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Puerperal mental disorders: psychosis, depression
Postnatal psychosis and puerperal depression is states which are shown at the woman as effects of the complications arising at the time of delivery. It is extremely important that young mothers for whom postnatal psychosis is diagnosed surely asked for the help the qualified specialist and received necessary treatment.
This moment should be considered because most of young mothers do not even suspect that they already suffer from displays of puerperal psychosis. Sometimes similar manifestations are not perceived as a serious disease and close people of the woman.
It is necessary to share the concepts "postnatal psychosis" and "puerperal depression". Both of these illnesses are very serious psychotic conditions which demand immediate drug treatment. But approach to therapy of these diseases is applied different: treatment of a puerperal depression takes place with use of antidepressants, and therapy of puerperal psychosis is carried out using antipsychotic means. In comparison with displays of a puerperal depression postnatal psychosis arises at women less often. It is necessary to distinguish accurately postnatal psychosis and from puerperal melancholy which at most of young mothers arises in the first weeks after the delivery. In most cases such melancholy passes independently. However it happens that the prolonged melancholy passes into a condition of a puerperal depression. Such state it is necessary to treat by means of qualified specialists.
Reasons of puerperal psychosis
Postnatal psychosis is a serious psychotic state. During pregnancy at the woman who has puerperal psychosis later noticeable aberrations are not observed. However those who are inclined to psychoses during the period after the delivery, as a rule, earlier suffered from strong emotional fluctuations during the period before periods
Till today there is no information on the accurate reasons of manifestation of a similar state at the woman after the delivery. There are some assumptions according to which change of mentality of the woman who recently gave birth to the child are connected with fluctuations of hormonal balance in her organism.
The high risk of development of puerperal psychosis exists at women who have various mental diseases and frustration in the anamnesis. So, the young mothers having schizophrenia and bipolar disorders are more subject to puerperal psychosis. Considerably the risk of development of puerperal psychosis at those who abused various drugs earlier increases.
However postnatal psychosis can develop also at healthy women who endured a severe emotional stress in connection with the birth of the kid.
Symptoms of puerperal psychosis
As a rule, postnatal psychosis is shown on 3 — the 6th day after the delivery. At the characteristic of features of puerperal psychosis often it is about loss of bonds of the patient with reality. When progressing puerperal psychosis higher nervous activity is broken. At women both the easy, and severe form of puerperal psychosis at once is after the delivery shown. If its current especially heavy, then young mother can lose completely ability to show care of the newborn.
In development of puerperal psychosis a number of various symptoms can be shown. At the woman certain maniacal manifestations which are expressed by the increased excitement level, emergence of obsessions which are not connected with reality are sometimes observed.
One more very widespread display of puerperal psychosis at women are hallucinations, mainly acoustical. At young mother changes of the personality gradually develop, her thinking becomes abnormal. It becomes difficult for woman subject to puerperal psychosis to formulate the thoughts aloud and to arrange them. Respectively, the woman can carry on desultory conversations, express thoughts without distinct contents.
The patient cannot give an adequate self-assessment, correctly defining own state. Convincing young mother that she needs to ask for the qualified help, her relatives and the family have to make considerable efforts to reach the desirable. Over time, after full treatment, the woman, as a rule, realizes an inaccuracy of own beliefs.
One more symptom of puerperal psychosis is disorder of appetite: young mother often cannot normally eat.
The woman in a condition of heavy puerperal psychosis is often visited by ideas about possible suicide or murder. The similar symptom demonstrates that a condition of the patient extremely heavy, and the help of specialists is necessary for her.
Diagnosis of puerperal psychosis
At the address of the woman to the doctor with complaints to manifestation of the symptoms described above the doctor has to conduct fuller examination of her state of health. Detection of organic illnesses, blood test and other researches promote an explanation of origins of puerperal psychosis. Besides, it is necessary to give neurologic inspection, and also to study results of a computer tomography.
Treatment of puerperal psychosis
Treatment of puerperal psychosis practices already for a long time. Now are applied both oral, and intravenous and intramuscular administration of drugs. But any drugs should be used at the first opportunity as treatment of puerperal psychosis has to be made as soon as possible. The success of such therapy directly depends on it. Respectively, efficiency of treatment can decrease if to begin it later.
If urgent medical intervention did not happen, then at puerperal psychosis the condition of the woman can sharply worsen. And it directly threatens health of the child and mother.
The puerperal depression can arise at each woman who recently gave birth to the child. The similar state is shown also at those women who gave birth to the dead child or after an abortion. The puerperal depression is shown by changes in a psychological state of the woman. She can suffer from continuous manifestation of feeling of grief, pessimism, a hopelessness. Young mother ceases to feel pleasure from life, pleasure from care of the child. Sometimes young mother feels that it is too heavy to it to show daily care of the kid. Today there are data that prevalence of display of a puerperal depression reaches up to 15%. It is very important to consider also the fact that the puerperal depression at mother can affect health of the child further.
If to estimate a condition of young mother at once after the child's birth, then the condition of fatigue, weaknesses and exhaustions is observed practically at each woman. In the first several weeks after the delivery young mother can suffer from sleeplessness, weakness. All these feelings at most of young mothers are shown in parallel with a condition of pleasure and big satisfaction from the fact that the child was born. But at a normality the woman already later feels several weeks that her state becomes stabler and unpleasant manifestations disappear without treatment.
