating, sleeping, changing the diaper ).
While it may seem good to let someone else take care of your worries for a while, this just serves to reinforce your child’s sense of inadequacy and dread in the long run and is why delegating isn’t a good answer.
Soon Enough, They Give Up.
Most people with depression try to alleviate their symptoms by cutting out some aspects of life, often beginning with the more enjoyable (going out, having fun, relationships with friends, etc.) and progressing to the more mundane (doing laundry, eating, etc). ( working, getting up, eating, washing … etc … ).
We give up because we are overburdened and exhausted, but even this doesn’t help since giving up doesn’t restore our strength; rather, it makes us feel even weaker and more decayed.
The more I give up on life, the more helpless and miserable I feel. This just serves to reinforce my decision to stop trying altogether.
With postpartum depression, a mother may renounce not only her role as a new mother with the child (similar to the delegation we mentioned above, but even more defined and continued over time), but also her care for herself (washing, combing, putting on make-up, going to the hairdresser), her social life, her leisure time, or her ability to return to work.
Relationship To Other Mothers
This is another sneaky way that new mothers try to solve their problems.
Moms who are experiencing emotions of uncertainty, worry, or distress about their new position may attempt to find reassurance by drawing comparisons to other mothers in their lives or reading about the experiences of other mothers on different online forums.
Confrontation isn’t always bad, especially if I go into it knowing what I’m doing and if my goal is to learn something rather than feel safe.
It may be really helpful for the novice to get advise on a technical issue (breastfeeding, how to clean bottles correctly, rather than on specific brands of diapers, or on the name of a reputable doctor).
Wanting to find one’s certainties in comparison with others is a poorly functioning solution because it does not really put me in contact with myself, does not make me grow in self-esteem, and makes me a slave to external judgment.
The problem arises when comparison is used to soothe the anxiety and anguish of not being a good mother.
Help From Family Members
This refers to any efforts made by the mother’s immediate or extended family members to aid her.
They do it out of love and good intentions, but even then, if their activities don’t help, they’ll just make things worse.
If you don’t pay close attention to the results of your actions, you can end up contributing to the issue rather than solving it.
Having a depressed person next to you is difficult, and it’s natural to want to shake the person you care about out of their “numbness,” or state in which they lose interest in everything.
To be honest, this tactic seldom works.
The mother’s sense that no one understands her is likely to grow as a result of the heightened tensions.
To try to reason with someone who is experiencing a condition that has nothing to do with reason is like trying to drive a nail with a screwdriver.
In such a situation, it’s best to just accept the mother’s tears and outbursts with compassion and silence, assuring her that you will be there to support her no matter what she decides to do to begin getting well, and that the answers are out there (first thing of course is that to contact a psychologist expert on the subject).
Ask Other Mothers How They Compare
It’s an effort at a solution that’s similar to the last one, which included comparing yourself to other moms.
I mean, what does it even mean?
That the kid has issues too? Or, “Look at your neighbor, how powerful she is, therefore you have to be…” and similar statements.
The underlying premise here is that shaking a mother might have a devastating effect on her already fragile sense of self-worth.
That’d be helpful if you want to give her some models to work from or share tales about situations like the one she’s going through that had a similar outcome and then resolved themselves.
There were a few rough months for her, too, and then life settled back into a routine.
Reminding the mother that postpartum depression is normal (in the sense that it is not a sign of weakness or strangeness) and that it can be resolved as long as it is treated can help her feel like she is not alone or the” strange “one, or that she has overcome other difficult moments in the past ( something that goes along with these: “be brave…” “you remember how much you suffered when…” “if you did it then you can do it now “).
Ensure That The Child’s Care Is Deputed
The most hazardous approach that close family members may try is to step in and take care of the kid themselves, as is often the case when a woman suffering from postpartum depression attempts to do.
It’s common to offer to take care of a kid beyond what’s required in order to relieve stress on the mother, but this approach might backfire if it’s maintained for too long.
So that she may relax and focus only on caring for the newborn, the mother should have family and friends take over all of her household responsibilities (such as cooking, cleaning, ironing, shopping, etc.).
However, taking on the additional responsibility of caring for the infant (barring the rare exception) disrupts the development of the mother-child bond, which is often the sole reason that drives the mother to struggle against her depression.
If the mother’s depression is so severe that she refuses to care for her kid at all (by not feeding him, letting him wail for extended periods of time in the cradle, not changing him, etc.), then obviously someone else has to step in and do so.
Take good care of the baby In all other less extreme circumstances, it is crucial that the mother “makes the effort” to care for the infant, maybe with companionship if required, but without ever being freed of the duty of mother.
Tips For Overcoming Postpartum Depression
Psychotherapy is the major treatment for postpartum depression. Quickly enacting a specific plan developed in tandem with a psychologist who specializes in the area.
