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Psychologists from Gdańsk have been implementing the “Mama Stop” project for four years. From this year on, it is available to everyone in Poland. Its goal is, inter alia, helping women struggling with postpartum depression. – There is a lot of ignorance in Poles and a tendency to stigmatize mental health difficulties – says psychologist Dr. Magdalena Chrzan-Dętkoś from the University of Gdańsk in an interview with PAP.
- Depression affects 12-19 percent. pregnant women. At postpartum – about 15 percent
- The symptoms of the latter include anxiety, irritability, difficulty thinking and memory, anhedonia, fatigue, insomnia, anxiety, guilt and thoughts of suicide – says the psychologist
- Postpartum depression has negative and lasting developmental consequences, also visible in the age of 18 of children
- More information can be found on the Onet homepage.
Postnatal Depression – How Many Women Experience It?
PAP: Who is affected by postpartum depression?
Dr. Magdalena Chrzan-Dętkoś: Postnatal depression affects about 15 percent of women. Of course, there are some risk factors.
What are these factors?
Previous episodes of depression, pregnancy depression, negative childbirth experiences, unwanted pregnancy, disturbed relationship with a partner, relationship violence, lack of social support, and more. In practice, however, it is impossible to predict who will get depression and who will not – we can only talk about risk factors. However, knowing that, for example, we meet them, it is worth taking extra care of yourself.
What about pregnant women? Can they also get sick?
Yes. 12-19 percent of women suffer from it. Furthermore, depression in pregnancy is a major predictor of the risk of developing depression after a baby is born. Women who suffered from depression during pregnancy may have a very severe course of the disease after childbirth, and they experience suicidal thoughts more often.
How do you recognize postpartum depression?
Mood disorders in the perinatal period are common among mothers. The continuum of these troubles extends from the mild and transient forms of the so-called baby blues, a state that does not require specialist intervention, experienced by 50-80 percent women, through typical depression with mild and moderate symptoms, to cases of postpartum psychosis understood as a severe depressive episode with psychotic features, often requiring hospitalization. One of the distinguished forms of mood disorders in the perinatal period is postpartum depression. The most common symptoms are restlessness, irritability, difficulty thinking and remembering, anhedonia, fatigue, insomnia, anxiety, guilt and thoughts of suicide. These symptoms are often accompanied by a drop in self-esteem, worry about the child’s health, anxiety related to caring for him, a sense of being worthless as a mother, lack of self-confidence and unrealistic expectations of oneself.
Can postpartum depression also be seen around the sick person?
Yes, noticing these symptoms in yourself or a loved one may be such an alarming signal that something is wrong and it is worth seeking help. Depression, in human language speaking, is a disease that consists, among other things, of on losing self-esteem, being able to take care of yourself. It is unlikely that someone who feels very bad will look for help on their own – so support and observation of loved ones may be of key importance here. It is often a partner, friend or other family member who notices that something is wrong. Some women may recognize their own mental state but not know how to talk about it. Then also the awareness of loved ones who can recognize the symptoms of depression and help the woman find support is very important.
Is there a risk of long-term depression?
And this is how we come to the Przystanek Mama project. Before about the project, however, please tell me what happens to women who will not be diagnosed, who will not receive help on time?
In some women, depression then becomes chronic, in others it passes after a few months. Suicide is the leading cause of death for women in the first year postpartum in the UK and is one of the most dramatic effects of untreated depression.
And in Poland?
As a country, we do not publish such statistics, so we can only rely on conclusions from other countries. Importantly, our program shows that, unfortunately, only 30 percent. women who have an elevated screening result benefit from further assistance.
Could maternal postnatal depression affect the baby in any way?
Yes. Untreated depression, both in pregnancy and postpartum, has significant consequences for both mother and baby. Depression during pregnancy doubles the risk of preterm labor, pre-eclampsia, diabetes and caesarean section. In the long run, it also negatively affects the emotional and social development of the child. The period of the first weeks after delivery is characterized by an exceptionally strong dependence of the newborn on the primary caregiver (in the vast majority of cases – the mother). Maternal depressive disorders are associated with higher levels of parental stress. However, I would like to emphasize that this does not mean that a mother does not love or care for her child. Her well-being, anxiety, mood, increased fatigue may or may not affect the way she cares for the baby.
What are the consequences for children’s development?
ALSPAC population studies have shown that postpartum depression has negative and lasting developmental consequences, also evident in children 18 years of age. A particularly vulnerable group of children are those whose mothers suffered from depression between 2 and 8 months after giving birth. These women were also diagnosed more often with depression 11 years later. Their children, on the other hand, were 4 times more likely to have behavior problems between the ages of 3 and 4, they were also burdened with a twice higher risk of difficulties in mathematics at 16 years of age and 7 times higher risk of depression at 18 years of age.
Therefore, everything must be done to help a diagnosed woman. Hence the MAMA Stop project. What is it about?
Mothers of infants can visit a psychologist working in our project after completing the Edinburgh Postnatal Depression Scale – the questionnaire can be completed independently on the website www.przystanekmama.copernicus.gda.pl or during an examination by a midwife. Psychological consultations in our program can be used when your score on the Edinburgh Postnatal Depression Scale is 10 or more, or when your answer indicates that you have such thoughts in the 10th question about wanting to hurt yourself.
Help for depressed mothers
The project is carried out by psychologists from the Copernicus hospital in Gdańsk. Does this mean that it is only available to patients from Pomerania?
Women from all over Poland can make an appointment with a psychologist in their area of residence or use a remote form of consultation. On our website, in the “psychological consultations” tab, you can find information on psychologists cooperating with us. Mom can have three free consultations. In a situation where mothers have a lower result on the Edinburgh Postnatal Depression Scale, but feel the need to talk to a psychologist, we encourage you to contact us via Messenger – we try to help in finding psychological help.
