My mother had psychosis after childbirth. Postpartum mental disorders: psychosis, depression. How to recognize the disease

With the birth of a child, a woman begins a difficult period. Emotional and physical stress increases. Dramatic changes in life put psychological pressure on a young mother. The stress of the first weeks negatively affects the psychological health of a young mother. Such stress often leads to mental disorders. Postpartum psychosis is one of the insidious diseases that occurs in 1 in 1000 new mothers.

Symptoms of postpartum psychosis are often labeled as depression and hoped to go away on their own. Conversely, a slight decline in mood is mistaken for psychosis. It is important to distinguish this disease from other mental disorders. Psychosis is a manic state that requires immediate treatment.

In this article, we described how to recognize the symptoms of postpartum psychosis in time, how to treat and prevent it.

Depression and psychosis after childbirth are conditions that require different types treatment. The outcome of the disease depends on the correct and timely diagnosis. Depression manifests itself in symptoms such as mood swings, tearfulness, guilt, and loss of appetite. They are not life-threatening for mother and baby, and occur in a quarter of women who give birth.

But in a state of postpartum psychosis, a woman does not control herself and can harm herself and the child. Postpartum psychosis overtakes a woman in the first 1 - 2 weeks after childbirth. The patient loses orientation in space. Confusion and auditory hallucinations appear. The young mother begins to have delusional ideas: that the child is a devil and must be killed. The woman insists that her baby was replaced in the maternity hospital.

The perception of tastes and smells changes or disappears altogether. As a result, the appetite disappears and the woman refuses to eat. She cannot sleep and suffers from insomnia. The mother, being in a manic state, is capable of suicide and causing harm to the newborn.

If at least one of the described symptoms appears, you should immediately consult a psychiatrist or call an ambulance. Relatives must take responsibility for calling a doctor, because a woman, as a rule, does not admit that she is sick.

Causes of the disease

Medicine has not yet given an exact answer to why some women experience postpartum psychosis. There is an assumption that women prone to hypochondria, excessive suspiciousness, and hysteria are faced with this disease. Women who suffered from PMS before childbirth are more likely to experience this disease than others. It also plays an important role hereditary factor. If you have a history of this disease in your family, the risk of experiencing postpartum psychosis increases.

Factors that provoke the appearance of postpartum psychosis can be:

Hormonal changes in the postpartum period. A sharp drop in estrogen leads to changes in mood.
Fatigue, lack of sleep, high emotional stress associated with the birth of a child.
Difficult labor and postpartum complications in the mother.
History of traumatic brain injury.
Schizophrenia, history of manic disorders.

When faced with manifestations of psychosis, you should not reproach yourself and try to change your attitude towards the situation. This dangerous disease, which is being treated with the help of a psychiatrist.

Treatment of postpartum psychosis

The basic principle of treating manic disorder is that the sooner you start treatment, the faster you can cope with the disease. Those who consult a doctor at the first signs of the disease will be able to get out of the state of psychosis within 2-4 weeks. If you start the disease, recovery will take from six months to a year.

Drug treatment

Therapy for psychosis is carried out in a hospital, using medications that are incompatible with breastfeeding. You will have to be separated from your child during treatment. The psychiatrist will first prescribe antipsychotics to eliminate delusions and hallucinations. Then treatment is carried out with antidepressants and normolytics, which stabilize the mood. In case some postpartum infection provoked a psychological disorder, then treatment of these diseases is carried out in parallel.

If the therapy gives positive results, after 2-4 weeks the woman is discharged home. But the course of treatment can continue for another year.

What should relatives do?

The support of loved ones during this difficult period is very important for a young mother. Relatives are required to:

Give the patient at least 8 hours of sleep at night.
Provide adequate nutrition with easily digestible food.
Strictly monitor the patient's medication intake.
Relatives should take on household chores.
Mom is recommended to take walks in the fresh air more often.

If treatment is started on time, then in 80% of cases it is possible to return to normal life.

Prevention of psychosis

In order to prevent the disease, you need to mentally and physically prepare for the birth of a child. It would be good to attend prenatal classes to know for sure what awaits the young family. Responsibilities for caring for the newborn are divided among all family members, thereby reducing the burden on the mother.

If a woman has encountered this disease in the past and is afraid of a repetition of the situation, then she needs to see a psychologist. He will give recommendations on how to avoid exacerbation of psychological disorder.

Postpartum psychosis is a very dangerous, rapidly developing condition. You cannot expect it to go away on its own, as is the case with other mental disorders after childbirth. Early consultation with a doctor in most cases guarantees a return to a full life and happy motherhood.

Postpartum psychosis And postpartum depression– these are conditions that manifest themselves in a woman as a consequence of complications that arise during . It is extremely important that new mothers diagnosed with postpartum psychosis seek help from a qualified professional and receive the necessary treatment.

This point should be taken into account due to the fact that most young mothers do not even suspect that they are already suffering from manifestations of postpartum psychosis. Sometimes such manifestations are not perceived as a serious illness by the woman’s loved ones.

The concepts of “postpartum psychosis” and “postpartum depression” should be distinguished. Both of these illnesses are very severe psychotic conditions that require immediate medical treatment. But the approach to the treatment of these diseases is different: postpartum depression is treated using antidepressants , and therapy for postpartum psychosis is carried out using antipsychotics . Compared to the manifestations of postpartum depression, postpartum psychosis occurs less frequently in women. It is necessary to clearly distinguish postpartum psychosis from postpartum blues, which most young mothers experience in the first weeks after childbirth. In most cases, such blues go away on their own. However, it happens that prolonged blues turns into a state of postpartum depression. This condition must be treated with the help of qualified specialists.

Causes of postpartum psychosis

Postpartum psychosis is a serious psychotic condition. During a woman who later suffers from postpartum psychosis shows no noticeable abnormalities. However, those who are prone to psychosis in the postpartum period tend to have previously suffered from strong emotional fluctuations in the period before menstruation

To this day, there is no information about the clear reasons for the manifestation of this condition in a woman after childbirth. There are some assumptions that changes in the psyche of a woman who has recently given birth to a child are associated with fluctuations hormonal balance in her body.

A high risk of developing postpartum psychosis exists in women who have a history of a variety of mental illnesses and disorders. Thus, young mothers suffering from schizophrenia and bipolar disorders are more susceptible to postpartum psychosis. The risk of developing postpartum psychosis is significantly increased in those who have previously abused a variety of drugs.

However, postpartum psychosis can also develop in healthy women who have experienced severe emotional stress in connection with the birth of a baby.

Symptoms of postpartum psychosis

As a rule, postpartum psychosis manifests itself on the 3-6th day after birth. When characterizing the characteristics of postpartum psychosis, we often talk about the patient’s loss of connections with reality. With the progression of postpartum psychosis, the highest nervous activity. In women, immediately after childbirth it manifests itself as light , so heavy a form of postpartum psychosis. If its course is particularly severe, then the young mother may completely lose the ability to care for the newborn.

As postpartum psychosis develops, a number of different symptoms may appear. A woman sometimes experiences certain manic manifestations, which are expressed by an increased level of arousal, the occurrence of obsessions, which are not related to reality.

Another very common manifestation of postpartum psychosis in women is hallucinations, mainly auditory. The young mother gradually develops personality changes and her thinking becomes abnormal. A woman susceptible to postpartum psychosis becomes difficult to formulate her thoughts out loud and organize them. Accordingly, a woman can have incoherent conversations and express thoughts without clear content.

