It is not uncommon to see young mothers in the news carrying their babies to their death, which makes people sigh with relief! Just become a mother, should be experiencing and enjoying the joy of life, but why will hold a small baby with the intention of jumping off a building? These events may seem unbelievable, but in fact, they are all postpartum depression caused by the trouble.
In fact, 50% – 80% of women will experience postpartum dysphoria (adaptation problems) after delivery, which develops 3-7 days after delivery, with mild symptoms, mainly manifested as emotional instability, frustration, crying, worrying, aggression, guilt, insomnia, loss of appetite, irritability, and lack of concentration. Postpartum depression can resolve on its own within 10-14 days after delivery. Postpartum depression is more serious, and it develops within 4 weeks after delivery, with low mood, depression, unhappiness; no sense of pleasure, no interest in anything; irritable mood, easy to get excited and lose temper; worrying and worrying, nervousness and fear, excessive concern or worry about the child, or lack of interest in the child, fear of not being able to feed the child, fear of hurting the child, fear of being home alone with the child, insomnia, loss of appetite, inability to take care of herself and the child. Inability to take care of themselves and their children; pessimism and despair, feeling of helplessness, hopelessness, self-blame and self-condemnation, self-injury and suicide. In severe cases, altruistic suicide, i.e., killing the child first and then committing suicide, occurs because of the fear of the child suffering in the world. About 5-8% of mothers suffer from postpartum depression.
Postpartum depression is mostly due to the fact that during pregnancy, estrogen and progesterone in a woman’s body increase tenfold, and the rapid decline of estrogen after childbirth can cause the mother to experience depressed moods. The change in social roles after having a child and the busyness of postpartum life put psychological pressure on the mother, increasing the risk of depression. Negative life events experienced by the mother, such as unemployment, separation of husband and wife, illness and bereavement of loved ones, and family disharmony, are important triggers for postpartum depression.
Postpartum depression should be recognized as early as possible, treated early and with adequate dosage and course of treatment. Mild to moderate depression can be treated by psychotherapy, if it lasts for two weeks and the symptoms are getting heavier, medication or medication combined with psychotherapy must be used.
1, drug treatment: ① antidepressants 5-hydroxytryptamine reuptake inhibitors (sertraline, paroxetine, fluoxetine, fluvoxamine, citalopram, escitalopram oxalate) these new antidepressants, good efficacy, small side effects, well tolerated, safe and convenient to use; other such as: venlafaxine, duloxetine, mirtazapine. Sedative-hypnotics and anxiolytics such as benzodiazepines (Valium, etc.), buspirone, etc. can be used in combination. If the mother needs to be treated with medication, the baby can be fed artificially to avoid the influence of medication on the baby as much as possible; regular outpatient review is required.
Treatment course: ① acute treatment period to control anxiety and depression symptoms, the course of treatment is generally 6-8 weeks; ② consolidation treatment period is to consolidate the effect of acute treatment, to prevent fluctuations in symptoms, the course of treatment is generally 4-6 months, the drug dose is generally maintained at the same dose; ③ maintenance treatment period to prevent relapse, maintenance treatment should last for how long there is no definitive, maintenance treatment drug dose and duration of drug use according to the specific circumstances of patients The dose and duration of maintenance therapy are patient-specific. When discontinuing the drug, the drug dose is reduced while observing and gradually stopping the drug.
2. Psychological interventions: to promote knowledge of pregnancy, childbirth, childcare and maternal diseases to patients and family members, to reduce maternal tension and fear of pregnancy, childbirth and childcare, and to seek support and help from family members; to identify and improve patients’ poor cognitive, emotional and behavioral patterns, such as excessive negativity, pessimism and negative perspective towards people, things, oneself and society, low self-esteem or excessive self-esteem, in the face of setbacks and difficulties Cultivate an optimistic, positive and healthy personality, guide patients to adopt positive cognitive, emotional and behavioral patterns, improve their adaptability to the environment, and avoid undesirable behavioral patterns, such as impulsive blindness, recklessness, isolation, solitude, lack of necessary communication and social interaction, etc.; adjust unfavorable psychological factors in marriage and family, and Provide crisis intervention; the mother herself do a good job of lifestyle adjustment and psychological adjustment, the spouse and family should give more understanding, care and support, and jointly adopt positive coping patterns to avoid and minimize the effects of adverse stress, so that the mother can maintain a good state of mind.
Postpartum depression is a common disease, and with early detection, positive adjustment and active treatment, the prognosis is generally good with symptom relief and recovery of social and occupational functions. Patients and family members should not be overly nervous and afraid, treat the disease correctly, build up confidence, insist on treatment in regular medical institutions and receive scientific treatment, which can avoid the occurrence of adverse consequences.