What is postpartum depression?
According to the National Medical Research Center for Obstetrics, Gynecology and Perinatology. Academician V.I. Kulakov, perinatal and postpartum depression are forms of depressive disorder. It occurs during pregnancy (perinatal) or after childbirth (postpartum, postnatal). A woman suffering from postpartum depression is depressed, her mental activity decreases, and movement disorders and somatic disorders may also be present. She does not feel the desire to take care of the child, feed him, bathe him, walk with him, she feels indifference and coldness towards him.
According to researchers from the Medical University of Sofia (Bulgaria), postpartum depression usually develops between four and six weeks after the birth of a child and lasts for at least two weeks.
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Treatment of depression with antidepressants
Despite the fact that depressive conditions can sometimes be reversed without treatment, the use of drug therapy with antidepressants accelerates the recovery process, improves the course of the pathology and prevents relapses.
Also, a very important reason for prescribing psychopharmacological treatment is the high likelihood of suicide in patients with depression.
Timing of taking antidepressants in the treatment of depression
Treatment begins with small doses of antidepressants, which are gradually titrated (adjusted) until the proper therapeutic effect is achieved. Any changes in drug dosage should be under the strict supervision of a physician to prevent side effects. Underestimating the doses of antidepressants used contributes to the chronification of a depressive state, the formation of therapeutic resistance (when the level of response to an antidepressant decreases), an increase in the time required to achieve remission, as well as a decrease in the quality of life of patients and the risk of suicidal thoughts and intentions.
Features of the use of antidepressants
It is necessary to understand that antidepressants begin to act only after 3 weeks from the start of treatment, which, in combination with a significant deterioration in the quality of life, is especially painful for the patient. All this time, anxiety, internal tension, sleep disturbances and other manifestations of depression may persist. Therefore, from the very beginning of treatment until the start of action of antidepressants (for a month or more), it is necessary to take sedative therapy - tranquilizers and/or anti-anxiety drugs (anxiolytics), and also, possibly, sleeping pills. They will reduce the intensity of anxiety, improve sleep, but will not affect low mood, lack of joy, as well as the desire and ability to perform usual work (partly due to cognitive failure). Therefore, patients do not feel an improvement in their condition for 1-2-3 weeks after starting treatment with antidepressants, they stop taking them, citing the fact that “it doesn’t help me.” How can an antidepressant help before it starts working?
But when antidepressants begin to work, the intensity of depression will decrease. And along with anxiety, the activity of the sympathetic part of the autonomic nervous system will decrease, which will lead to the elimination of heartbeat, a decrease in high blood pressure, restoration of the motor function of the stomach and intestines, an increase in the speed of motor reactions, muscle tone and other somatic symptoms that often mask the typical clinical picture of depression .
What are the most common causes of postpartum depression?
The exact etiology of the disease is unknown: it can occur in women of different ages and with different social situations. Doctors suggest that the disease can be triggered by severe stressful situations, anxiety and worry experienced during pregnancy, especially in the third trimester.
Depression can also be caused by maternal sleep disorders, problems related to the child's health, cessation of breastfeeding, and a woman's anxiety about changes in her body after childbirth. In addition, a woman may experience postpartum depression if none of her relatives or loved ones help her with the child or household chores and she feels that she is left alone with them. If a woman already had depressive symptoms during pregnancy, this may also be a risk factor for developing the disease.
What to do if the illness persists
You should not self-medicate, it can harm your health. If the selected treatment is ineffective, the disease can last for years. You should consult a psychiatrist. The doctor will make an accurate diagnosis, prescribe suitable antidepressants, and prescribe an individual dosage. If necessary, medications can be replaced during therapy.
Psychotherapy will also be required. Cognitive behavioral therapy is effective in combating depressive conditions. This technique helps to identify destructive attitudes and behavior patterns and replace them with positive ones.
The support of your close circle is important. You cannot devalue the patient’s problem, deny the existence of the diagnosis, blame him or get angry because of the presence of a mental disorder. Need support. Social adaptation is of great importance: due to pathology, a person can interrupt communication with friends. To prevent bad thoughts and feelings from aggravating a person’s condition, you should protect him from possible stress, do not start conversations with him about your own problems, and do not compare circumstances.
The patient should avoid taking stimulants: alcoholic beverages, drugs. They can aggravate the condition and are often incompatible with medications.
It is important that the diet contains a sufficient amount of vitamins, since vitamin deficiency increases the severity of manifestations.
How to recognize postpartum depression and what are its main symptoms?
psychologist Maria Merkulova told AiF.ru , postpartum weakness is typical for many women who have become mothers. During pregnancy and childbirth, they spend a lot of energy, so weakness, memory loss and bad mood are a common condition for young mothers. We can talk about depression if the depressed state lasts more than two months.
A woman may experience apathy, loss of strength, fatigue, anxiety, cry frequently and suffer from insomnia. Often added to this state are feelings of guilt, fear and despair associated with the fact that she is supposedly a bad mother who is not coping well with her role.
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According to the medical center named after. Kulakov, the symptoms of perinatal depression can be divided into basic and additional. Typically, to be diagnosed with depressive disorder, a woman must have two core symptoms and at least three additional symptoms. The main symptoms of the center's doctors include depressed mood, which, regardless of the circumstances, persists for a long time (from two weeks or more). In addition, a woman loses interest in activities that previously brought her pleasure, gets tired quickly, and constantly feels a loss of strength. It, like fatigue, does not go away even after rest.