The patient cannot give adequate self-esteem, correctly determining her own condition. Convincing a young mother that she needs to seek qualified help, her loved ones must make significant efforts to achieve what she wants. Over time, after complete cure, a woman, as a rule, realizes the fallacy of her own beliefs.

Another symptom of postpartum psychosis is appetite disorder: a young mother often cannot eat normally.

A woman in a state of severe postpartum psychosis is often visited by ideas about possible suicide or murder. Such a symptom indicates that the patient’s condition is extremely serious and she needs the help of specialists.

Diagnosis of postpartum psychosis

When a woman contacts a doctor with complaints about the manifestation of the symptoms described above, the doctor should carry out as much as possible full examination her state of health. Identification of organic ailments, blood tests and other studies help explain the causes of postpartum psychosis. In addition, it is necessary to bring neurological examination, and also study the results of computed tomography.

Treatment of postpartum psychosis

Treatment of postpartum psychosis has been practiced for quite some time. Currently, both oral and intravenous intramuscular injection drugs. But any drugs should be used at the first opportunity, since treatment of postpartum psychosis should be done as early as possible. The success of such therapy directly depends on this. Accordingly, the effectiveness of treatment may decrease if it is started later.

If immediate medical intervention does not occur, then with postpartum psychosis, a woman’s condition can sharply worsen. And this directly threatens the health of the child and mother.

Postpartum depression

Postpartum depression can occur in any woman who has recently given birth to a child. A similar condition also occurs in women who gave birth to a stillborn child or after a miscarriage. Postpartum depression is manifested by changes in the psychological state of a woman. She may suffer from constant feelings of sadness, pessimism, and hopelessness. The young mother ceases to feel the joy of life and the pleasure of caring for her child. Sometimes a new mother feels that it is too difficult for her to take care of her baby on a daily basis. Today, there is evidence that the prevalence of postpartum depression reaches up to 15%. It is very important to take into account the fact that postpartum depression in the mother can affect the child’s health in the future.

If you evaluate the condition of a young mother immediately after the birth of a child, then a state of fatigue, weakness and exhaustion is observed in almost every woman. In the first few weeks after childbirth, a young mother may suffer from insomnia and fatigue. All these sensations in most young mothers manifest themselves in parallel with a state of joy and great satisfaction from the fact that a child has been born. But in a normal state, after a few weeks a woman feels that her condition is becoming more stable and the unpleasant symptoms disappear without treatment.

Causes of postpartum depression

There is an opinion that the cause of postpartum depression is a sharp hormonal imbalance in a woman’s body, which manifests itself immediately after the birth of the baby. During pregnancy, significant changes occur in a woman’s body. psychological , somatic And endocrine character. Mental dysfunction in the period after childbirth, according to doctors, is associated with a sharp decrease in the amount of gonadotropic hormones V.

However, there are some factors that increase the risk of postpartum depression. First of all, it is important to consider that postpartum depression most often manifests itself in those women who previously suffered from such a disease when giving birth to children. Postpartum depression occurs especially often in this category of women when a child is born after 35 years of age. However, there is evidence that postpartum depression occurs much more often in women at the birth of their first child.

In addition, the risk of manifestation of this condition significantly increases the lack of adequate support for the young mother, which should be provided by relatives and friends. Postpartum depression occurs more often in women who have had severe . It can be triggered by health problems in the newborn, regular colic in the child, or the presence of other family or psychological problems.

If a woman was susceptible to depression during the period of bearing a child, then in 75% of cases a depressive state will manifest itself in her after childbirth. The young mother's hereditary disposition to depressive states either to bipolar disorder .

Symptoms of postpartum depression

Since the birth of a child is a serious stress for a woman, the development of depression in the postpartum period occurs quite often.

The most typical symptom of postpartum depression is the young mother's denial of the need for qualified help. A woman who has just given birth to a child feels that it is very difficult for her to cope with new responsibilities, and at the same time experiences a feeling of guilt. The woman suffers from severe anxiety, and she becomes very slow and has great difficulty concentrating. Sometimes a woman completely rejects everything social contacts and is completely immersed in worries about the child. In other cases, postpartum depression forces the mother to give up caring for the child altogether. Often postpartum depression becomes chronic and long time negatively affects the condition of the child and mother.

Very often, a young mother also suffers because she does not receive confirmation of the theory that her maternal instincts will help her endure all the difficulties of the period of adaptation to the child quickly enough. But in fact, for such a connection between mother and baby to appear and strengthen, it takes several months. Consequently, disappointment from failures can provoke a worsening of depression. In addition, very often the mother is convinced that she alone is responsible for the child.

Thus, a feeling of sadness, spiritual emptiness and constant anxiety can haunt a woman for a long time. Gradually she loses the ability to enjoy everyday pleasant little things. Symptoms of postpartum depression also often include loss of appetite and sudden weight loss in a young mother. A woman may also suffer from insomnia.

The symptoms described above can appear in a woman both in the first week after childbirth, and after several turbulent weeks. Postpartum depression can last for about three to four months in a new mother.

Types of postpartum depression

IN medical practice A certain classification of postpartum depression has been adopted. At neurotic depression in a woman, those disorders that occurred during pregnancy become aggravated. She is depressed, often cries, and gradually reaches an extreme degree.

Traumatic neurosis , as a rule, appears after a very difficult birth process. In women who have experienced a difficult birth, before the next birth of a child, a state of anxiety and obsessive fears gradually increases.

At melancholy, which is accompanied by delusional inclusions , the woman’s condition is characterized by severe inhibition, a feeling of guilt, as well as thoughts of her own inadequacy. A woman may not recognize people close to her and suffer from the constant manifestation of unpleasant hallucinations. Very often this condition precedes the manifestation manic-depressive psychosis .

With postpartum depression with a neurotic component, a woman may experience symptoms of a hypochondriacal nature, as well as insomnia and a feeling of powerlessness. The mother is constantly afraid of harming her child in some way.

Most often, young mothers experience a prolonged course of postpartum depression. Moreover, this condition very often goes undiagnosed in women, although approximately 20% of young mothers suffer from it. Symptoms of this condition include: constant feeling fatigue, despondency, exhaustion. It is very difficult for a mother to tolerate the baby's crying; she becomes irritable, and at the same time constantly feels guilty for such behavior.

Diagnosis of postpartum depression

Diagnosis of postpartum mental disorders is carried out by medical examination, as well as a detailed interview with the patient. It is extremely important that the woman tells the doctor in as much detail as possible about her own feelings, thoughts and emotions that prevail in her after the birth of the child. During the treatment process, the doctor must monitor the patient and monitor her psychological state. It is important that the doctor pays close attention to the woman’s complaints, as they sometimes go unnoticed.

Treatment of postpartum depression

Treatment of postpartum depression and postpartum psychosis requires a mandatory consultation with a psychologist and the use of medications. For postpartum depression, a woman is prescribed treatment antidepressant medications . But if the patient has moderate postpartum depression, then in some cases you can do without medications. Today, the use of modern antidepressant drugs makes it possible not to give up breastfeeding child, since they do not provide negative impact for the baby. But it is very important that such remedies are prescribed exclusively by a specialist.

However, treatment for postpartum depression also involves proper nutrition, a certain physical activity, sufficient hours of sleep each day. In addition, a woman needs to realize the wrongness of her own behavior and be sure to seek help from her loved ones.

