Pregnancy is a wonderful, magical experience for any expectant parent. The expectant mother experiences a wide range of emotions ranging from self-doubt to ecstasy. This period around childbirth is also a hormonal storm wherein major changes occur in the internal milieu of the mother. There exists an increased risk of developing or exacerbating mental illness after child birth.
Post partum mental health issues
40-60% of all mothers experience postpartum blues withing the first few days of giving birth. These symptoms of unstable mood, crying spells, irritability and anxiety usually occur within the first 10 days and peak around 3-5 days and are usually self-limiting, however persisting blues beyond 2 weeks can lead to significant depressive episodes.
Around 10-15% of mothers develop pervasive low mood and irritability, poor sleep, appetite and concentration. Preoccupation with the infant’s health and feelings of inadequacy predominate the thought process. When this interferes with functioning and lasts over two weeks it is termed postpartum depression.
Around one in 1000 mothers experience symptoms such as delusions and hallucinations that may lead to serious deficits in self-care and care for the infant. These symptoms can occur either secondary to severe depression or due to change in levels of certain neurochemical substances in the brain which distorts reality and poses a risk to mother and child. This is termed post partum psychosis.
Further, some mothers might develop repetitive, intrusive but senseless thoughts or images of harm to the baby resulting in significant distress and impairments in personal and social functioning. OCD may have postpartum onset or exacerbation.
These changes result from a marked decrease in gonadal steroids ( Substances produced in the body during the normal course of a woman’s sexual life cycle), there is a decrease in the levels of progesterone as childbirth proceeds through the stages of labor. And estrogen levels drop suddenly after the expulsion of the placenta. These sudden changes in hormones have profound effects on the neurotransmitters like serotonin and dopamine which are implicated in the above issues.
In addition to the above, psychosocial factors such as support systems and liabilities and the social circumstances surrounding the pregnancy play an important role in the development of mental illness post-pregnancy.
- Perinatal or natal complications.
- A past history of mental illness.
- A family history of psychiatric illness.
- Previous episodes of postpartum disorders.
- Stressful life events.
- History of sexual abuse.
- Vulnerable personality traits and social isolation.
- Unsupportive spouse.
How are these issues managed ?
Mild to moderate illnesses such as depression or anxiety that do not cause major impairment in functioning can be treated with psychotherapy and/or self-help measures alone. Some individuals will need medications to get better. Early treatment prevents unnecessary complications. There are several medicines that have been extensively studied for safety in pregnancy and one does not have to be wary of the same.
The crux of the issue is that awareness about metal illness after child birth is very very poor, this adds to the distress of women suffering from the same. Some people prefer to seek magical and religious treatment even for severe problems thereby wasting essential time and risking the limb and life of mother and child. Mental illness is caused by abnormalities in the brain and is manageable to a large extent.
Take a quick free screening test for post partum depression