– We managed to brown motherhood. We do not hide that the satin gown is a blouse dirty with dripping milk, and the smiling baby is a screaming brat. We talk to the psychiatrist Dr. Maja Herman about postpartum depression.
- “I didn’t want to touch her, I didn’t want to look at her, I didn’t want to have anything to do with her” – this is how the actress, Brooke Shields, described her postpartum depression in 2005
- – We managed to brown motherhood. Today it is said aloud that you can be heartily fed up with your own child, get mad at it or dislike it temporarily – says psychiatrist, Dr. Maja Herman
- According to statistics – postpartum depression affects 20 percent. mothers. Its milder version – the so-called baby blues – it concerns up to 80 percent. women after childbirth
- Dr. Herman: Contrary to appearances, a wanted pregnancy preceded by long attempts for a child may increase the risk of postpartum depression. hormonal stimulation before IVF is also important
- You can find more similar stories on the TvoiLokony home page
– It started in the hospital. I turned my head, hid my hands under the covers. I didn’t want to touch her, I didn’t want to look at her, I didn’t want to have anything to do with her – this is what Brooke Shields wrote about postpartum depression in her book Down Came the Rain: My Journey Through Postpartum Depression, which was published in 2005. Fifteen years later, is it easier for us?
I have the impression that it is. First, many famous women, following in the footsteps of the American actress, admitted that they suffered from postpartum depression. Secondly, we managed to brownish motherhood. Today it is said aloud that you can be heartily fed up with your own child, get mad at them or dislike them periodically. We stopped hiding that a “satin robe” is actually a blouse dirty with dripping milk, and a smiling baby is a brat who screams out loud. Until recently, it was taboo – being a mother was written only in the context of a miracle. Children loved each other – at least in theory – from the day they were born with the greatest love, and every inconvenience: insomnia, decreased libido or breaking social contacts was called “grace”. It is certainly much harder to admit to being depressed at the peak. So I win gold at the Olympics, in the glow of the flashes I leave the stage and go back to bed.
Statistics say: top 20 percent – can there be more women with postpartum depression?
I think so. In the world and in Poland, there are more and more research works that show the scale of the phenomenon. The problem, however, is not how many women get sick, but how many are treated. In Poland, there is not much – gynecologists who check women after giving birth, do not diagnose postpartum depression, mums downplay their own symptoms and do not tell their loved ones about them, the lines to the specialists are shockingly long.
The situation is to be improved by the obligatory tests for depression introduced as part of the perinatal care standards.
This is a step forward, not an ideal solution. Assessment of the risk and intensity of depression symptoms using the Beck test is performed three times – twice during pregnancy and in the postpartum period, approximately 4 weeks after delivery. When completing the questionnaire consisting of 21 items, the woman marks the answer that most accurately describes her well-being over the last two weeks. In practice, there is a group of patients who feel well after giving birth, and suddenly, for example after six months their mood drops significantly and they start to fall ill. So, in many cases, this depression goes undiagnosed.
- Is it depression? Take the test and see what the risks are
Many moms confuse postnatal depression with “baby blues” – how can you tell the difference from one another?
The most important criterion for distinguishing is the duration of the symptoms. “Postpartum sadness” “Baby blues” is a phenomenon of mild mood changes, usually lasting up to fourteen days after giving birth. According to statistics, it applies to 80 percent women. When it comes to postpartum depression, the severity of dysfunction is much greater and may appear even a year after the baby is born.
Can baby blues become postpartum depression?
This is often the case, especially when the woman’s environment is unfavorable. So the child’s father says: get a grip – millions of women give birth to children, grandmother: I have been through it many times and I have never been hysterical, and my mother-in-law: Bartuś will leave you if you don’t get it together …
If we had to name one person from our immediate vicinity who might be an inhibitor or a catalyst for mom’s postpartum depression, would that be the partner?
The closest person. If the father takes paternity leave, it may indeed be him. In another case, helping mother or mother-in-law.
The most common symptoms are fatigue, crying, insomnia, fear of your own baby?
Not so much fear of your own child as belief in own incompetence and inexperience. Women with postpartum depression feel worthless: I’m a hopeless mother, completely unfit.
And the thought: I wish it would disappear?
Not that it disappears. To kill … Toss out the window or throw it off the changing table. We are talking about a very severe form of depression with psychotic symptoms, which occurs with a frequency of 1-2 cases per 1000 births. Women with bipolar disorder or schizophrenia are primarily at risk.
In the press, we often read about bloodthirsty child killers or degenerate mothers who throw their children into the garbage or put them in the “window of life”. How many of them may have undiagnosed psychosis or postpartum depression?
Based solely on the media coverage, I can say that these stories show great chaos, disorganization and the death of a child. There is no deliberate action, cause-effect or motive in them. There is helplessness.