The project has been running since 2019, how many women have managed to help so far?
We have completed over 600 psychological consultations, screening tests were performed on over 21 women – I am talking only about the northern macroregion. The MAMA stop also operates in the following voivodeships: Mazowieckie, Łódzkie, Siedlce and Lubelskie.
How is the project assessed by its participants?
Most of the mothers who use our project positively assess their benefits (on average almost 6 points on a 7-point scale), and about 60% of women say that thanks to the consultation they experienced an improvement in mood and decreased anxiety. Additionally, for about 60 percent of my consultations, I was motivated to seek further help.
Until now, in order to use the project, it was necessary to meet certain requirements, including concerning the place of residence. What is changing in the project now?
The project was to be implemented in six regions of Poland, thus involving women from all over the country with help – unfortunately, the implementers did not come forward in some of them. Perhaps it shows the attitude of the society and medical staff to the problem of postpartum depression. Due to the lack of implementers, the Ministry of Health decided to extend the activities of the existing projects: Przystanek Mama Północ, Siedlce, Center – Iron Hospital together with the Empowering Children Foundation and the Eastern Prevention Center. Thanks to this decision, the existing projects will be able to provide free psychological help to women from all over Poland, regardless of the voivodeship they live in. Such consultations can be carried out remotely.
Is telephone or remote support sufficient? Does a person suffering from postpartum depression need therapy, e.g. in an office?
It is a very individual matter. For some women, the three consultations we offer are enough, even remotely – but only when it is the beginning of a low well-being. Of course, however, some may not be enough. According to our research, about 57 percent of women who have benefited from consultations under the MAMA Stop are referred for further treatment – and here we are talking both about further psychiatric treatment, individual or group psychological therapy and support groups, but also psychiatric treatment. Importantly, about 50 percent of moms work together with our psychologist to develop a plan for the further path of help. For the rest, consultations play the role of a quick psychological intervention, the possibility of discussing difficulties, dilemmas, anxieties, and also satisfying the need to understand, listen without judging. For the vast majority of mothers, our consultations are also a source of psychoeducation, thanks to which they are equipped with knowledge and tools that will allow them to notice disturbing signals in the future and deal with tension and difficult emotions.
By implementing the project, you want to increase public awareness of depression. How is it now with the awareness and knowledge of Poles on this subject?
We do not have mental health classes at school in Poland – and mental health difficulties will affect one in five Poles over the course of a lifetime. We have subjects like Education for Safety, perhaps the introduction of a subject where you can learn in a practical way how to regulate your mood, which improves it, how to deal with difficult feelings and thoughts, would be an important preventive factor in the context of mental health, and it would also improve public knowledge and awareness of mental disorders. So far, Poles have a lot of ignorance and tendency to stigmatize mental health difficulties. Various campaigns are currently underway to change this. It is also one of the goals of our business. We want to be a place where you can find reliable knowledge about postpartum depression and mental health in general.
What are the consequences of a lack of knowledge in this area?
According to a Canadian economic study, the cost of untreated pregnancy depression, including discontinuation of antidepressant medications, has been estimated at $ 14 billion annually. Until now, Poland has not only lacked data on the costs of untreated depression, but above all any systemic solution for screening and treating parents suffering from pre- or postpartum depression. From January 1, 2019, the Ministry of Health introduces changes that will bring the Polish health policy closer to the health policy conducted in most European countries. I think this is an important step in building public awareness of depression.
Another goal of the project is to increase knowledge about the prevention of postpartum depression among medical workers, with particular emphasis on midwives, nurses and doctors. Why should this professional group increase their knowledge in this field?
Midwives and nurses are currently screening the Edinburgh Postnatal Depression Scale. The organization of perinatal care in Poland offers them such an opportunity. Midwives and nurses in this critical period have relatively frequent contact with mothers. Thanks to this, they have a chance to notice disturbing symptoms, catch signals at an early stage and encourage the mother to seek professional help. Our training is aimed at equipping this professional group, so actively involved in contact with mothers and responsible for screening, with the necessary knowledge about the symptoms of perinatal depression, the scale of its incidence, and ways of talking to women.
When it comes to the level of empathy, it is probably an individual matter, but let us remember that just as a mother who feels “cared for” and rested has more opportunities to care for a newborn, so does a midwife who is not overwhelmed by work, bureaucracy, and the need to work overtime. , has more opportunities to care for the mother empathically.
At the moment, we have trained about 400 people from the medical staff – this element of Przystanek MAMA is also a very important part of our work. If disturbing symptoms can be detected fairly quickly, talking to a trusted supportive person can play a preventive role. In many countries, such as Great Britain, Malta, midwives and nurses are trained to conduct the so-called Listening visits – and contact with them is associated with the reduction of depression and anxiety symptoms in mothers.
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Dr. Magdalena Chrzan-Dętkoś is a psychologist, psychotherapist, content coordinator of the “Mama Stop” project in the northern region. He works at the Department of Psychology and Psychopathology of Development, Institute of Psychology, University of Gdańsk.
“Mama Stop” project jis carried out on the basis of an agreement concluded with the Ministry of Health. It is financed until 2023. It corresponds to the assumptions of the National Health Policy Program entitled «Postpartum Depression Education and Prevention Program». The main goal of the project is to increase the early detection of postpartum depression through education and increase social awareness of postpartum depression, and as a consequence to increase the percentage of women diagnosed with postpartum depression early.
Author: Piotr Mirowicz.
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