Post-Partum Depression
From Encyclopedia of Sex and Sexuality
A term “that is commonly used to describe an emotional depression suffered by many women immediately after childbirth. Although it is not a diagnostic term in the medical community, it is frequently used by both medical professionals and the general public to describe a broad range of emotional responses following the birth of a child, ranging from an apparent euphoria to “the blues” and, rarely, to full psychosis.
There are several possible causes for post-partum depression. They include the stress of childbirth itself, the rapid hormonal changes that occur at the end of pregnancy, and perhaps a sudden realization of the new or added responsibilities of motherhood. The degree of the depression’s severity may also depend on one’s prior emotional strength and stability and the emotional history of the family.
In fact, cases of the “blues” occur after half of all normal deliveries—they are so common that they are considered part of a woman’s normal emotional response to childbirth. The “blues” usually start within hours or a few days after delivery and gradually fade away after one or two weeks.
Post-partum depression is marked by sadness, frequent episodes of tearfulness, fatigue and lack of energy, generalized anxiety, and sometimes extreme irritability. Treatment consists of reassurance, emotional support, and, if it seems necessary and the new mother is not breast-feeding, the use of mild, mood-enhancing medications and/or sleeping pills.
Post-partum psychosis, however, can be life-threatening and a true medical emergency. Though classified as an unusual psychosis, it includes all the typical psychotic symptoms: delusions, hallucinations, and greatly disorganized behavioral and thought patterns. It is sometimes accompanied by major depression and weight loss—occasionally to the point of anorexia.
This extreme condition usually occurs in only one or two deliveries per thousand, though it is more likely to occur if the new mother or the family has a history of emotional instability. (In very rare instances it can occur among new fathers.) Cases usually appear within days or at most a month after the delivery. It may evolve from the blues but usually occurs on its own. Early symptoms include those of the blues but also include lack of interest in the baby, fears of wanting to hurt the baby, or obsessive concern with the baby’s health. There may be delusions that the baby is dead or was born defective. There may also be paranoid suspicion, and thoughts of killing the infant or of suicide.
The psychotic mother is a danger to herself and to the infant and must be hospitalized. Treatment includes the use of antidepressants and often antipsychotic and sedative medications. During acute phases of the illness, visits with the baby, though usually helpful, must be supervised. As the psychosis subsides, the mother will show increasingly appropriate interest in the child and should be allowed more prolonged childcare visitation.
After discharge from the hospital, when the woman has returned to a more normal emotional state, individual psychotherapy is in order. It will usually help the mother come to an understanding of what has happened and help her deal with the feelings raised by her illness.The father’s involvement in some form of counseling is also important. Once a woman has experienced post-partum psychosis, future pregnancies bring an increased risk of recurrence, and counseling is appropriate.
