Psychological interventions are effective in women with postnatal depression
Postnatal depression is a mood disorder that can affect women after giving birth. It can manifest shortly after delivery or a year after. In most cases it is manifested within the first three months after delivery. It is estimated that the prevalence at a global scale is of 13% in high income countries, while in medium or low income countries is of 20%.
This disorder can show extreme emotions of sadness or anxiety and can even affect the capacity of women to take care or their family, this because of the severity of the symptoms. Anxiety, irritability, sadness, and restlessness are common during the first two or so weeks after delivery. Depression can develop when this first stage of post-pregnancy do not disappear or when they manifest after one or more months after delivery.
Symptoms of postnatal depression are the same as that of depression that can appear at any moment of life. Some of them are:
- Restlessness or irritability.
- Changes in appetite.
- Sentiments of worthlessness or guilt.
- Feeling withdrawn or not aware.
- Lack of interest of pleasure.
- Loss of energy.
- Suicide thoughts.
- Problems to sleep.
A mother with postnatal depression can also:
- Feel afraid of staying alone with her baby.
- Have negative feelings towards her baby or even hurt the baby (though this kind of thoughts rarely materialize, it is important to mention this to the doctor).
- Intensely worry about the baby or, on the contrary, show little interest in it.
There are no exact causes, but hormonal changes during and after pregnancy can affect a women’s mood. Among other factors that can affect mood during pregnancy are: body changes because of pregnancy and birth, changes in social or work relationships, having less time or freedom to herself, lack of sleep or worries about her capacity of being a ‘good mother’.
Other factors can influence a mother to have higher probabilities of developing postnatal depression, such as: if her has less than 20, alcohol drinking, illegal substances or smoking; an unwanted pregnancy; having depression, bipolar disorder or anxiety disorders before pregnancy; passing through an stressing event during pregnancy or delivery; having a bad relationship with her partner or being single; financial or housing problems or little to no family support.
Research has shown that low social support is a risk factor for postnatal depression, suggesting that primary health care specialists must make sure that psychological therapies and proper medication to patients are available. Furthermore, the use of psychological intervention on primary health care is positive.
A meta-analysis evaluated the effectiveness of psychological intervention in women with postnatal depression. They were recruited and treaded on a primary health care environment. The study combined results of 10 RCT’s (randomized controlled trials), involving 1,324 mothers suffering from this disorder, and showed that psychological interventions performed in community environments are effective treatments. Improvement on symptoms were substantial on 4 to 6 months of monitoring and, statistically, improvement on anxiety and stress was showed, as well as matrimonial relationship, paternity and social support.
Reviewers: Brenda Giselle Álvarez Rodríguez (Public Health Research Unit), and Cassandra Saldaña Pineda (Knowledge Management Unit).
Sources:
- Article: “Effectiveness of Psychological Interventions for Postnatal Depression in Primary Care: A Meta-Analysis”. Annals of Family Medicine, Inc. April 2016.
- National Public Health Institute
- The National Institute of Mental Health
- MedlinePlus