A shorter and more effective treatment intervention is achieved when it is initiated at the onset of symptoms.
As long as a good psychotherapy route is engaged as soon as feasible, it is usually not required to use medication unless the situation is really dire.
It’s crucial that the mother, as well as her husband or other concerned loved ones, realize that seeking professional psychological help is a perfectly reasonable and healthy course of action.
Sometimes a consultation may help reframe the scenario as typical for a new mother’s life, disproving the concept of postpartum depression in the process. However, only a trained professional is capable of making such a determination. After a period of counseling, psychotherapy is pursued if deemed required.
Brief strategic therapy’s initial step is to zero in on the precise methods the mother and her support system have tried to use in an effort to solve the problem.
As the mother recovers a new equilibrium, first with herself and then in the connection with the child, after the pathogenic balance has been disrupted, support is required.
Postpartum Depression And Psychotherapy: A Study Case
To protect the identity of the patient, I will refer to her as Sarah, a made-up name. She is quite anxious about herself and what is happening to her after the birth of her first child six months ago; she is just 35 years old.
She is obviously exhausted every time she visits my clinic; she is a mother who gets little sleep, but that’s not all. She confides in me that she is scared because she is experiencing feelings inside herself that go beyond the fatigue caused by the sleep loss associated with the child’s frequent nighttime awakenings.
She is easily annoyed, has frequent bouts of sobbing and unprovoked rage, seldom finds “pleasure” in the things she formerly found enjoyable, and is terrified of being left alone with the baby when her husband returns to work in a few months.
He also claims to have a serious problem falling or staying asleep: even if he is very exhausted, after the feeding is over and the baby is asleep, he is unable to go back to sleep.
Because she is so “uncertain” about her day-to-day life, she avoids leaving the house out of concern that she would forget her kid in the vehicle or at the grocery store, which only serves to heighten her feelings of resentment and depression.
Her husband is kind and supportive, but he works long hours and is seldom home until the evening, so she is often on her own. This is partly because she has never been taught to rely on her extended family for assistance.
Symptoms Of Postpartum Blues
Afraid of being considered a “bad mother” because of the problems she is experiencing, for the fact that sometimes she only feels the weight of this new condition and not the beauty, which it still lives and acknowledges, Sarah trembles as she tells me these things.
She begs me to help her get through this difficult time in her life so that she may regain her sanity and protect her baby from her own irrational fears and the potentially harmful effects of the unusual feelings she is experiencing.
Much of our first session consists of me just listening to her and letting her talk about whatever is on her mind without interfering or trying to fix anything. I think this may be the first time she has felt safe enough to talk about her problems openly with someone.
Next, we examine his so-called “solutions,” or the things he’s doing in an effort to fix the issue but that are, in fact, making things worse, such as isolating himself, suppressing his emotions, not venting his frustration, not leaving the home, not asking for assistance around the house, and so on.
These activities, taken reflexively out of a misguided belief that they would assist, end up making things worse.
Because of this, it’s crucial to step in and make adjustments to the plan and provide it with new resources to cope with challenging situations.
Already in the first session, she is given a tool to use in times of uncontrollable anger and crying, a tool for the fear of being able to go crazy and hurt the child, and they review the value and importance of asking for help, which, while it may seem like weakness and immaturity at other times, is actually a sign of strength and great intelligence at this one.
In addition, when a woman is experiencing postpartum distress, it is crucial to reassure her that the physical and emotional fatigue she is feeling is a natural response to the tremendous physical and emotional exertion she has endured during her pregnancy and childbirth, show her that she is still in a transitional period when a full return to balance is unrealistic, but is possible if she accepts her shortcomings as a natural part of the process and doesn’t let them scare her.
When a mother’s recent delivery experiences are framed as “normal,” she is less likely to feel “weird” or “alone,” so alleviating a number of concerns stemming from the mistaken belief that her situation is unique.
Naturally, I let her know that it is vital that she allow me to accompany her for a time, since it is her isolation that forms the basis of the issue in her particular circumstance.
Nicoletta has improved to the point that she can attend the next meeting.
By breaking her solitude and asking her mother-in-law for assistance with some housekeeping, she immediately felt less alone and less condemned, despite her dread of her.
She tried some of the methods I advised, and although she still has some emotional “ups and downs,” she says she feels like more of an active participant in her life rather than a passive bystander.
As The Healing Begin
In Sarah’s case, several more sessions are planned in similar vein, with her husband attending one of them to get insight into his wife’s experience, and we continue to see progress and restoration of health and happiness at each session.
Sarah reports feeling much better after just five sessions, but I advise scheduling further appointments at a later date to ensure the improvements she’s experiencing are permanent.