Severe Perinatal Depression Management - A Detailed Review

Introduction

About one in ten women will, at some point in their lives, experience serious depression, which is two times more prevalent than depression rates among men. Pregnancy and the postpartum phase together make up the perinatal period, which is one of the periods when women are most susceptible to developing depression. According to a systematic review conducted in several different countries, 7.4 percent of women encountered the criteria for depression in the first trimester, 12.8 percent in the second, and 12 percent in the third. In the postpartum period, depression has been found in 10 to 15 percent of women.

What Is Perinatal Depression?

Perinatal depression is a mental condition that can affect women both during and after pregnancy. The period of time before and after a child is born is referred to as "perinatal." Prenatal depression and postpartum depression are two types of depression that can develop during pregnancy and after giving birth, respectively. Extreme grief, worry, and exhaustion are experienced by mothers who have perinatal depression, which can make it difficult for them to do everyday duties like taking care of others or themselves.

What Are the Causes of Perinatal Depression?

Perinatal depression is a medical condition that can impact any mother, regardless of age, color, income, cultural background, or education. Perinatal depression is not a result of anything a woman has done or has not done. The causes of perinatal depression are multifactorial. Studies indicate that prenatal depression results from hereditary and environmental factors. Perinatal depression may arise as a result of life stress (such as pressures at work or traumatic experiences), the physical and psychological strains of childbearing and taking care of a newborn, and hormonal changes that happen during and after pregnancy. Furthermore, women who have already had perinatal depression during pregnancy or who have a personal or familial history of depression or bipolar illness are more likely to suffer it again.

What Are the Symptoms Associated With Perinatal Depression?

When it comes to perinatal depression, some women may just have a few symptoms while others may have several. The following are a few of the typical signs of perinatal depression:

• Constantly feeling depressed, nervous, or empty.

• Intolerance.

• Feeling powerless, worthless, hopeless, or regretful.

• Loss of enjoyment or interest in activities.

• Exhaustion or unusually low energy.

• Having difficulty staying still or feeling restless.

• Inability to focus, recall details, or make decisions.

• Oversleeping, waking up early in the morning, or trouble falling asleep.

• Unusual hunger, fluctuations in weight, or both.

• Headaches, cramps, stomach issues, or aches and pains (that are not clearly related to a medical cause or do not go away even after treatment).

• Difficulty developing an emotional tie or relationship with the newborn (doubts about one's capacity to care for the newborn).

• Ideas of ending one's life, killing oneself, or hurting the child.

Only a medical professional can tell a woman whether her symptoms are caused by perinatal depression or anything else. Women who encounter any of these signs must consult a medical professional.

What Are the Treatment Options Available for Perinatal Depression?

As prenatal depression can have major health consequences on both the mother and the unborn baby, treatment for the condition is crucial for both. Most women feel better and have fewer symptoms when they receive the right care. Therapy, medicine, or a combination of the two are frequently used in the treatment of perinatal depression. Electroconvulsive therapy and other brain stimulation techniques may be worth considering if these treatments are unable to reduce symptoms.

• Cognitive Behavioral Therapy (CBT)- An effective psychotherapy for depression and anxiety is cognitive behavioral therapy (CBT). It teaches people many approaches to thinking, acting, and responding to circumstances. To improve their depressed and anxious sensations and emotions, people learn to question and alter harmful thought and behavior patterns. CBT can be used on an individual basis or in a group setting with others who share similar concerns.

• Interpersonal Therapy (IPT) - IPT is a research-based treatment for depression, particularly perinatal depression. It relies on the idea that interpersonal and life events influence mood and vice versa. IPT aims to assist individuals in strengthening their interpersonal communication abilities, creating social support systems, and setting reasonable expectations that enable them to handle life's unexpected events and other problems that might be fueling their feelings of depression.

• Medication - Women suffering from perinatal depression are most usually treated with antidepressants. They might facilitate better utilization of specific brain chemicals that regulate stress and mood. Before beginning antidepressant medication, pregnant or nursing women should let their doctor know so that the doctor can take steps to reduce the amount of the drug that the unborn child is exposed to while the mother is carrying the child. When antidepressants are used throughout pregnancy, there is very little chance of birth abnormalities and other issues for the unborn child. However, women should discuss treatment options with their healthcare provider to choose which option is best for them. Examples of antidepressants used for perinatal depression are:

  • Bupropion.

  • Selective serotonin reuptake inhibitors (SSRIs).

  • Serotonin and norepinephrine reuptake inhibitors (SNRIs).

  • Tricyclic antidepressants (TCAs).

Do not discontinue taking antidepressants without consulting a doctor. Sometimes, people who take medications feel better and then stop taking the prescription on their own, and the depression returns. Abruptly stopping a medicine can result in withdrawal symptoms. The doctor will assist the patient in gradually and safely reducing the dosage once the patient and the doctor have determined it is time to quit the medicine.

Conclusion

Perinatal depression refers to depression that develops during and after pregnancy. Depression during this period may be influenced by hormonal changes. The first people to notice signs of perinatal depression in a new mother could be her spouse, family members, or friends. Family members can help with everyday chores like taking care of the baby or the house, support the mother emotionally, and encourage her to speak with a healthcare professional. Treatment can lessen symptoms or perhaps eliminate them. Management may include medications, talk therapy, along with other therapies.