Prevention of postpartum mental disorders

It should be understood that the prevention of postpartum depression and postpartum psychosis must be taken care of long before the birth of the child. The expectant mother should always be in a comfortable environment to feel cared for and supported. It is especially important to provide such conditions for women who have an increased risk of developing mental disorders. IN in this case The attitude of her partner towards a woman is extremely important.

Both husband and wife must understand before giving birth that every woman has a risk of developing postpartum depression, so it is important to recognize this condition in time and provide adequate treatment.

It is still not entirely clear why this happens: after the birth of a child, the mother experiences mental illness. She is sometimes gloomy and depressed, sometimes overly active; bouts of euphoria are replaced by panic and nervous attacks. Women at home, and first of all, the newborn, suffer from sudden mood swings. You cannot explain to a baby that the mother has postpartum psychosis, that she is still inadequate and even dangerous for her own child. So, on the heels of happiness, trouble comes to the family. Is it possible to return the baby’s mother, calm and healthy, or is mental disorder a life sentence: let’s take a closer look.

When does postpartum psychosis occur?

A rather rare mental disorder that awaits a mother at 2–4 weeks of a baby’s life is called postpartum psychosis. The main symptom of the disease is a woman’s manic desire to do something with herself or with the baby. For loved ones, this state of a new mother is like a bolt from the blue. If the disease develops gradually, it is difficult to recognize in the early stages.

According to statistics, on average, one young mother out of a thousand suffers from postpartum psychosis. More often, mental disorder overtakes women who have given birth for the first time.

Causes of mental disorders after childbirth

Until now, scientists have not fully figured out why young mothers occasionally fall into insanity. There is a connection with hormonal imbalance in the woman’s body. Childbirth itself leads to a disruption of hormones, however, according to doctors, with the birth of a baby, hormonal levels should quickly recover. In practice, this rarely happens: the mother’s lifestyle, worries, and worries interfere with the “reconfiguration” of the delicate mechanism.
With postpartum psychosis, instead of joy from the birth of a baby, a woman is seized with manic anxiety, which has no serious basis

Research has identified reasons that can “push” the onset of postpartum psychosis. Among the main ones:

Bad heredity: the presence of a mental disorder in one of the close relatives on the female side.
The presence of schizophrenia or bipolar disorder in the mother herself. Schizophrenia is a distortion of thinking and perception, when the patient’s head mixes up imaginary and reality. With bipolar disorder, a woman alternates between mania and deep depression. In this case, the appearance of postpartum psychosis is natural.
Reluctance to have a child, unwillingness to become a mother.
Difficult, prolonged labor, with copious blood loss. The consequence may be disturbances in the functioning of the nervous system, which in turn leads to emotional instability and in some cases ends in psychosis.
Health problems after childbirth: horse racing blood pressure, liver dysfunction.
Alcohol and drug abuse.
Severe emotional stress associated with the birth of a baby. Psyche even healthy woman may not be able to withstand the experience and become upset.
Constant lack of sleep, chronic fatigue.
Difficult family situation, quarrels and scandals.

Some experts believe that social and psychological factors have little influence on mental disorders in women after childbirth; the main reasons lie in heredity.

How to recognize the disease

The patient is not able to make a diagnosis for herself: as a rule, she believes that everything is fine with her, it’s just that for some reason the people around her are behaving inappropriately. Therefore, family and friends should be concerned about the strange behavior of the young mother. Relatives must convince the patient to go to the doctor.

Where it all begins

The clinical picture of the disease is varied; some women exhibit individual symptoms.

The first signs of psychosis after childbirth are usually:

The woman is constantly in a bad mood, which intensifies in the morning. Outbursts of aggression are abruptly replaced by a depressed state.
Sleep is disturbed and she constantly feels tired.
Loses the thread of conversation, cannot clearly express thoughts, speech is incoherent.
Wakes up early, no appetite.
He is tormented by a feeling of guilt, ascribes to himself non-existent sins.
Unable to make decisions, even simple ones.
Panicks about the child's health, although the baby gives no reason for concern.
Yells at the baby, which annoys the woman.

It happens that postpartum psychosis proceeds sluggishly: insomnia, lack of appetite, forever Bad mood- that's all there is to it. Perhaps this condition is nothing more than postpartum depression, which affects approximately every seventh woman who has given birth. A few weeks later, the young mother comes to her senses: her mood rises, life gets better.

It is much more difficult to get out of a state of psychosis, the main characteristic of which is manic syndrome.

Acute form

If a woman has had a difficult birth and is also giving birth for the first time, the nervous system may not be able to withstand the physical and psychological stress and may fail. An emotional decline sets in. At first, the mother’s suppressed feelings do not cause anxiety: the mother in labor had a hard time, but gradually she will come to her senses. However, after two weeks, negative emotions finally take precedence over the feeling of joy from motherhood. The woman's behavior becomes inexplicable. There is acute psychosis, the symptoms of which are:

When conversations begin about wanting to commit suicide, rest assured: the patient requires urgent medical attention. It is important to foresee such a development of events and in advance, by hook or by crook, to lure the woman into the psychiatrist’s office.

Schizophrenic psychosis after childbirth

Sometimes they try to cure mental disorders after childbirth with the help of hormonal medications. In some cases, such therapy leads to the development of schizophrenic psychosis - the most dangerous shape diseases. Signs:

When the insanity passes, the patient will not even remember what she did. The human psyche has not yet revealed all its secrets to researchers, so it is difficult to imagine how it is possible for a mother to kill her own child. To prevent a terrible outcome, it is necessary, even at the stage of the first panic, to isolate the mentally ill woman from the child, and then take her to the doctor. Prompt medical care provided to the mother will likely save the baby's life.

Treatment of postpartum psychosis

Do not be mistaken that a mother’s insanity after childbirth is a temporary phenomenon. Unfortunately, psychosis, if not cured in time, drags on, progresses and ultimately leads to irreparable consequences. Even when a mentally ill mother does not kill or maim the baby, the child will most likely grow up to be physically or mentally retarded.

Before choosing therapy, doctors - a neurologist and a psychiatrist - must make sure that the woman has psychosis. To clarify the diagnosis:

Collect information about the presence of mental disorders in close relatives. Every second young mother with severe heredity will experience a recurrence of the disease.
They examine the patient and ask questions to determine the degree of mental disorder.
They send you for a blood test - the level of leukocytes, ESR affect mental condition sick.
Do computed tomography- helps to identify the causes of the disease when the doctor still has doubts.

In case of mild psychosis, the woman may be allowed to be treated at home, prescribed medications and ordered to see a doctor regularly.

If the diagnosis of “acute psychosis” is confirmed, the patient is placed in an inpatient psychiatric clinic: the woman needs constant monitoring. The child has to be left at home because there is no equipped place for the baby in such medical institutions. In any case, breastfeeding should not be done while treating psychosis: components of medications containing mother's milk crumbs will penetrate the body and harm health.

After 2 weeks, with proper therapy, the patient’s condition improves: the main symptoms disappear. Perhaps the woman will be discharged from the clinic to continue her treatment at home. There is a long rehabilitation ahead - from six months to a year. The young mother will have to step by step get rid of anxiety, depression, and oppressive feelings of guilt.