I think that if the “degenerate mothers” of tabloid headlines were included in the prevention program, we would have avoided a tragedy in many cases. Especially since early postpartum depression is easy to treat.
Many of these dramas started with an unwanted or unplanned pregnancy, is that a risk factor?
Contrary to appearances, the wanted pregnancy was preceded by long attempts for a child may increase the risk of postnatal depression. For a simple reason: childbirth takes place at a time when a woman already has an emotional disturbance.
- Testing Worth Doing If You Suspect Depression
This is why postpartum depression can occur after IVF?
Yes, we have a long way to go to motherhood and hormonal stimulation in vitro, and chronic stress and hormones are two factors that play an important role in the pathogenesis of depression and exacerbate its course. In Poland, it is not mentioned at all, individual analyzes have been published in the world, including in the Journal of Midwifery and Women’s Health showing that the risk of postpartum depression after IVF rises to 25 percent. The preliminary results of my research confirmed this. Unfortunately, I did not manage to collect the right number of patients.
In our country, IVF is still a taboo, used by the Church and politicians as a substitute topic. It is enough to look at who admitted the famous people: Bogna Sworowska, Małgosia Rozenek, Kinga Korta … and that’s it. Not much, considering that in Poland every year, in vitro procedures are used by several thousand pairs.
There are many myths surrounding the treatment of postpartum depression – the most damaging one is it will pass over time.
No, it won’t. The later the treatment is started, the longer the disease lasts. The only problem with treatment concerns breastfeeding and the need to take medications.
You have to choose?
Yes, interestingly we have the bible of pharmacology, Ernst Mutschler’s book “Pharmacology and Toxicology” published every year. In addition to data on individual groups of drugs, the manual also includes the results of the latest clinical trials. Thus, in the 1997 edition it was stated that paroxetine, an antidepressant of the selective serotonin reuptake inhibitor (SSRI) group, is safe during pregnancy and breastfeeding. However, in the 2018 edition, we can read that it is deadly.
This is the research?
And the length of the drug’s stay on the market. Pregnant and breastfeeding women belong to special populations, i.e. a subgroup of patients who require special treatment in clinical trials. We always have to consider the potential risks and benefits – as a scientist, I would be afraid to recruit one of them. When it comes to breastfeeding and taking antidepressants we only have case reports and single studies on small groups of patients. We still don’t know how the use of antidepressants while breastfeeding affects babies in later years. Maybe patronizing, maybe not. Even after sertraline, one of the safest drugs, fatal complications have been reported. I will not prescribe the drug myself if the patient does not go to the “deal” with me. The arrangement is that for eight weeks, he takes the drug and does not breastfeed, but maintains lactation. Two months is the optimal time for the drug to work and for the woman to feel the difference. Later, she has the choice: to stay with treatment or to return to breastfeeding.
I?
None came back. They all decided that their mental health was more important than a bottle of mother’s milk. Not only for them, but also for their children.
How long does treatment take?
Typically one to two years.
Can’t we treat postpartum depression only with psychotherapy?
In the case of a mild depressive episode, it is possible, but due to the lack of prevention, it is rarely seen. In postpartum depressions, the standard disturbances in the field of neurotransmission are also accompanied by a hormonal storm, which only adds a woman to the furnace. Drugs or psychotherapy alone are not enough, the immediate family, especially the partner, should be involved in all elements of treatment. Support groups for women who have experienced or are experiencing postnatal depression would also be ideal.
Does a mother with postnatal depression care for her baby differently?
He doesn’t – he can’t. One of the popular “good advice” is give her the baby, hold her to her breast and she will feel better immediately, and she will feel even worse. Though she does everything right she has the impression that she is doing everything wrong: she feeds in a wrong way, rewinds like that, bathes in a wrong way. She does not tell anyone about her emotions, and her closest family does not notice anything.
It has long been said that depression affects the entire life of a family, and how can maternal postpartum depression affect a child?
May have difficulty recognizing emotions. Let’s not forget that we learn through modeling, that is, observing the behavior of others, and the depressive mother stops feeling and expressing emotions. He perceives the world in black colors, has difficulty making simple decisions, does not enjoy life. We can talk about the disturbance of mutual ties and the risk of developing mental disorders in adulthood. Much depends on the extent to which other family members will be able to compensate for the child’s lack of care.
The editorial board recommends:
- This is what smiling depression looks like. «I took this picture and then I went back to crying in the bathroom»
- How will you know when stress is having a negative effect on your health?
- Men do not want to talk about it at all, prefer to drink alcohol. Women usually report to a psychiatrist themselves
The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.Now you can use e-consultation also free of charge under the National Health Fund.