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DEPRESSION II

THIS TIME, IT'S POSTNATAL


WARNING: The information contained herein is not for those of nervous disposition


"IT'S BACK. And this time it's nastier than ever...

Within every pregnancy, there is something that could strike out and serve as a chilling reminder that there is no excuse for complacency. "

For most, pregnancy and its consequences are fantastic. But it's a fact that women suffer more mental illness and mood disturbances both before and after birth. The reasons are many: social, environmental and biological - they all have something to contribute. Some of the biggest changes in a woman's life happen after childbirth, and adjusting to the change can be traumatic.

"Postpartum blues"

"Postpartum blues" are a form of temporary mild depression and can affect up to 80% of women between 2 and 5 days after the birth. Losing sleep, extra demands from the baby and getting all the hormone levels back to normal all play a role. One theory is that there's simply not enough b -endorphin (which produces analgesia and euphoria) around after birth. The placenta produces loads of b -endorphin during pregnancy and suddenly removing it may well be similar to the withdrawal symptoms experienced by heroin addicts. The hypothalamic-pituitary-adrenal axis also has to readjust and there may be some sort of relationship with all this (yet to be discovered).

Postnatal Depression

This is bad, and can strike 1 in 10 mothers. Postnatal depression isn't temporary and this time you can't blame unstable hormones. According to experts, a woman may experience the most significant - and stressful - changes in her life in her first pregnancy and childbirth. Studies have shown that the women that are most likely to be affected are those that put off having kids until they'd developed their careers, and who haven't had much contact with other mums or support from their families.

Before, they were competent, reliable, independent, and emotionally stable - the opposite to the depressed stereotype. They now fall into the trap of believing that everything is their responsibility. One factor may be social conditioning of 'female role' responsibilities. What does this mean? Well, picture a baby (let's call him John) who isn't very happy and cries quite a bit. John's mum is probably thinking 'what am I doing wrong, what can I do differently?' John's dad, on the other hand, externalises the problem and says, 'what's wrong with the baby. What can we do to settle the baby down?'

Alcohol, smoking, nutrition and other stresses also have some part in this and depressed mums are urged to ask for help from their partner, family and friends.

Postnatal psychosis

What? There's more? Yep, a tiny proportion of mums get severely mentally ill after childbirth - affecting an estimated 1 in 1000 deliveries. Old Hippocrates back in 400 BC even wrote it down (probably hoping it would become a best seller). Firstly, it's idiopathic and can lead to violence like suicide, child neglect and abuse - the mum usually needs to be put into hospital to protect both herself and the child.

[For those of you who are really into this sort of thing, there are two types. The first one, occurring 3-10 days after birth, the mum suffers an agitated, confused state, often being delirious or even schizophrenic. The second type begins after the 3rd week and consists of depression, confusion and somatic complaints.]

What happens to these poor people? 70% get better after a very difficult time. Which leaves the 30% who stay at whatever level they happen to go to or go downhill to chronic schizophrenia or even dementia. For those who do get better there's a 0.1% of relapse - but this increases to 25% if they get pregnant again. The cause is usually unknown, but may indicate a brain lesion, infection, metabolic derangement or AIDS...

"Strange... but true?"

 

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