Medicines

Treatment begins with mood stabilizers - drugs that stabilize mood specifically when manic disorders psyche. Antidepressants are also used, since depression usually accompanies psychosis.

Under the supervision of a psychiatrist, in extreme cases it is necessary to resort to psychotropic drugs. First, small doses of medication are given to prevent complete clouding of the mind. The dosage is gradually increased.

If the patient flatly refuses to take medication, she is given a solution by injection.

Table: antidepressants to combat the disorder

Name	How it works	Dosage and course of administration	Side effects	Contraindications	Price
Amitriptyline	Drug from the group tricyclic compounds; reduces feelings of anxiety, nervous agitation, symptoms depression. Renders analgesic effect.	2–3 tablets per day, drink at night (doctor maybe gradually increase the dose); course of treatment - 3 months.	Headache, nausea, dry mouth, diarrhea, urticaria, swelling faces, memory impairment, aggressiveness, nocturnal nightmares.	Allergy to components, heart failure, alcohol poisoning, severe diseases of the kidneys, liver, stomach ulcer, breastfeeding.	28–60 rubles
Pyrazidol	Balanced acts on the central nervous system; positively affects thinking, attention, speech.	Start with reception 1/2 tablet 2 times a day, then the dose is increased. After 2–4 weeks dose are gradually reduced.	Dizziness, tremor, dry mouth, tachycardia.	Hypersensitivity to components, acute hepatitis, blood diseases, feeding chest.	137–317 rubles
Paroxetine	Reduces feelings of anxiety, fear, nervous excitement.	1 tablet 1 time per day; it is possible to increase the dose. The course of treatment is 6–8 weeks, possible extension until several months.	Dry mouth, nausea, tremor, insomnia; in some cases - constipation	Increased sensitivity to the active substance - paroxetine, breastfeeding.	298–403 ruble
Citalopram	Reduces symptoms obsessive states, feeling of fear.	1/2 tablet 1 time per day, dose if necessary increase. Course of therapy - 6 months.	Headache, insomnia, aggressive behavior, apathy, suicide attempts, nausea, vomiting, tachycardia, frequent urination.	Allergy to the active substance - citalopram. Effect on lactation not installed.	168–537 rubles

At the second stage of treatment, a patient with acute schizophrenic psychosis may be prescribed semi-shock therapy. This is treatment with large doses of insulin, which puts the patient in a comatose state. It is also practiced for drug intolerance. After the procedure, the patient quickly regains consciousness. This treatment method requires the written consent of the patient or her legal representative.

When postpartum psychosis lasts more than two months and the patient still has a desire to commit suicide, electroshock treatment is sometimes used. The brain is irritated with an electric current, causing seizures. This stimulates the release of norepinephrine and dopamine into the hypothalamus: it is the lack of these hormones that scientists believe leads to depression and psychosis. And although the mechanism of action of electric shock has not been studied in detail, remission after the procedure is obvious. Voluntary consent of the patient or her guardian is required.

Photo gallery: drugs used

Amitriptyline is both an antidepressant and analgesic
Pyrazidol will help restore clarity of speech and thinking
Paroxetine, compared to other antidepressants, has little side effects and contraindications
Citalopram is a medicine against fear, but it has many side effects

Folk remedies

If the psychosis has not reached a severe stage, traditional medicine methods will help alleviate the condition of the sick mother. For example, a bath with an infusion of poplar leaves is good for calming frayed nerves.

Before taking medicinal plants internally, a doctor’s approval is required: many herbs are prohibited during breastfeeding, as they pass through the mother’s milk to the baby and cause allergies.

Here are recipes for remedies that are used to get rid of panic conditions and obsessive thoughts:

Mint decoction. 1 tbsp. l. pour a glass of boiling water over the herbs. Cook for 10 minutes over low heat. Cool, drink 2 times a day, morning and evening.
Knotweed infusion. 1 tbsp. l. herbs are poured with 2 cups of boiling water. Leave covered for 1 hour. Drink in small quantities before meals.
Thyme infusion. 5 g of herb is dipped in 500 ml of boiling water (2 cups). Leave in a closed container for half an hour. Take 2-3 times a day for 1 week. After a two-week break, the course can be repeated.

Photo gallery: Herbal remedies to relieve symptoms of psychosis

Mint is taken in the form of a decoction or added to tea. Knotweed is a common weed that is abundant in summer cottages; not all gardeners know about the medicinal properties of the plant. Thyme infusion will help you calm down and overcome obsessive fear.

The support of loving people will help the patient cope with the disease. Patience will be required from family and friends, since at first their efforts are unlikely to be appreciated.

What is important to do:

Take on household chores and caring for the baby.
If the mother is being treated at home, create comfortable conditions for a relaxing holiday.
Patiently endure offensive words, remembering that a woman is not responsible for her actions. Speak calmly and kindly.
Do not blame the young mother for inappropriate behavior.
If a manic state worsens, be prepared to call for urgent psychiatric help.
Make sure you take your medications correctly.
Accompany the patient during visits to the doctor.
Leave a woman alone as little as possible.

After taking medication, the patient will need a qualified psychotherapist. The doctor will help the young mother understand herself, overcome the feeling of guilt before the child and loved ones, which depresses the fragile psyche and interferes with rehabilitation. Individual psychotherapy sessions can be combined with family ones, so that family members can clarify for themselves the details of what is happening and better understand what a loved one has experienced.

After undergoing long-term rehabilitation, three out of four patients recover completely. Finally, it's all over. Mom is back with her family and is thinking about having another child. Of course, thoughts of a recurrence of psychosis haunt the woman. The worry is not in vain: according to statistics, every second person who has experienced a mental disorder after childbirth experiences the disease again after giving birth to the next child.

Prevention of postpartum psychosis

To minimize the risk of the disease returning after a new pregnancy, the mother needs to take care of herself even at the stage of gestation. The main thing is to overcome shyness and not be afraid to reveal a “terrible secret” from the past: experienced psychosis. It is possible that those whom you are embarrassed about are not entirely mentally healthy themselves.

According to the World Health Organization, 10% of the world's population suffer from mental disorders of varying severity. Some experts consider WHO statistics to be inaccurate and claim that there are now 20% of people on the planet with mental disorders.

So, boldly look into the eyes of those you meet: you have overcome the disease and you have nothing to be ashamed of. Now, while expecting your next child, take preventive measures:

No one is immune from postpartum psychosis: even if you have never experienced the disease, you should protect yourself. Pay attention to special courses where pregnant women are taught breathing techniques, proper care for the baby and other useful things. Prepare yourself for motherhood so that it does not come as a surprise and bring mental problems.

Childbirth and hormonal changes, following them, are stressful for female body. In addition, with the birth of a child, especially the firstborn, a woman has many new experiences and responsibilities. Often the events that occur during this period are radically different from how the woman imagined motherhood. In this regard, 80% of women in the first month after childbirth experience emotional and behavioral disorders of varying severity: postpartum despondency, postpartum depression and postpartum psychosis.

In some women, the disturbances go unnoticed by others and disappear after a few days. 15-20% of women in labor experience disorders that require psychological help and consultation with a neuropsychiatrist or psychiatrist.

Risk factors for developing postpartum disorders

It is possible to determine whether a woman will suffer from postpartum disorders during pregnancy. There are factors that increase the risk of developing postpartum disorders. One of the main ones is hereditary predisposition. Features of brain function are inherited, such as: the release of neurotransmitters responsible for a good mood (dopamine, serotonin and norepinephrine), disruption of the functioning of serotonin receptors.

