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Postpartum depression

Postpartum depression is a serious type of depression that occurs after the baby is born. Depression can begin during pregnancy but is not called postpartum depression unless it continues after the baby is born, this is a common case. Statistics show that between 10 and 15 women out of every 100 women have a child, and the real number can be higher than that because many women do not ask for help and talk to others about their feelings. 

It is reported that postpartum depression is a serious type of depression, affecting between 10 to 16% of postpartum women, accelerated by the occurrence of hormonal and physical changes, and lifestyle changes. After removal of the placenta, the level of sex hormones in the body of women reaches levels Extremely low, some women are susceptible to these changes. If a woman breastfeeds her baby, the production of hormones from the ovaries remains suspended. Thus, the level of sex hormones continues to decline. Depression may occur during pregnancy, often accompanied by anxiety, and thus the most appropriate term. , Is perinatal depression. 

It is common after the birth of a woman’s sense of mood deterioration, crying, fear of being a bad mother, and inability to adapt; a feeling is often temporary, and then known as postpartum depression, and if these symptoms continued for more than several weeks, , Postpartum depression is likely to be postpartum. If the woman is depressed after childbirth and does not have the capacity to perform her role as a mother, antidepressant medication may be the lifeline, and the patient should be monitored closely and may need to be placed in Hospital, as there is a constant risk that the mother will suffer from n-harm Spoil, or hurt her newborn child, and it is very important to have a close family network, to provide support and care without rushing to judge the mother from family and friends. 

Often, depressed women will not be aware that they are infected and may focus their negative feelings on the behavior of their children – for example, they may say things like “What if he is sleeping,” “What if he stops crying,” or “What if he has all his bottle feeding “In these cases, the mother, especially with her first child, or the elderly mother, may have asynchronous expectations of the child’s normal behavior. It is important that doctors and family members listen to these concerns honestly and not underestimate them. , Some children are difficult to satisfy, where they are many demands, and women may need to feel one of them The postnatal period is the period of non-sleep, adjustment, and the child’s extreme need for it. There may be a need to develop some simple survival strategies. Feeding the child, getting food And enough exercise, as well as taking every opportunity to rest and sleep, is an important priority for every mother. 

Normal progesterone therapy can help relieve depression and may be given with an antidepressant. Progesterone should be given in the form of cream, and doses range between 20 and 400 mg per day. 

If fatigue is severe, DHS capsules can regenerate and often increase mood within a week of use. DHS doses vary between 10 and 30 mg per day.

 In general, treatment with progesterone or DHS , or both, does not interfere with breastfeeding, and they are safe to use until the depression is eliminated; it may take only a few months.

 If fatigue or other physical symptoms are dominant, it is important to investigate whether there is a medical problem for the woman, such as thyroid disorders, anemia, adrenal fatigue, immunological diseases, and nutritional deficiencies. One should assume that fatigue is just a symptom of depression. 

If the patient decides not to breastfeed her baby, other hormones can help reduce postpartum depression. A blood test can be used to determine the level of testosterone and estrogen. If these hormones remain low for 8 weeks after birth, a cream containing estrogen, testosterone, or both may be used. Estrogen and testosterone will restore libido, improve mood, If small doses are used in the form of cream, there will be no significant risk of blood clots, and estrogen can not be used if the woman breastfeed, which can reduce the amount of milk. 

Dietary supplements containing fish oil, magnesium and iron, and B vitamins group, can help relieve postpartum depression and fatigue.

 Women suffering from postpartum depression should not be rushed to take antidepressants or hormone therapy because there are severe types of depression. It is necessary to avoid any relapse. With infant infanticide or suicide, it is important to recognize that Postpartum depression is a major cause of maternal death and the risk of infant mortality is at its highest level during the first year of life. 

In the first few days or weeks after birth, women with postpartum psychosis suffer from delusions and hallucinations. They are also very disturbed, hyperactive and overactive; during this period of psychosis The mother and child are at high risk and need to be placed in a hospital to avoid any tragic consequences. This type of psychosis is likely to occur in women with a family history, a history of bipolar disorder, bipolar disorder, schizophrenia . 

If a woman suffers from severe depression during pregnancy or during breastfeeding, she should or she will have to decide whether to take antidepressants. This can be a major dilemma because her baby will be at some risk in this case because of the medication, Antipsychotics, and antidepressants, are relatively safe during pregnancy and lactation, safety information has been derived essentially from databases and experiments are not double-blind, thus this information is inadequate.  

The use of selective serotonin reuptake inhibitors is associated with a relatively high risk of coronary heart disease and hypertension. All antidepressants and antipsychotics are associated with high risk for relatively early birth (mean 39 weeks vs 40 weeks) and withdrawal symptoms in infants (sleep disturbance and severe irritation) . 

There is a risk for the mother and child if the depression is not treated effectively, so the mother and father must take all the pros and cons into consideration. Perinatal depression is associated with premature birth, low birth weight, malnutrition, poor child attachment, Infant, or mother suicide.

 By

Dr. Ali Abdul – Zahra Al – Faham

 

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