Introduction:
Maternal suicide has become a public health issue. It is considered the second most common reason for death during the postnatal period. The consequences faced by the family and newborn leave them in ruin. It was found that perinatal depression may be the link to suicidal tendencies among mothers.
What Is Perinatal Depression?
Pregnancy is a period in which physical and social stress can affect maternal, physical, and mental health. This may, in turn, affect neonatal, infant, or childhood outcomes. Perinatal depression is a combination of depression that occurs during pregnancy (prenatal depression) and in the weeks after childbirth (postpartum depression).
It has been estimated that 17 % of pregnant females are affected by postpartum depression (PPD). It was found in a study that females with PPD face an increased risk of death, especially due to suicide. The increased risk was high in the first year after the diagnosis and remained elevated up to 18 years later.
Symptoms of Perinatal Depression:
The symptoms of perinatal depression appear similar to depression.
Symptoms of perinatal depression may include:
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Intense sadness.
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Difficulty in bonding with the baby.
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Face difficulty breastfeeding a baby.
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May harm the baby or themselves in severe cases.
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A feeling of emptiness.
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Feel hopelessness or worthlessness.
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Brain fog.
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Exhibit emotional detachment.
These symptoms are accompanied by other symptoms such as poor sleep, bad appetite, digestive issues, and thoughts of suicide or self-harm. PPD should not be misunderstood for postpartum blues. Postpartum blues have similar symptoms like changing mood, weakness, tearfulness, irritability, and anxiety. The difference between PPD and postpartum blues is that symptoms get better within two weeks after delivery in the case of postpartum blues.
What Are the Causes of Perinatal Depression?
Many factors are involved in perinatal depression.
Factors responsible for the onset of perinatal depression include:
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Hormonal changes during and after pregnancy.
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History of depression that may be personal or family-related.
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Major life stressors.
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Marital conflict.
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Lack of social support system.
Perinatal depression (PND) is not completely understood, but it was noted that the causes may differ from person to person. Studies conducted have suggested that some women with PND may exhibit differences in how their bodies treat gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter that controls mood. This research led to the development of GABA modulators for the treatment of PPD.
A rapid shift in estrogen, progesterone, and allopregnanolone can be observed in the postpartum period. These hormones are considered to be responsible for influencing mood-regulating neurotransmitters. Hence, the shift in hormones is thought to cause postpartum depression.
Other factors, like marital dissatisfaction faced by women, a lack of social support, and stressful events that occur during or after pregnancy, play a role in postpartum depression. These types of conditions indicate an underlying susceptibility to depressive disorders.
Women with a history of depression or who suffer from bipolar disorder tend to exhibit a greater risk for postpartum depression. Women with postpartum depression exhibit recurring depressive episodes that are not related to reproduction. Hence, apart from hormones, psychological and social factors may affect or contribute to the development of PND.
It was observed that all new birthing parents are at risk of developing postpartum depression in any case, regardless of age, relationship status, education, or income level.
Is there a link between perinatal depression and increased suicidal risk?
According to a study, women with PND exhibited a greater risk of mortality. The findings were consistent, and they were independent of the presence of psychiatric conditions. This was observed among those who died by suicide, and that was during the first year after the diagnosis of PND.
Becoming a parent is considered a big transition in life. Along with rapid hormonal shifts, the psychological transition to parenthood affects the brain and the body. During this transition period, an individual requires proper support. If the right support is not provided, the postpartum period will suffer due to many challenges. This is considered another reason for maternal mortality due to PND.
The study has found that major depression, a mental illness, may result in many other medical illnesses and mortality. Mortality may occur due to suicide. Studies found increased mortality related to major depression, whether it was due to postpartum or not.
Researchers also found that if the individual had experienced major depression once, then the chances of getting it again would be 50 %. If an individual has experienced this two times, then the chances of an attack due to major depression are 80 %.
The recurrence in the case of PPD and outside PPD is the same as with major depression.
Another study conducted on 86,551 women found that PND can have troubling implications for 18 years. A study found that women with PND exhibited three times the risk of suicide, which included attempted or completed suicide. A study found that women with PND had more than six times the risk of dying due to suicide when compared to those without the diagnosis of PND.
Suicide was found to be a major cause of death among those who suffered from PND. This was found by a study conducted over 18 years and compared with women without the diagnosis of PND.
A study was conducted among 20000 women with PND and compared with their biological sisters without PND; it found that the risk of suicidal behavior was three times higher among those with PND when compared to sisters without PND. Hence, in this study, researchers found that depression plays a greater role than genetics and childhood environments. The treatment of PND is not completely understood. Antidepressants can be given to those with PND. Individuals without treatment may exhibit worsening conditions and increased suicidal behavior.
Conclusion
Perinatal depression is considered a more serious condition than other mental health disorders. The reason is that the risk of suicidal tendencies or behavior is found to be high in the case of PND. This risk does not depend on the presence of mental health disorders. This condition is underdiagnosed. Hence, it becomes important to know about PND, its causes, symptoms, and association with suicidal tendencies.