There are other risk factors:

Weak unstable type of nervous system;
High level life stress and low stress resistance;
Severe pregnancy - toxicosis later pregnancy, threat of miscarriage;
Depression occurring before and during pregnancy;
Difficult childbirth resulting in health problems for the child or mother;
Financial difficulties in the family;
Frequent conflicts between spouses before the birth of a child;
An incomplete family is a situation where a mother is forced to raise a child herself in the absence of support from loved ones;
Low self-esteem, especially in the postpartum period;
Low level of education of women;
Unplanned pregnancy;
Avoid breastfeeding for the first 3 months after birth.

You can reduce the likelihood of developing postpartum disorders by applying the preventive measures described below.

Postpartum sadness

Postpartum sadness- short-term emotional disturbance, which is described as a decline in mood after childbirth. This condition is also called “postpartum blues” or “the blues.” It develops on the 2-5th day after birth. During this period, a woman feels a decrease in mood, causeless anxiety, fears for the life and health of her child, and uncertainty that she can cope with maternal responsibilities. In countries where the baby, in the absence of complications, is discharged on the 3rd day after birth, the onset of the “maternal blues” often coincides with the period of returning home from the hospital.

Postpartum depression is observed in 70-80% of young mothers and is largely associated with the mental and physiological reactions of the body in the postpartum period. It occurs in most women in labor, regardless of character, attitudes and life circumstances. The number of women suffering from postpartum blues is approximately the same in different countries, despite differences in culture, traditions and rituals accompanying childbirth. This suggests that the “blues” are associated with the reaction of the nervous system and body to the birth of a child.

The emotional disturbance lasts 5-12 days and goes away without treatment, provided that the woman receives sympathy and moral support from loved ones. A woman’s condition improves when she gets used to a new lifestyle, and also as physical recovery and stabilization of hormone levels.

Causes of postpartum sadness

Physical and mental stress caused by childbirth;
Hormonal changes in the body;
Lack of experience in child care;
Restructuring of life style in connection with the birth of a child.

Signs of postpartum sadness

Periods of despondency appear on days 2-3, replacing the joy of the birth of a child. Signs of blues intensify when a woman is tired and weaken after rest.

Periods of low mood that can last from half an hour to several hours;
Mood instability, emotional instability - sadness is replaced by disgust from communicating with a child;
Anxiety for the child’s health, for one’s condition and the atmosphere in the family;
Tearfulness, but without a sense of loss;
Feeling overwhelmed, constant fatigue;
Irritability;
Feeling of lack of time;
Appetite and sleep disorders.

If postpartum depression lasts more than 14 days, and the woman most day arrives in a depressed state, then consultation with a psychologist or psychiatrist is necessary. Because long-term low mood can be a symptom of postpartum depression.

Treatment for postpartum sadness

Postpartum sadness does not require special treatment. Relatives can alleviate a woman’s condition by helping her with the child and housework. Moral support from relatives, approval and rest allow the young mother to quickly regain emotional balance.

Understanding that depression is temporary. A woman should remember that postpartum depression goes away when the lactation process normalizes and hormones return to normal. This usually takes 5-10 days.
Adequate rest and proper nutrition. To normalize the emotional state, it is important to restore the strength wasted during childbirth. The first 4-7 days after childbirth, all the time not taken up by caring for the child, a woman should devote to rest. Lactation consultants recommend co-sleeping with the child and skin-to-skin contact, which helps to establish milk production, find mutual understanding with the child and gain strength.
Help from loved ones. Often women refuse the help of loved ones, driven by pride and a heightened maternal instinct, which provokes a reluctance to trust the child to other people. However, the right decision would be to adopt the practical skills of others. It would be good if someone more experienced showed how to bathe the baby, put him to the breast, dress him, etc.
Husband's support. A woman may not trust her husband to take care of the child, justifying this by the young father’s lack of experience. A man shouldn't insist. It is better to take care of the mother, cooking and other housework.
Return to normal activities. To restore emotional well-being, it is necessary that the things to which a woman is accustomed accompany her after the birth of the child. A few days after giving birth, you can return to your favorite activities. You need to find time to devote to yourself - do makeup, go to the hairdresser, do what you love.
Maintaining physical fitness. You can start exercising 3-5 days after giving birth. For this purpose, a special complex has been developed that takes into account the characteristics of the female body during the postpartum period. Possible physical exercise help to quickly restore health and figure.

For about 10% of women, postpartum sadness turns into postpartum depression. Therefore, it is important to protect the young mother from overwork and stress, as well as monitor her emotional state to prevent the development of depression.

Postpartum depression

Postpartum depression or postnataldepression is a mood disorder that occurs during the first year after childbirth. Moreover greatest number cases of postnatal depression occur in the first four months after the birth of a child. This disorder can last from several weeks to several years.

According to various sources, postpartum depression is found in 15%-40% of women giving birth. In 60% the disorder is mild, in 3% it is severe. The remaining cases occur during depressive episodes moderate severity.

Women often hide their mental state from others, fearing that depression may be perceived as weakness, laziness, or a sign of insufficient love for the child. There is also an opinion in society that a depressed state after childbirth can be associated with damage or the evil eye. Even being in deep depression the woman hides the symptoms and does not seek help, fearing the “stigma” associated with a psychiatric diagnosis. A woman can suffer for months, tormenting her husband and child, instead of quickly getting rid of the problem.

Unlike postpartum depression, which often develops against a background of complete well-being, the appearance of postpartum depression is closely related to stress. The formation of depression is significantly influenced by negative events that occurred during pregnancy and for 9 weeks after the birth of the child. At the same time, women with a stable nervous system who adapt well to difficult situation, are not prone to developing postpartum depression. It was also found that the rate of depression is significantly lower in those women whose spouse provided them with full support.

Why is postpartum depression dangerous?

The depressed state of the mother complicates communication with the baby. The mother holds him less often, talks and plays with him less, which leads to a delay in the child’s cognitive development. He later begins to sit, walk and talk, has difficulty concentrating, remembering, suffers from hyperactivity and lack of self-confidence. In a state of depression, the production of prolactin decreases and the amount of breast milk decreases, so the baby does not gain weight well. In addition, the baby reads emotional condition mother, he becomes restless, sleeps worse, cries more, which further worsens the woman’s condition.

Violation of emotional contact between mother and child prevents the formation of a sense of basic security, which is fundamental for mental health baby. Therefore, untreated postpartum depression can cause disturbances in the child’s mental activity and various psychosomatic disorders, such as tics, enuresis, stuttering, neurodermatitis, dizziness and headaches.

In addition, postpartum depression in a woman has a bad effect on the family situation, relationships with her husband and older children. Women have an increased risk of alcohol and drug use. When depression is unrecognized and untreated, there is a risk of developing chronic depression.

Causes of postpartum depression

Postpartum depression occurs when a woman is influenced by three factors: hereditary predisposition, physiological changes associated with childbirth and psychosocial changes caused by the birth of a child.