Reasons of a puerperal depression
There is an opinion that the sharp hormonal imbalance in the woman's organism which is shown at once after the birth of the kid is the reason of display of a puerperal depression. In development of pregnancy in an organism of the woman there are essential changes of psychological, somatic and endocrine character. Mental dysfunction during the period after the delivery, according to physicians, is connected with sharp reduction in an organism of amount of gonadotropic hormones.
But at the same time there are some factors which provoke increase in risk of display of a puerperal depression. First of all, it is important to consider that the puerperal depression is more often shown at those women who at the birth of children already suffered earlier from such disease. Especially often puerperal depression arises at this category of women at the child's birth after 35 flyings. However, there are data and that the puerperal depression is much more often shown at women at the firstborn's birth.
Besides, lack of adequate support of young mother which the family has to provide considerably increases risk of manifestation of this state. The puerperal depression arises at the women who had a severe stress more often. It problems with health at the newborn, regular gripes at the child can provoke, existence of other family or psychological problems.
If the woman was subject to a depression even during incubation of the child, then in 75% of cases a depression to be shown at it and after the delivery. Also the hereditary favor of young mother to depressions or to bipolar disorder increases chances of display of a depression.
Symptoms of a puerperal depression
As the birth of the child is a serious stress for the woman, development of a depression in a puerperal period happens rather often.
The most typical symptom of a puerperal depression is denial by young mother of need of the qualified help. The woman who only just gave birth to the child feels that it is very difficult for it to cope with new duties, and at the same time has sense of guilt. The woman suffers from strong concern, at the same time she becomes very sluggish and with great difficulty concentrates. Sometimes the woman completely rejects all social contacts and completely plunges into efforts about the child. In other cases the puerperal depression forces mother to refuse cares of the child in general. Often puerperal depression passes into a chronic form and a long time negatively influences a condition of the child and mother.
Very often young mother suffers so that she does not receive confirmation of the theory that its maternal instincts will help to transfer all difficulties of the period of adaptation to the child quickly enough. But actually in order that similar communication between mother and the kid appeared and got stronger, several months are necessary. Therefore, the disappointment from failures can provoke aggravation of a depression. Besides very often mother is convinced that only she is responsible for the child one.
Thus, the feeling of grief, sincere emptiness and constant uneasiness can pursue the woman a long time. Gradually it loses ability to rejoice to daily pleasant trifles. Symptoms of a puerperal depression it becomes also frequent appetite loss, sharp weight reduction at young mother. The woman can also suffer from sleeplessness.
The symptoms described above can be shown at the woman both in the first week after the delivery, and several restless weeks later. The puerperal depression can proceed at young mother about three-four months.
Types of a puerperal depression
In medical practice a certain classification of a puerperal depression is accepted. At a neurotic depression at the woman those frustration which took place even during pregnancy escalate. She stays in despondency, often cries, and gradually reaches extreme degree of nervous exhaustion.
Traumatic neurosis is, as a rule, shown after very heavy process of childbirth. At women who endured the hardest childbirth before the following birth of the child the condition of alarm, persuasive fears gradually accrues.
At melancholy which is followed by crazy inclusions strong block, feeling of fault, and also thought of own insolvency is characteristic of a condition of the woman. The woman can not recognize people close to it, suffer from continuous display of unpleasant hallucinations. Very often similar state precedes display of maniac-depressive psychosis.
At a puerperal depression with a neurotic component at the woman symptoms of hypochiondrial character, and also sleeplessness and manifestation of feeling of powerlessness are possible. Mother constantly is afraid to do much harm something to the child.
Most often the long course of a puerperal depression occurs at young mothers. At the same time the similar state very often proceeds at the woman not diagnosed though about 20% of young mothers suffer from it. As symptoms of a similar state there is a constant feeling of fatigue, despondency, exhaustion. It is very difficult for mother to transfer crying of the kid, she becomes irritable, and at the same time constantly feels fault for similar behavior.
Diagnosis of a puerperal depression
Diagnosis of puerperal mental disorders is carried out by carrying out medical examination, and also detailed poll of the patient. It is extremely important that the woman as it is possible more in details told the doctor about own feelings, thoughts and emotions which prevail at her after the child's birth. In the course of treatment the doctor surely watches the patient and watches her psychological state. It is important that the attentive relation of the doctor to complaints of the woman as mental disorders sometimes remain unnoticed took place.
Treatment of a puerperal depression
Treatment of a puerperal depression and puerperal psychosis assumes obligatory consultation of the doctor-psychologist and reception of medicamentous means. At a puerperal depression to the woman appoint treatment drugs-antidepressants. But if at the patient the moderate puerperal depression takes place, then in certain cases it is possible to do without medicamentous means. Today use of modern drugs-antidepressants allows not to refuse breastfeeding of the child as they do not make negative impact on the kid. But it is very important that such means were appointed only by the specialist.
However treatment of a puerperal depression assumes also healthy nutrition, a certain physical activity, enough hours of a daily dream. Besides, the woman needs to realize abnormality of own behavior and it is obligatory to ask for the help the relatives.
Prevention of puerperal mental disorders
It is necessary to understand that it is necessary to care for prevention of a puerperal depression and puerperal psychosis long before appearance of the child. Future mother has to reside in a comfortable situation to feel care and support. It is especially important to provide similar conditions to women at whom the risk of display of mental disorders is increased. In this case the attitude towards the woman of her partner is extremely important.
Both the husband, and the wife even before childbirth have to understand that the risk of development of a puerperal depression exists at each woman therefore this state is important to distinguish and provide its adequate treatment in time.
Section: Childbirth and puerperal period