Additional symptoms include pessimism, feelings of guilt, anxiety or fear, in particular, fear of being alone with the baby after childbirth, and problems with lactation. In addition, a woman may feel self-doubt, fear and guilt because she is not coping with the child, she has difficulty concentrating and making decisions, she loses her appetite and loses weight, cannot sleep or constantly has nightmares, her self-esteem drops. Also, affective disorders may predominate in behavior: reactions of refusal and despair combined with hyperactivity or aggression. A woman suffering from postpartum depression may begin to abuse alcohol.
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Prognosis for the treatment of depression
Modern antidepressants, the availability of approved protocols for the treatment of depressive disorder, the possibility of changing and combining drugs to achieve a better therapeutic effect, make it possible to predict with a high probability a significant improvement in mental health in depression.
Obstacles to achieving results may include underestimating doses of required medications, patient ignorance about the duration of therapy, and prejudices associated with long-term medication use.
Also, the human factor, the attitude of the patient himself, as well as a trusting relationship with the doctor play a significant role in the effectiveness of treatment for depression. If there is a desire to get well, to get away from the disease, then the likelihood of success increases significantly.
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Is postpartum depression treatable?
Yes. Without proper treatment, postpartum depression can last for months or even years and, in some cases, be life-threatening. Therefore, if the mother herself or her loved ones think that she may have postpartum depression, then you should definitely consult a specialist: a psychologist or psychotherapist. In this case, talking or drug therapy can help. In some cases, you may need medications prescribed by your doctor, some of which can be taken while breastfeeding.
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Postpartum depression: symptoms and methods of combating
Psychologists point out that for a woman suffering from postpartum depression, the support of loved ones and their help is very important. Often, while on maternity leave, a woman feels isolated from society, so it is important to be with family and friends, feel their support, and take a walk in the fresh air at least once a day. Maria Merkulova also advises anyone who has recently given birth to gradually reintroduce sports into their lives. In the first months, the mother may also experience exhaustion due to the fact that the child does not respond to all the conversations and games with him. But it is important to listen to your emotions, analyze them and understand that all this is temporary.
How long does depression last in men?
The duration of depression in men depends on the severity of the condition.
Mild and moderate forms of depression can last up to 9 months. In most cases, a man is able to cope with it on his own. However, consulting a specialist and taking the necessary medications can significantly shorten this period.
The dysthymic form of depression can accompany a person throughout his life. If such a condition is associated with a specific situation, for example, loss of a job, then depression, as a rule, recedes when entering a new position.
What can you do to prevent postpartum depression?
Doctors advise future parents to begin to prepare psychologically for childbirth already in the early stages of pregnancy: find out information in advance about possible complications, difficulties of the postpartum period and caring for the newborn. Prevention of depressive disorders also includes first contact with the child, early breastfeeding and breastfeeding. In addition, antenatal clinics and perinatal centers provide positions for psychotherapist and psychologist, to whom women can come for consultation.
Consequences of prolonged depression
If depression lasts too long, quality of life deteriorates. Since this condition deteriorates performance, a person may lose his job or lose his place of study. It is possible to stop communicating with close friends, or to part with a lover due to illness.
Often the causes of mental illness are related to the functioning of the brain. If left untreated, various mental disorders may appear.
Suicidal tendencies appear. Destructive behavior and the emergence of bad habits are possible: after intoxication, symptoms often temporarily weaken, which attracts the patient.
Dear readers! We strongly recommend that you consult a doctor before taking medications or self-medicating. There are contraindications.
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How to get out of depression
Psychologists advise to be attentive to your body, at the first signs of depressive episodes, try to help yourself before visiting a doctor. It is important to follow these rules:
- There is no need to avoid a bad state and mood and hate yourself for it. The patient must accept himself as he is at a particular moment. This is a normal phenomenon that occurs under the influence of external and internal factors. Depression must be fought, but this must be done gently, without putting strong pressure on the psyche.
- Redirecting focus to another activity. Reading books, riding a bike, going to the gym, swimming, and changing the environment helps a lot. If finances and time allow, you can go on a trip, see many interesting and new places, in this case the apathy often goes away on its own. Perhaps the person simply lacked impressions.
- You need to get rid of the fear of losing your positive emotions. Manifestations of joy, euphoria, and pleasure should be enjoyed at the moment they appear, and not constantly replay bygone times in your thoughts.
- Communication with new people, interesting contacts. You can go to an exhibition, cinema or theater, meet interesting interlocutors, let others help. There is no need to be afraid of being rejected or not needed; in most cases, such experiments end successfully.
- The psychotherapist will recommend meditations that can be used when the first symptoms of depression approach. Such techniques help develop a sense of inner integrity.
- Normalization of sleep and rest patterns. An exhausted body needs help first. A full eight-hour sleep helps restore its reserves and promotes inner peace.
Depression test
The psychological tools that psychiatrists, psychologists and psychotherapists use in their work have certain specifics. These can be tests, questionnaires, questionnaires, projective techniques. The difficulty lies in the correct interpretation of the material received from the patient.
It is strictly not recommended for patients to use their own intuition and information on the Internet. The patient may misdiagnose himself and prescribe medications that are not required in his case.
Moreover, most tranquilizers, antidepressants and other strong drugs are available only with a doctor's prescription. The use of dubious remedies will not only not help, but will also aggravate the situation and increase the level of intensity of symptoms.
In addition to tests, Dr. Isaev’s clinic performs diagnostics using modern equipment, which can be used to determine the presence of concomitant diseases. In some cases, treatment must begin with them, since such pathologies complicate the clinical picture.
Questions and answers
Is it possible to get rid of a bad mood on your own with the help of antidepressants?
We categorically do not recommend prescribing medications yourself. This is done by the doctor based on examination of the patient. Many medications have a number of contraindications, which the patient himself may not be aware of.
How long does it take to treat depression?
This is an individual indicator, it all depends on the form of the disease and its stage.