Some of the most common causes of postpartum depression are:

Hormonal changes. In the postpartum period, the production of progesterone and hormones decreases significantly thyroid gland. At the same time, the synthesis of the hormone prolactin, which regulates lactation and activates the maternal instinct, increases. The hypothalamus-pituitary-adrenal system works with maximum efficiency, which causes strong emotional fluctuations.
A woman believes that she is not capable of performing maternal functions at the proper level. This is typical of a woman prone to perfectionism, striving to do everything perfectly, who wants to become an exemplary mother and considers the child as the center of her existence. The development of depression can be caused by a lack of child care skills, insufficient milk supply, or the inability to devote full time to the child.
Lactation disorder. If a woman, for any reason, cannot provide breastfeeding to her child, she suffers from a feeling of guilt and considers herself a bad mother. This is a significant factor in the formation of depression.
A woman cannot combine career and childcare. Motherhood causes deterioration social status and loss of independence.
The birth of a child radically changed the mother's lifestyle, entailed a complication of life and a decrease in social activity. A woman falls out of her usual social circle. She is forced to adapt her lifestyle to the needs of the child, taking into account the need for feeding and daytime sleep.
Unrealistic ideas about motherhood. If a woman has idealized the postpartum period, the child’s behavior and her condition, then the discrepancy between reality and ideas can deprive her of mental balance. This character reason is for women who gave birth to their first child, who led an active social life before giving birth.
The child was diagnosed with serious pathologies. Numerous expensive examinations and courses of treatment, fears for the health and life of the child are a significant reason for the development of depression.
Complications in the relationship between spouses. With the birth of the child, the spouse suffers from attention deficit. Fatigue, lack of sex and a growing number of responsibilities often lead to an increase in mutual claims and quarrels.

Symptoms of postpartum depression

Symptoms of postpartum depression may appear within 6 weeks of giving birth. The first signs often appear on the 5th day after birth, which is associated with strong hormonal fluctuations that make a woman more vulnerable to other factors that cause depression.

Decreased mood. A woman experiences negative emotions and unpleasant expectations for a long time. She does not have periods of good mood, she rarely laughs. The woman complains that she feels a sense of loss, although there is no reason for this. Outwardly, she seems sad and indifferent to what is happening. Minor incidents may cause periods of screaming or crying.
Depression, exhaustion. The woman experiences chronic fatigue, which is considered a characteristic symptom of depression. The lack of mental and physical strength makes a woman sedentary and slow. She tends to spend a lot of time in bed.
Detachment and hostility towards the child. At the same time, the woman understands that her behavior is outside the norm. In this regard, she feels shame. Not wanting to be seen as immoral and insensitive, she hides her symptoms of depression from others. In some cases, she avoids contact with relatives and friends.
Communication with the child does not cause pleasure and interest. With severe depression, a woman may completely refuse to care for her child. It happens that a woman devotes all her time to caring for her child, refusing other activities. However, this activity does not bring her pleasure, but is accompanied by anxiety and excitement.
Hot temper. Minor events cause irritation. The woman becomes grumpy and picky.
Tearfulness. The desire to cry is unreasonable or is caused by minor reasons: the cry of a child, lack of breast milk, the need to prepare food, etc.
Feeling helpless. The inability to calm a crying child, perform usual household chores, or devote enough time to an older child causes despair. A woman constantly experiences self-doubt and the correctness of her actions; she doubts and finds it difficult to make a decision.
Pessimistic attitude. With depression, thinking changes, which is manifested by pessimism, negative judgments, anticipation of troubles, and concentration on possible risks. A woman experiences guilt and anxiety for minor reasons.
Dissatisfaction with one's own appearance . If a woman was unable to quickly restore her physical shape, she has the idea that she will no longer be able to regain her former attractiveness.
Sleep disorders. Despite the fact that the woman suffers from lack of sleep, she has difficulty falling asleep. Sleep becomes intermittent and superficial, with frequent awakenings not related to the child’s activities. A woman wakes up tired and overwhelmed.
Increasing nervous tension. A woman lives with the feeling that her nerves are on edge and that a nervous breakdown could occur at any moment. She tries not to give vent to negative emotions, which further increases nervous tension.

A woman does not necessarily have all of the listed signs. Most often, several are clearly expressed, and the remaining symptoms may not attract attention.

Diagnosis of postpartum depression

Diagnosis of postpartum depression is carried out by a psychiatrist. Consultations with a gynecologist-endocrinologist and a psychologist are also required. In practice, most women prefer to seek help not at a psychoneurological dispensary, but at a private clinic with a psychiatrist, psychotherapist or psychologist.

Diagnostic criteria for postnatal postpartum depression

A woman suffering from postpartum depression realizes that her condition is beyond the norm.
A depressed mood is typical for a woman most of the day and repeats from day to day.
Loss of pleasure in activities that usually spark interest.
Increased fatigue and loss of strength.
Suicidal thoughts and desire to harm oneself (usually unconscious).
Emotional instability.
Complaints of malaise, pain in different parts body, excessive concentration on one’s health.
Changes in appetite (increase or decrease) and sleep disturbances.
Guilt.
Cognitive impairment, manifested by fear and anxiety that disrupts the thinking process. Decreased concentration.

To be diagnosed with postpartum depression, the depressive episode must last for more than 2 weeks.

Before starting treatment, the doctor determines the severity of the depressive episode using the Edinburgh Postnatal Depression Scale.

Treatment of postpartum depression

Treatment of postpartum depression consists of three stages: correction of the daily routine, psychotherapy and drug treatment.

Correction of daily routine

Treatment begins with correcting the rest and wakefulness regime of the young mother, which includes:

Help from a spouse (relatives or nanny) in child care and housekeeping;
Sleep 6-7 hours a day;
5 meals a day in small portions;
Wellness massage;
Walks in the fresh air 3-5 hours;
Physical exercise: daily gymnastics, then swimming, cycling.

Psychotherapy for postpartum depression

In the event that self-help measures do not provide positive result, then the woman is recommended to undergo a course of psychotherapy. The main task of the psychotherapist is to instill in the patient confidence that she is an excellent mother and can cope well with her parental responsibilities.

Cognitive behavioral therapy gives good results in the treatment of postpartum depression. This direction of psychotherapy views postpartum depression as a woman’s reaction to her “shortcomings” and “mistakes” that affect her ability to be a mother.

Within this direction, it is believed that depression is caused by the fact that a woman suffers from the thought that she does not love her child much enough, does not feel his needs, or during pregnancy and after childbirth she made mistakes that affected the health of the baby. Therefore, psychotherapy is aimed at eliminating feelings of guilt and creating the attitude of a healthy person. She teaches you to direct energy to actions “here and now”, and not torments of conscience and mental anguish. To achieve these goals, various techniques and exercises are used:

