Sunday, December 8, 2013

Post-Natal Depression

Dealing with the Baby Blues & Post Natal Depression
With your body undergoing such a massive transformation over the nine months of pregnancy and the subsequent birth, the readjustment of your hormone levels can have some unexpected effects.

The Baby Blues
The baby blues are a mild form of post natal depression. Most women will experience a period of anxiety and emotional turbulence in the first few weeks after the birth of a baby. This is normal, and it's to be expected after such a huge biological event. This period is referred to as the 'baby blues' or the 'maternal blues' in popular culture, and will pass after a few weeks.

The Cause of the Baby Blues
Since 75-80% of mothers experience the baby blues, it's pretty safe to say that the cause is biological, not psychological. It's caused by the hormone balances in your body; over the nine months of your pregnancy your body has learned to depend on the raised levels of estrogen, progesterone and endorphins. So after the birth, when these chemicals are suddenly no longer coursing healthily through your veins, you enter a sort of 'withdrawal' period, just as you would if you'd just quit smoking, for example. Combine the biological elements with the fact that you're exhausted from the mental and physical exertions of giving birth and caring for a newborn baby and you have a recipe for, frankly, a rough couple of weeks. But those rough couple of weeks will pass.

Symptoms of the Baby Blues
You will probably be aware of, or will have experienced, most of the symptoms of the baby blues before your pregnancy, since many of them are in common with the symptoms of any other type of depression.

They include:
* Depression - You are low a lot of the time. You're miserable, melancholy. You may have moments of real contentment which give you hope, but it passes and the depression seems all the more profound.

* Irritability - You are grumpy and snappy with people around you. You shrug off and reject any physical contact, and even inquiries about your well-being irritate you.

* Fatigue - Lethargy and listlessness add to a general sense of malaise, yet you may not be unable to get much sleep despite how tired you are. This can be the most frustrating symptom, since all the lying awake provides loads of time to explore in your mind all the negative emotions you're currently feeling.

* No Appetite - You forget to eat or you're never hungry. When you eat, it's only small amounts and with no real interest. The lack of food makes you feel rundown. You may even be aware that you're not eating enough, but are not inclined to do anything about it.

* Joylessness - You find that you can derive virtually no pleasure from any activity. Even the sense of safety and comfort you previously derived from sex has evaporated and you are reluctant to partake.

* Guilt - You experience waves of unendurable guilt, a sense that you could and should be trying harder with your baby, a real sense of uselessness occurs to you. Guilt that you feel so low when you are aware that it should be a time for real happiness, and this knowledge exacerbates your feelings.

* Anxiety - You feel panicky and your heart races and thumps causing you to worry that you are unwell or have a heart condition. Further, you worry about your relationship with your baby, whether you are bonding or not, whether your baby is breathing steadily enough and if he or she is healthy. You are wracked with worry when your baby is in the care of another, and you're anxious about the possibility of cot death, choking, or drowning. You may also be worried that you will harm your baby yourself.

Every new mother has all or some of the symptoms listed above. However, there are cases where the symptoms are extreme, leading to a serious condition that we will discuss in just a moment. Before we do, you have to be aware that it is difficult, nearly impossible in fact, for you to determine when your symptoms have moved from the mild depression of the baby blues, and onto the vaguely termed 'extreme'. It's difficult to tell the difference between the baby blues and PND when your experiencing one or other of them.

It may take another person, perhaps a spouse, family member, or doctor, to help you. When this is the case, you may find that you've been diagnosed with Post Natal Depression. Post Natal Depression (PND) is different from the baby blues. Post natal depression is a serious medical condition which can be dealt with quickly if it's diagnosed early. You can't diagnose yourself, but your GP is trained to recognize PND, so if the symptoms listed above persist for more than a month after the birth of your baby, it might be worth contacting him or her.

Common Factors in Post Natal Depression
PND is a form of clinical depression and is treated as such. Although there is no single individual cause of post natal depression, there are occasionally cases in which obvious factors are at play. In these cases, any treatment will be primarily focused on those factors. They include:

* Prenatal Depression - Depression during pregnancy seems to be the most common contributing factor to postnatal depression.

* Low Self Esteem - A mother who has consistently had low self-esteem or a low opinion of herself, or places little value or importance on her place in the world may risk developing PND.

* Childcare Stress - If a mother has been really, seriously anxious about her ability to raise a child, anxious to the point of becoming unwell, then PND may develop.

*Life Stress - An unusually or extremely stressful lifestyle can be detrimental to your mental health after the birth of your baby.

* Low Social Support - PND has been connected a lack of support from friends and family. Women who have been rejected by their families will generally have a higher chance of developing PND.

