Pregnancy is a period marked by illusions, but also by suffering . Some mothers experience, shortly before or after delivery, what is known as perinatal depression (DPN) .

This form of depression, which can be especially tragic for both her and her son, is a peculiar manifestation that requires different treatment from major depression, as it has its own characteristics. We explain the keys to understanding it and review the most effective treatments.

Perinatal depression, rather than postpartum

For some time now, psychologists have been expanding the definition of what used to be labeled as depression that began in the postpartum period.

We know that depression can start a few months before delivery and that it is the same phenomenon that will haunt the mother’s mood for a year after she gives birth.

Clinical description

Perinatal depression includes any major or minor depressive episode that occurs during pregnancy or within 12 months after delivery . There is a certain degree of uncertainty regarding the incidence of the disorder. Several studies agree on prevalence rates ranging from 10-15%. However, excluding studies where the diagnosis is based only on self-reports, rates of 6.5% to 12.9% are reached. This is a global phenomenon, not exclusive to Western society.

Symptoms

Mothers who suffer from it feel extremely guilty, some even hate their child. They feel lonely and overwhelmed, they need help and do not know how to ask for it. They are filled with ruminative thoughts, sticky beliefs that are very difficult to get rid of and that seriously hinder their lives.

Women with perinatal depression are in a period of role transition, from women to mothers , which is difficult to assume. Difficulties in communication with the partner can also aggravate the feeling of being completely alone.

The severity of the disorder is not limited to how disabling it can be for the person suffering from it. Maternal perinatal depression is associated with a higher incidence of excessive crying in the child, colic, sleep problems, temperament difficulties, poorer self-regulation, and more indicators of stress. It is also associated with negative mother-child interactions, including detachment, withdrawal, intrusion and hostility as well as poorer interpersonal functioning of the infant, insecure attachment and high rates of behavioral and emotional problems.

The main risk factor for perinatal depression is inadequate social support. The danger is increased by different deficiencies in social support such as

  • Not having someone like that to talk to openly.
  • No friends or intimate relationships.
  • Not getting support without asking for it.
  • Feeling socially isolated.

Treatment and advice

A very common feature of perinatal depression is that mothers are embarrassed to suffer from depression, so much so that they don’t ask for help. For this reason, it is especially important to normalize perinatal depression .

Anyone can suffer from an emotional disorder, especially during the difficult period of pregnancy and the enormous change it brings to family life. The arrival of a child always marks a before and after.

1. Psychoeducation and activation

The first stone in overcoming perinatal depression is laid when the mother understands what is happening to her and why. Once this is done, she can start planning a whole series of activities that will get her going and make her feel useful again.

2. Learning to be a mother

One of the main concerns of mothers with perinatal depression is not being up to it and being a “bad mother” . The truth is that no mother learns by magic, and it can cost some people more than others. In addition to attacking these thoughts, it will be vitally important for mothers to learn to feel comfortable interacting with their baby.

A good way to do this may be to attend workshops that teach you how to play with your baby, how to handle difficult situations (crying incessantly, tantrums, etc.) or problems at mealtimes. Support groups can be very helpful in suggesting alternative behaviors that will promote the optimal relationship with the baby.

3. Working the social network of support and communication

Because perinatal depression is a markedly social disorder, it is vital to identify communication patterns that are not working. Both parents will need to learn how to relate and communicate their thoughts in a clear and non-judgmental way. If we can do this, we will achieve two things: the mother will be able to ask for and receive help, and she will no longer feel completely alone and overwhelmed.

Support groups are a very important network in this respect . Being able to talk to other mothers who are going through the same process, share your own experiences and receive advice from other women will make you feel sheltered and better prepared to face motherhood.

4. Role transitions

Motherhood is difficult to incorporate . The change of role can mean the loss of personal meaning, going from being a working woman to simply being a mother.

It will be very important to recover those activities that were part of the mother’s identity. Identify those reinforcers that existed before the baby such as the feeling of doing a good job or enjoying an afternoon with friends, as well as finding opportunities within the new routine to incorporate them again.

There may also be a conflict between long-term goals (e.g., between family and work). Sometimes it will be necessary to rethink goals and restructure them to make them as harmonious as they are realistic.

5. Attacking Disadaptive Thinking

As in any emotional disorder, we will have to work through cognitive techniques the thoughts that instead of helping , anchor people in the depths of depression.

Mothers must learn to identify the situations in which they appear and acquire strategies to anticipate them or know how to neutralize them when they appear with more adaptive and realistic thoughts.

In addition, it is especially important to get into the habit of thinking about problems only if they are to be solved. It is very easy to get stuck in the emotional distress caused by worries, but the only way to get out of this quicksand is to take a step back and remind yourself that when faced with a problem there is no other way out but to look for a solution.