The psychological disorders of puerperal depression that cannot be ignored

  Puerperal depression is defined as maternal depressive symptoms after delivery. There is less information in China. The prognosis of this disease is good, and about 70% of patients are cured within one year, but there is a tendency of recurrence in another pregnancy. Some mothers may also show a lack of confidence in life and family, a decrease in initiative, a boredom with life, a slow reaction to things and a difficulty in concentration. Patients with puerperal depression may also have symptoms such as dizziness, headache, stomach discomfort, increased heart rate, increased breathing, constipation, etc. In severe cases, they may have thought disorders, persecution delusions, and even infant injury or suicidal behavior. Western medicine considers treatment to include both psychotherapy and medication. Psychological treatment, through psychological counseling, to remove the psychological factors that cause the disease (such as wanting to have a boy but having a girl, poor marital relationship, previous history of mental disorders, etc.).  The puerperal women are given more care, consideration and attention, try to adjust various relationships in the family, and are guided to develop good sleeping habits. Medication: apply antidepressants, mainly selective 5-hydroxytryptamine reuptake inhibitors, tricyclic antidepressants, etc. For example, paroxetine, sertraline, fluoxetine, amitriptyline, etc. The advantages of these drugs are that they do not enter into breast milk and do not affect breastfeeding. The disadvantages are dry mouth, constipation, effort to urinate, blurred vision, dizziness, drowsiness, addiction and many other side effects. The “Treatise on the Origin of the Diseases” of the Sui Dynasty earlier discussed the origin of similar diseases. In the Song dynasty, the “Good formula of the Women’s Book” extensively discussed related diseases, including “postpartum seizure, postpartum delirium as if there is a god, postpartum incoherence”, which laid the foundation for later generations. According to Chinese medicine, the main cause of this disease is postpartum sorrow and worry, overwork and fatigue, or the usual introverted personality of depression. If the mother is anxious, depressed, restless, depressed, fatigued, withered, and stuffy in the lower abdomen after childbirth, it is considered to be a deficiency of both the heart and spleen, and the treatment is to strengthen the spleen and benefit the qi, nourish the heart and calm the mind. Also known as Nourishing the Heart Soup (《胎产心法》), Ginseng 30g, Astragalus 30g, Angelica 15g, Chuanxiong 10g, Poria 20g, Yuanzhi 9g, Phellodendron 15g, Ziziphi 15g, Sour Jujube 15g, Wu Wei Zi 9g, Cinnamon 3g, Licorice 3g. The treatment is to invigorate blood circulation and eliminate blood stasis, sedate and tranquilize the mind, using the formula of Adjusting Menstruation San (Taiping Huimin and Pharmaceuticals Bureau Formula), with 15g of angelica, 6g of cinnamon, 10g of myrrh, 3g of amber, 15g of red peony, 15g of white peony, 3g of fine spice, and 1.5g of musk. The above herbs together can invigorate blood circulation, remove blood stasis, calm the mind and have no side effects. Modern people, life, work pressure, this disease has a rising trend, so the postpartum maternal mood changes need to pay sufficient attention. In particular, it is necessary to carefully observe the abnormal changes in mood and spirit in the early stage, and give more warmth to the family to comfort and enlighten, so as to prevent the aggravation of the disease.