* Poor Marital Relationship - A loveless conception is a possible factor in the development of post natal depression. A loving relationship is beneficial anyway, but perhaps more poignantly so in cases of mental health.

* A History of Depression - If you have a history of clinical or manic depression, there may be an elevated chance of post natal depression manifesting itself.

* Infant Temperament Problems / Colic - A particularly 'fussy' or 'colicky' baby often puts enormous pressure on mothers. Listening to their baby crying for such extended periods of time can lead to the belief that they are neglecting something important that their child desperately needs. This feeling can lead to stress, depression, feelings of helplessness, and low self-esteem, all of which, as we have seen, can be a factor in the development of postnatal depression.

* Single Parenthood - A lack of support and feeling of economic insecurity can be damaging at the best of times, but it's effect on a vulnerable new mother can potentially be devastating.

* Low Socioeconomic Status - Associated with many of the points already mentioned, your status and economic situation have the capability to seriously affect your mental health.

* Unplanned/Unwanted Pregnancy - An unwanted or unplanned pregnancy brings many of the stresses and anxieties that we've already covered, along with associated feelings of shame and an immediate problem bonding with the baby.

Treating Post Natal Depression
Just as there is no single cause for post natal depression, there is no single cure for it. It is fully treatable however, and most women go on to make a full recovery. Antidepressants are commonly prescribed, and have a positive effect in up to 70% of its applications in medium to severe cases of postnatal depression. However, some antidepressants are transmitted through breast milk, lithium, clozapine, and lamotrigine for example, and as such can't be prescribed to new mothers.

For less severe cases of PND, talking treatments have been found to be just as effective as antidepressants. Counseling sessions with a psychologist or other mental health specialist can be really helpful, and may be prescribed over medical treatments in some situations.

There are three main types of talking treatments being practiced in the UK today. The first is 'cognitive therapy', and it's based on the idea that your thoughts and emotions can directly affect your physical well-being. The second kind is 'cognitive behavior therapy', and it involves changing any behavior that is harmful, as well as incorporating the ideas in cognitive therapy. The third kind of talking treatment includes 'interpersonal therapy' and 'problem solving therapies'. Any combination of these treatments might be prescribed and all depend on the severity of the depression and the patient herself.

To supplement any medical or psychological treatment, taking regular exercise can help in all sorts of ways.
As we mentioned, the earlier the condition is identified, the easier it is to treat. But, now we know what post natal depression is and what can be done when it's diagnosed, why don't we consider a few pointers on

Preventing Post Natal Depression
No one's really sure if PND is inevitable for the unfortunate women who develop it, but there are a few steps that pregnant women can take to reduce the likelihood of developing the condition.

* First, and perhaps the most obvious of all the following points and one that should apply regardless of the worry of PND, don't smoke, don't take drugs, and don't drink.
* Sleep well, relax and rest whenever you can.
* Low blood sugar levels can make you feel pretty down, so make sure you eat a balanced, healthy, and varied diet.
* Support that diet with a multi-vitamin supplement.
* Take gentle exercise and keep yourself occupied.
* Budget your time and pace yourself: while you may be able to multi-task efficiently most of the time, you should try to take things one step at a time in the lead up to the birth.
* Open up to friends or family, or especially your partner, about your concerns. It can be really dangerous to try to bear the burden of concern alone, set let other people help.

These tips won't necessarily prevent PND, but they will help. You know that phrase, 'healthy body, healthy mind'? Well it works the other way, too, 'healthy mind, healthy body'. Keep your mind active and lively and keep your body relaxed but healthy.

The Partners of PND Sufferers
It can be almost intolerable to have a partner suffering from postnatal depression. But for a while, you may have to endure a lack of sympathy while she gets better. She will need you, but she may be reluctant to ask. She may even try to push you away. In these instances, try to relieve some of the pressure on her by holding the baby for a few hours so she can get some sleep. Do chores that she would normally do, but try not to step on her toes, she may resent feeling like she's being pushed out.

It's essential that the new mother feels understood and supported. To facilitate this, try to make yourself available as often as possible, and don't feel abandoned if she needs to confide in someone other than you. The last thing needed for the sake of her mental health as well as your own is for your self-consciousness and insecurities to cause further friction. Be patient, she will eventually come to appreciate the space you have given her, as long as you are still there when she needs you.

Learn as much as possible about her condition, but don't act like you know more than she does about it, or even pretend to know what she's going through. Use your knowledge to adapt how you act, not to teach her how to act.

Further Information on Post Natal Depression:
For further information on Post Natal Depression or the Baby Blues visit these websites: The Royal College of Psychiatrists (RCPSYCH), Mind, NHS Direct.

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