One in 10 mothers 'affected' by postnatal depression

Postnatal depression affects 10 per cent of women and seriously influences their quality of life, according to the Richmond Foundation.

While no figures exist on the local situation, the foundation believes this is the state of affairs in Malta and it is important for women with postnatal depression to seek professional help because the condition can be successfully treated.

This form of depression is being tackled at length in a seminar, The Other Side of Motherhood: Your Emotional Well-Being, being held at St James Cavalier, in Valletta tomorrow to coincide with the activities marking International Women's Day.

Organised by the Richmond Foundation and Parentcraft Services, the seminar aims to give more information about postnatal depression, raise awareness and provide personal experiences.

The seminar will be opened by Parliamentary Secretary Helen D'Amato and will include a woman's experience of postnatal depression, the husband's version and the role of self-help groups, among others.

The foundation said that symptoms of postnatal depression included guilt feelings, sadness, tearfulness and irritability.

Although baby blues - a mild depression following birth - is far more common and affects 40-85 per cent of women, postnatal depression is somewhat different and symptoms are more severe and long-lasting.

Healthcare professionals say a woman should seek help if symptoms of baby blues last more than two to three weeks, become severe and start to seriously affect her quality of life. The foundation pointed out that postnatal mood disorders range from baby blues to puerperal psychosis.

At the mildest end of the spectrum there is baby blues, where the mother could experience anxiety, sadness, tearfulness, mood swings and problems in appetite and sleeping habits. This could be caused both by hormonal changes as well as by the changes the mother has to adopt after giving birth. However, these symptoms normally fade away after 24 to 72 hours. If symptoms persist postnatal depression can be the cause.

The causes of postnatal depression appear to be multi-factorial. Certain factors, such as a family history of depression, poor or abusive marital relationships as well as a lack of social support, could place some mothers at greater risk.

Some psychologists have attributed the cause of postnatal depression to the inherent psychological makeup of the person. The cognitive model explains that a patient's negative view of the world and herself leads to depression through low self-esteem and disturbed relationships. It adds that patients with abnormal attitudes of self-control may develop a learned helplessness leading to depression.

On the other hand, some biological theorists suggest that one of the leading causes of postnatal depression could be the hormonal changes brought about during pregnancy and childbirth. The good news is that postnatal depression can be successfully treated with medication, psychotherapy or a combination of both.

The foundation said that pharmacological treatment is the preferred intervention in patients with more severe or chronic symptoms, prior episodes or family history or a prior response to treatment.

However, patients need frequent monitoring of side effects and treatment response, frequent monitoring of compliance to medication, re-evaluation of the diagnosis and monitoring in order to increase dose or change treatment. When medication is prescribed special consideration is given to breastfeeding women.

Psychotherapy is usually combined with medication in patients with more severe depression, chronic psychosocial problems, incomplete response to medication or evidence of a concurrent personality disorder.

The foundation is insisting that information on the incidence and warning signs of postnatal depression should be an intrinsic part of prenatal education.

Even more importantly, clinicians need to identify patients who have suffered prior episodes of depression or have poor support and put them at the high end of risk for postnatal depression.

These patients need careful follow-ups. Moreover, during the postnatal phase of care, clinicians need to recognise the symptoms of depression and realise that patients are embarrassed about feeling unhappy during a time when society expects them to be elated.

Symptoms of postnatal depression

¤ The mother feels sad and often cries for no apparent reason. However, certain mothers can feel extremely sad but feel that they cannot cry.

¤ The mother is irritable with other family members such as husband and other children.

¤ Decreased sexual desire which could be misinterpreted by the husband as personal disinterest in him as a person.

¤ The mother finds it difficult to fall asleep even though she might be extremely tired or else she might feel like she wants to sleep all the time.

¤ The mother is extremely tired and feels that she cannot even cope with the baby, let alone with the other children and everyday work.

¤ Others try to pretend nothing has happened and try to cope with their everyday jobs. However, they end up focusing and overemphasising non-essential things such as obsessions about cleanliness in their home.

¤ The mother feels sad, disinterested in life and nothing gives her pleasure.

¤ The mother starts having ambivalent feelings towards her baby and blames the baby for feeling this way. Despite their love towards the baby, mothers with postnatal depression might suffer from loss of energy and therefore find it difficult to meet the baby's needs, in turn affecting the bond between the mother and child.

¤ The mother starts finding it difficult to concentrate and becomes forgetful in such a way that she starts thinking she is unable to carry out simple everyday tasks.

¤ Many mothers who suffer from postnatal depression would not want to go out in order to avoid meeting others. They also become overwhelmed by an extreme fear.

¤ At times, anxiety might be present and normally it is focused on the baby.

¤ Some mothers with this type of depression lose their appetite while others pick at food at unusual eating hours.

¤ Many blame themselves for no reason and start to feel guilty if they are not giving their baby enough love. They feel they are not good mothers.

¤ Others panic with no apparent reason.

¤ At times, mothers suffering from postnatal depression could start thinking of ways to harm themselves because they believe they are failures.