Recording your own thoughts. It is required to keep a diary where all disturbing thoughts and situations in which they arose, and the emotions accompanying them are recorded. Thoughts are recorded in chronological order. They also indicate the approximate time it took to think about the thought. A thought diary gives the specialist the opportunity to determine what worries the patient most, identify the motive for action and the mechanism for the development of depression.
Identifying dysfunctional thoughts and moving away from them. The woman is explained that negative thoughts and depressive emotions arise automatically, under the influence of previously experienced negative experiences. These thoughts need to be identified and recognized as something harmful that prevents you from adapting to a changing reality.
Writing down the pros and cons of stereotypical thoughts that occur during depression. For example: a woman is often tormented by the thought that she is a bad mother. On a piece of paper in two columns, you need to write down arguments that confirm and refute this belief.
Using authoritative sources of information. The psychotherapist provides facts from authoritative sources confirming that a woman is able to provide her child with optimal conditions for development. For example, in a situation where a mother is unable to breastfeed, she is provided with the same research results as when artificial feeding the child is developing normally.
Decatastrophization. The specialist discusses with the patient how catastrophic the consequences of the event that worries her will be. For example, a woman is afraid to leave her child with her husband. The psychotherapist’s task is to instill the idea that a frightening act will not become a disaster for either the mother or the child.
Making a plan for the future. The woman, together with the psychotherapist, draws up an action plan in case of situations that worry her. This may be the child's illness or the need to leave him in the care of his grandmother. The woman is instilled with confidence that as long as the situation has not arrived, she need not worry. And if this does happen, then she has already prepared instructions.
Positive imagination. The woman is asked to replace the frightening image with a positive one. For example, when a picture of an accident with a child involuntarily arises in her imagination, she should imagine a positive situation - everything is fine with the child, he is healthy and safe. This technique relieves emotional stress well.
Role reversal. A specialist talks on behalf of a depressed mother. The woman’s task is to take on the role of a psychotherapist and convince her interlocutor that his ideas are wrong and prevent him from adapting to motherhood.
Repeated repetition of productive attitudes. This method is based on auto-training. The woman repeats the necessary settings 10 times three times a day until inner confidence appears. For self-hypnosis, formulas are used: “I am a good mother. I love my child. I blend in well with parenting responsibilities.”

The course of psychotherapy consists of 10-20 sessions, which are held weekly or 2 times a week. If during this time there are no signs of depression, then the woman is considered healthy.

Drug treatment of postpartum depression

Drug treatment of postpartum depression is carried out for moderate to severe depressive episodes. When prescribing medications, it is necessary to temporarily stop breastfeeding. Therefore, before prescribing medications, a risk analysis is carried out; what is more dangerous for the child is refusal of breast milk or a depressed state of the mother.

For the treatment of postpartum depression, SSRI antidepressants are considered the most effective ( selective inhibitors serotonin reuptake):

Sertraline (Zoloft) - 50-100 mg/day
Paroxetine (Paxil) - 12.-20 mg/day
Citalopram (cipramil) - 20-40 mg/day
Escitalopram (cipralex) - 10-20 mg/day

With postpartum psychosis, a woman suffers from melancholy, heartache, anxiety and self-recrimination. She loses control over her behavior and is not aware of the changes occurring in her psyche; she does not understand that she is sick. At certain moments, a woman may look healthy, but the danger is that her actions cannot be predicted, so the patient can pose a danger to the child and herself.

Depending on the cause, there are several types of postpartum psychoses:

Somatoreactive psychoses: delusional, affective-delusional, catatonic, acute paraphrenic syndrome. Mental disorders associated with postpartum disorders in the nervous and hormonal system.
Infectious-toxic psychoses- associated with infectious and inflammatory diseases that occur after childbirth (mastitis, endometritis, metroendometritis). They are caused by damage to the central nervous system from toxins. Manifests itself as amentia syndrome.
Psychoses associated with exacerbation of pre-existing mental illnesses: manic, depressive, manic-depressive psychoses.

Causes of postpartum psychosis

Hormonal changes in the body during the postpartum period. Placental hormones, which regulate the body’s activity during pregnancy, stop producing and ACTH levels decrease 50 times. At the same time, the production of prolactin increases, which significantly affects the functioning of the nervous system. This is the main reason for the development of somatoreactive psychoses that develop after childbirth.
Decreased cerebral circulation. Under the influence of hormones, blood supply to the brain is reduced by 30-40%, which can provoke mental disorders even in balanced women.
Exacerbation of pre-existing mental illness. Childbirth can serve as a trigger and reveal a disease that was not previously apparent, or cause an exacerbation of the disease after a period of calm.
Burdened heredity. Women who have close relatives with mental illness, are more at risk of developing psychosis. This is due to the fact that the characteristics of the functioning of the brain are inherited.

It is believed that mental trauma suffered by a woman cannot cause postpartum psychosis.

Symptoms of postpartum psychosis

Postpartum psychosis may occur against a background of complete health, or it may be preceded by postpartum depression. At first, oddities in behavior are barely noticeable. Over time, the patient's condition worsens, and new signs of the disorder appear.

The concept of “postpartum psychosis” combines several conditions that have different syndromes - groups of symptoms characteristic of one or another form of postpartum psychosis. The most common ones are described below.

Bipolar disorder

Bipolar disorder- a mental disorder in which alternating episodes of mania and depression.

Depressive episode accompanied by three main symptoms:

Depressed mood. Depending on the form of the disorder, the following may come first: melancholy, anxiety, fear, pessimistic expectations, irritability, anger, tearfulness.
Slow thinking. The woman reacts late to what is happening. Mental work causes her significant difficulties. Attention is scattered, memory is weakened.
Motor retardation. A woman spends a long time in one position, her head and shoulders are lowered, her movements are slow. She shows no desire to perform any actions.

In general, the picture of the depressive period corresponds to the state of postpartum depression and includes the symptoms described in the previous section. The woman's condition fluctuates throughout the day. As a rule, symptoms of depression ease in the evening.

Manic episode also has three main symptoms:

Elevated mood. The woman's mood becomes silly. Playfulness is combined with irritability and aggressiveness. She can behave impulsively and recklessly. During this period, she experiences a surge of energy and practically does not need sleep.
Accelerated thinking. There is inconsistency, unfounded arguments, overestimation of one’s own strengths, and stereotypical thinking. At the same time, half of women experience suicidal thoughts. Absent critical thinking. Delusions of grandeur may appear. In this case, the woman is groundlessly convinced that she has a high birth, is famous, rich, and has achieved significant success in any field.
Increased physical activity- fussiness, constant change of posture, desire to take on many things at the same time. The pace of speech accelerates, the woman speaks loudly and emotionally.

Periods of depression and mania may be prolonged or may alternate several times within one day.

Affective-delusional syndrome

This type of postpartum psychosis is characterized by a combination of delirium with emotional disturbances: depression, fear, anxiety, euphoria.

Rave for postpartum psychosis:

Delirium of persecution. It seems to the woman that some people wish harm to her or her child. Moreover, both close and strangers may be under suspicion. A woman fiercely defends her opinion; it is impossible to convince her otherwise.
Hypochondriacal delirium. The woman is firmly convinced that she is suffering from a severe somatic (physical) illness. She often attributes fatal, untreatable, unknown to science, or shameful diseases to herself. The fact that doctors do not confirm their diagnosis causes anger and accusations of unprofessionalism against health workers.
Delirium of witchcraft. The patient becomes confident that she is under the influence of “dark forces.” They want to jinx her or the child, cause damage, damage the biofield, take away her husband, etc.
Delirium of staging. The patient is sure that everything around her is part of a staging, a performance staged by someone. The people around her are actors in disguise who are performing a play around her for a specific purpose, for example, to take away a child.

Affective (emotional) disorders

Emotional disturbances are a constant background that determines the nature of delirium. The predominant emotions are: depression, fear, melancholy, a sense of hopelessness, and anxiety. At the same time, thoughts of suicide arise much less frequently than with depressive-manic psychosis.

With affective-delusional psychosis, the mother's attitude towards the child changes. This could be indifference, irritation or open hostility. The baby’s natural behavior (intermittent sleep, crying) is perceived by the mother as conscious actions directed against her.

Catatonic syndrome

Catatonic syndrome in postpartum psychosis is a group of symptoms that describe movement disorders: inhibition or agitation.

