Comprendre et traiter la dépression post-partum

Understanding and treating postpartum depression

Sep 24, 2023

The arrival of a newborn into a family is often celebrated as one of the happiest moments in life. However, for many women, the period following childbirth can be a confusing and emotionally intense experience, marked by profound physiological and psychological changes. Among the challenges some mothers face is postpartum depression. Positioned as one of the most common complications of childbirth, it is a pathology which should not be taken lightly.

Key Points of Postpartum Depression

Postpartum depression is not diagnosed in its own right. In reality, this is a specificity of depressive disorders . It is characterized by symptoms meeting the criteria for depression, persisting more than two weeks after delivery. This pathology, considered disabling, affects 10 to 15% of women. Fortunately, it is treatable.



What causes postpartum depression?

The pathophysiological mechanisms responsible for postpartum depression still remain poorly understood. In other words, the true cause of this disease remains a mystery . However, there is evidence that biological factors, such as hormonal, genetic and immune factors, may play a role in this process. Thus, a history of depression, hormonal changes during the puerperium ( corresponds to the period following birth), sleep deprivation or even a genetic predisposition could contribute to postpartum depression.

Other elements are also considered risk factors . These include a history of depression, significant stress factors, a lack of family or marital support, etc.

What are the differences between postpartum depression and baby blues?

Although the baby blues and postpartum depression are often confused, it is important to understand that they are two very distinct disorders. Two elements mainly allow them to be differentiated:

  • The duration. The baby blues are a common emotional reaction that usually occurs during the first week after birth. These transient depressive symptoms last on average 2 to 3 days (and maximum two weeks). Conversely, postpartum depression persists beyond two weeks.
  • Gravity. Baby blues is a pathology considered to be of moderate severity, with symptoms including anxiety, irritability, decreased concentration and even insomnia. These usually disappear spontaneously, without the need for treatment. In contrast, postpartum depression is a more serious and long-lasting condition, significantly disrupting the mother's daily activities. It is considered disabling.

Distinguishing between these two emotional states is essential to obtaining support and appropriate accompaniment.

How does postpartum depression manifest?


Postpartum depression manifests itself through a series of symptoms that can profoundly alter the daily life of women after childbirth. The main symptoms may be:

  • A persistent depressed mood .
  • A loss of interest or pleasure .
  • Anxiety that can lead to a panic attack.
  • A feeling of uselessness or guilt . Intrusive thoughts such as the feeling of being incapable of taking care of the child or of not being a good mother can thus set in.
  • A decrease in the ability to concentrate .
  • Suicidal thoughts .
  • Mood fluctuations . _ _
  • Sleep disturbances resulting in insomnia or hypersomnia .
  • Appetite disorders that can lead to significant weight loss or, on the contrary, weight gain associated with overeating.
  • An agitation or a psychomotor slowdown .
  • Uncontrollable crying fits .
  • Extreme fatigue .
  • Headaches ( headaches ).
  • Muscle aches or pains .
  • Unrealistic anxieties about feeding , or, conversely, total disinterest.
  • Irritability as well as a feeling of anger.

These symptoms are actually similar to those of depression unrelated to childbirth. Their severity can vary from one person to another. Far from being harmless, postpartum depression can cause problems for the mother, the child, but also for the entire family.

How to get out of it?

Appropriate management of postpartum depression is essential to promote the recovery of affected women . The treatment to be considered depends on the severity of the symptoms, and it may sometimes require a comprehensive and multidisciplinary approach. Without treatment, postpartum depression can resolve spontaneously in some women, but it can also develop into a chronic form, with an increased risk of recurrence .

 

Drug treatments

Treatments for postpartum depression vary depending on each case. They may include the use of antidepressants , particularly when the depression is severe or resistant to other approaches. Other medications like anti-anxiety medications can help reduce the anxiety associated with postpartum depression. However, it is important to note that taking drug treatments is never harmless , and that it can be associated with risks of dependence and side effects. Therefore, the decision to use medications should be made after careful evaluation by a healthcare professional.

Psychotherapies

Psychotherapies, such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT), have also been shown to be effective in treating postpartum depression and the anxiety that often accompanies it. It is strongly recommended to consult a health professional to determine the type of psychotherapy that is best suited to each situation .

 

Natural treatments

Alongside medical and psychotherapeutic treatments, it is important for women with postpartum depression to maintain a healthy lifestyle. This may include eating a balanced diet, engaging in regular physical activity , managing sleep, or using stress management strategies. For example, studies have shown that moderate aerobic exercise can help reduce symptoms of postpartum depression. Behavioral interventions aimed at improving infant sleep may also have a positive impact on maternal mood . At the same time, showing kindness to oneself and seeking support from couples and family can also play a vital role in recovery.

Regarding stress management , several areas may be relevant to explore, such as:

Regardless of treatment, early detection of postpartum depression is fundamental to enable rapid and effective intervention. It is therefore recommended to identify symptoms as soon as they appear in order to start treatment as soon as possible .

In short, postpartum depression is a complex and disabling pathology, which can be responsible for numerous symptoms. Its management requires a personalized approach and ongoing support to help women regain their emotional well-being and their ability to care for themselves and their child.

References

Stewart DN Vigod S. (January 2019). Postpartum depression: pathophysiology, treatment and emerging therapies . Annual review of medicine. Flight. 70:183-196.

Moldenhauer J. (January 2022). Postpartum depression . MD, Children's Hospital of Philadelphia.

UNICEF. What is postpartum depression? Recognize the signs and find help.

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