POSTPARTUM PSYCHIATRIC DISORDERS ( Eugenia Ameyaa Gyan, RM)

 

The postpartum period is the time after delivery when a woman's body returns to its normal state. This is within 6 to 8 weeks. During the postpartum period, about 85% of women experience mood swings to some extent. The majority of these are mild and short-lived, but there are about 10–15% of women who develop more serious symptoms of depression or anxiety. These disorders are grouped into three categories:

1. Postpartum blues.
2. Postpartum depression
3. Postpartum psychosis.

1.      POSTPARTUM BLUES.

This is also called "baby blues". This mood disorder is very common among new mothers, kicks in around the 4th day after delivery, and can last for about 2 weeks. The sudden shift from pregnancy to parenthood can be quite overwhelming for some mothers. These mood swings are believed to be caused by hormonal changes that occur in a woman's body after she gives birth. Levels of the hormones estrogen and progesterone needed during pregnancy suddenly drop, causing shifts in mood.

Mothers with baby blues show the following signs:

1. Crying for no reason or over trivial issues
2. I find it hard to concentrate.
3. Feel sad most of the time.
4. Restlessness.

Postpartum blues requires no treatment as it goes away on its own. The best ways to support mothers with postpartum blues are:

1. Be patient, and give them emotional support.
2. Ensure a healthy diet.
3. Avoid Alcohol.
4. Assist them with housework and taking care of the baby.
5. Encourage mothers to have enough rest.

2.      POSTPARTUM DEPRESSION.

This is more serious than postpartum blues and requires treatment. It involves feelings of extreme sadness and worry. The sudden drop in pregnancy hormones after delivery can lead to postpartum depression. Those with a higher risk of developing postpartum depression are:

1. Those with a history of postpartum depression
2. Victims of domestic violence
3. Stressful life issues like low income.

 

Women with postpartum depression show the following signs:

1. Trouble bonding with their newborn.
2. Sad mood
3. Crying spells
4. Loss of interest in usual activities
5. Change in appetite
6. Suicidal thoughts or thoughts of harming the newborn
7. Sleep disturbance. 

Treatment and Management

Treatment of postpartum depression should involve:

1. Therapy, which may involve counseling with a psychologist
2. Group therapy: having a group discussion with mothers who have the same problem
3. medication, which includes antidepressants.
4. Help reduce stress by assisting in the care of the mother and baby.

3.      POSTPARTUM PSYCHOSIS.

Postpartum psychosis is a rare but serious form of mental disorder in postpartum women. It occurs in about 1–2% of births, usually 2 weeks after delivery. The onset is sudden and requires immediate attention. The new mother loses her sense of reality and has extreme difficulty responding to the needs of her newborn. In 50% of the cases, it usually occurs in women with previous mental health issues or who have a family history of mental health, but the other half of the affected have no history or family history of mental health issues.

Symptoms:

1. Delusions (beliefs in things that are not real)
2. Hallucinations (seeing, hearing, or experiencing imaginary things)
3. Severe insomnia
4. Paranoia (suspicious feelings)
5. Sudden thoughts or attempts to harm the baby

 Treatment/ Management

1. Antipsychotic medications
2. Antidepressants
3. Therapy (counselling with psychiatrists or psychologists)
4. Separate the baby from the mother in order to prevent the mother from harming the baby and treat the mother.
5. Ensure the mother has enough rest.
6. Family members should be calm and supportive.

Eugenia Ameyaa Gyan is a Registered Midwife in Ghana.