During pregnancy, some pre-mothers may feel deeply sad.
Pregnancy is a period marked by illusions, but also by suffering. Some mothers experience, shortly before or after childbirth, what is known as perinatal depression (PND).
This form of depression, which can be especially tragic for both her and her child, is a peculiar manifestation that requires a different treatment from major depression, since it has its own characteristics. We explain the keys to understanding it and we review the most effective treatments.
Perinatal depression, more than postpartum
For some time now, psychologists have expanded the definition of what was previously labeled postpartum-onset depression.
We know that depression can start a few months before delivery and that it is the same phenomenon that will haunt the mother’s mood for the year after giving birth.
Perinatal depression includes any minor or major depressive episode that occurs during pregnancy or within 12 months of delivery. There is a certain degree of uncertainty regarding the incidence of the disorder. Various studies agree on prevalence rates that range between 10-15%. However, by excluding studies where the diagnosis is based only on self-reports, rates of 6.5% to 12.9% are achieved. It is a global phenomenon, not exclusive to Western society.
Mothers who suffer from it feel extremely guilty, some even hate their child. They feel alone and overwhelmed, they need help and they don’t know how to ask for it. They are filled with ruminative thoughts, sticky beliefs that are very difficult to get rid of and that seriously hinder their life.
Women with perinatal depression are in a period of role transition, from women to mothers, that is difficult to cope with. Also, difficulties in communication with the partner can further aggravate the feeling of being completely alone.
The severity of the disorder is not limited to how disabling it can be for the person suffering from it. Maternal perinatal depression is related to a higher incidence of excessive crying in the child, colic, sleep problems, difficulties in temperament, poorer self-regulation and more indicators of stress. It is also associated with negative mother-child interactions, including detachment, withdrawal, intrusion, and hostility as well as poorer infant interpersonal functioning, insecure attachment, and high rates of behavioral and emotional problems.
The main risk factor for perinatal depression is inadequate social support. The danger is increased by different deficiencies in social support such as:
- Not having someone like that to talk to openly.
- Not having friends or intimate relationships.
- Not receiving support without having to ask for it.
- Feeling socially isolated.
Treatment and advice
A very common characteristic of perinatal depression is that mothers feel ashamed of having depression, so much so that they do not reach out for help. For this reason, it is especially important to normalize perinatal depression.
Anyone can suffer an emotional disturbance, especially during a period as difficult as pregnancy and the enormous change it makes in family life. The arrival of a little one always marks a before and after.
1. Psychoeducation and activation
The first stone in overcoming perinatal depression is laid when the mother understands what is happening to her and why it is happening to her. Once that’s done, you can start planning a whole series of activities that will get you going and make you feel useful again.
2. Learning to be a mother
One of the main concerns of mothers with perinatal depression is falling short and being a “bad mother. ” The truth is that no mother learns by magic, and some people can cost more than others. In addition to tackling these thoughts, it will be vitally important that mothers learn to feel comfortable interacting with their baby.
A good way to achieve this can be to attend workshops that teach you to play with your baby, how to handle difficult situations (incessant crying, tantrums, etc.) or problems at mealtime. Support groups can be of great help in proposing alternative behaviors that promote the optimal relationship with the baby.
3. Working the social support network and communication
Because perinatal depression is a markedly social disorder, it is vital to identify communication patterns that are not working. It will be necessary for both mother and father to learn to relate and communicate what they think clearly and without accusations. If we achieve this, we will achieve two things: that the mother can ask for and receive help, and stop feeling completely alone and overwhelmed.
Support groups are a very important network in this regard. Being able to talk with other mothers who are going through the same process, share your own experiences and receive advice from other women will make you feel protected and better prepared to face motherhood.
4. Role transitions
Motherhood is difficult to incorporate. The change of role can mean the loss of personal meaning, going from working woman to simply mother.
It will be very important to recover those activities that were part of the mother’s identity. Identify those reinforcers that existed before the baby such as the feeling of doing a good job or enjoying an afternoon with friends, as well as finding opportunities within the new routine to be able to incorporate them again.
Also, there may be a conflict between long-term goals (for example, between family and work). Sometimes it will be necessary to rethink your goals and restructure them to make them as harmonious as they are realistic.
5. Attacking maladaptive thoughts
As in any emotional disorder, we are going to have to work through cognitive techniques the thoughts that instead of helping, anchor people to the bottom of depression.
Mothers must learn to identify in which situations they appear and acquire strategies to anticipate them or know how to neutralize them when they appear with more adaptive and reality-adjusted thoughts.
In addition, it is especially important to get into the habit of thinking about problems only if it is to solve them. It is very easy to get stuck in the emotional discomfort that worries cause us, but the only way to get out of those quicksand is to step back and remind yourself that when there is a problem there is no other way out than to find a solution.