The most common picture of catatonic syndrome in psychosis is:

Motor excitement. The patient is constantly in motion, changes position, jumps up, moves aimlessly around the room, and actively gesticulates. This condition is accompanied by a rise in temperature to 38 degrees.
Stereotyping of speech and movements. Repetition of the same actions and phrases indicates a disorder in thinking.
Contact unavailable. The woman avoids contact with others, ignoring appeals to her.
Negativism. The patient does everything contrary to what she is told: she refuses to eat when asked to eat, leaves when asked to stay where she is.
Impulsivity of behavior. A woman’s actions become ridiculous and unpredictable, as the logic of thinking is lost.
The attitude towards the child depends on the stage of the disease. At first, the patient experiences anxiety for the health and safety of the child. Subsequently, when thinking and perception are impaired, she perceives the baby as a character in her fantasies. The baby may seem to her like an alien, an elf, someone else's child, etc.

Hallucinatory-delusional syndrome

In this course of psychosis, patients experience delusions accompanied by hallucinations.

Rave. Delusions are predominantly about persecution and influence.

Delusions of persecution. The woman is sure that she is the object of surveillance by ill-wishers (special services, aliens).
Delirium of influence. The patient “feels” that she is being influenced: they control her thoughts, force her to make movements (wave her hand, nod) and actions against her will. Patients attribute the appearance of unusual sensations in the body to extraneous influences, which are accomplished with the help of hypnosis, radiation, or laser.

Hallucinations. Visual, auditory, tactile, olfactory. A woman sees, hears, feels what is not there. Hallucinations may have the character of a movie in which the woman does not take part. In this case, she looks distant and silent, does not react to anyone addressing her or what is happening in reality.
Mood disturbance. The woman is depressed and confused, she is tormented by fears. There are periods of increased strength and increased mood, but at the same time the woman is embittered and aggressive. The patient speaks in abrupt phrases due to confusion in her thoughts.
Attitude towards a newborn. Concern for the child gives way to indifference, and over time, hostility.

Amentive syndrome

Amentive syndrome is characteristic of infectious-toxic psychoses. Poisoning of the brain with toxins causes specific changes in the psyche:

Absent-mindedness. The woman looks lost. She cannot comprehend the events taking place and connect them into a logical chain. Poorly oriented in what is happening, has difficulty realizing where she is and what is happening.
Incoherent thinking which is manifested by confusion of speech. Phrases and individual words are not connected by meaning. The patient may experience short-term hallucinations.
The mood is unstable. Positive and negative emotions quickly replace each other. Anxiety and fear predominate.
Chaotic aimless movements. Sometimes activity gives way to lethargy, when the patient freezes for a while.

Diagnosis of postpartum psychosis

If the described symptoms appear, the woman’s relatives should immediately contact a psychiatrist or neuropsychiatrist, because the earlier treatment for psychosis is started, the lower the risk that the disease will become severe. The specialist makes a diagnosis based on a conversation with the patient and her relatives. You will also need to consult a gynecologist to rule out inflammatory diseases mammary glands and reproductive organs, which can cause infectious-toxic psychosis.

Treatment of postpartum psychosis

In most cases it is carried out drug treatment postpartum psychosis. Psychotherapy is prescribed only after the symptoms of psychosis have been eliminated, when thinking and emotions have returned to normal.

If purulent-inflammatory diseases that provoke psychosis are detected, antibiotics are prescribed wide range actions. To eliminate the symptoms of psychosis, antipsychotics are used, as well as multivitamins, nootropics and herbal-based sedatives.

For the treatment of postpartum psychosis the following are prescribed:

Aminazine 0.5 g/day. Neuroleptic, belongs to the group of antipsychotic drugs, eliminates symptoms of depression, delusions, hallucinations, reduces anxiety, fear, mental and motor agitation. The first few days it is administered intramuscularly, then in tablet form.
Lithium salts- lithium carbonate, micalite. Used to treat manic states. Lithium preparations have an antipsychotic and calming effect, eliminate aggressiveness, and normalize the activity of the nervous system.
Chlorprothixene 50-100 mg/day. A drug from the group of antipsychotics has a calming and antidepressant effect. At the same time, it reduces the synthesis of hormones from the hypothalamus and pituitary gland, which is important in the postpartum period.
Bromocriptine 1.25 mg/day. The drug is a dopamine receptor agonist. Used to stop milk flow. It also affects the hormonal function of the pituitary gland, which helps to quickly restore endocrine balance after childbirth.
Piracetam 1.2-2 g/day. Nootropic drug that improves cerebral circulation and brain functions. Helps reduce the effects of toxins on the nervous system.
Persen and other plant-based sedatives relieve emotional stress and help stabilize mood.

For affective disorders and severe forms of psychosis, treatment is carried out in the psychosomatic department of a psychiatric clinic. If the psychiatrist has decided on the possibility of treatment at home, then one of the family members should be with the woman around the clock. If the mother does not mind, then you can isolate the child for a while to protect him.

Psychotherapy for postpartum psychosis.

Psychotherapy is carried out once a week for 2-4 months. The purpose of the classes is to strengthen the bond between mother and child, improve parenting skills, increase self-confidence and stress resistance. Meetings with a psychotherapist can take place in the form of individual or group sessions. The psychotherapy technique is similar to that used for postpartum depression.

Prevention of postpartum disorders

Prevention of postpartum disorders is psychological preparation to childbirth, which includes several aspects.

Psychotherapeutic support for women during pregnancy and after childbirth. It is carried out at antenatal clinics and private clinics. Attending special courses for pregnant women will help prepare for childbirth psychologically and physically, create positive attitude and develop realistic expectations about childbirth and motherhood.
Communication in groups. It is important for a pregnant woman and a young mother to feel that she is part of society and leads an active lifestyle. She needs to communicate with women who have similar problems and concerns.
Optimistic attitude. The expectant mother needs to be instilled with confidence in the favorable outcome of childbirth and the naturalness of this process. Relatives must convince the woman that she will cope well with the responsibilities of caring for the baby, and if necessary, she can count on their help.
Autotraining and visualization. These self-hypnosis techniques help balance the nervous system, create a positive mood, improve overall well-being, and increase resistance to stress.
Proper nutrition and compliance with work and rest schedules extremely important both during pregnancy and after childbirth. Following recommendations for nutrition and daily routine helps to give birth to a healthy baby, provide him with breast milk, and also quickly restore mental and physical strength.

Postpartum disorders are very common. But one should not dramatize the situation, because in the vast majority of cases the disorders are mild. Even with the development of severe postpartum psychosis, the changes are reversible, and with proper treatment the woman will be completely healthy.

Postpartum depression - how not to go crazy

In the first days after childbirth, some women may experience a rare mental disorder - postpartum psychosis. The disease is serious, but treatable. It is important to recognize the signs of an emerging disorder in time. Moreover, it may turn out to be a big surprise for relatives, appearing suddenly. Although gradually developing psychosis is difficult to recognize immediately.

Postpartum psychosis is a rare mental disorder that usually occurs in the first 2-4 weeks after childbirth. With timely diagnosis and prompt initiation of therapy, a woman can recover from this rapidly developing condition within a few weeks, but with a delayed diagnosis, recovery can take months. Often, a woman suffering from postpartum psychosis is not aware of her painful condition. Source: Wikipedia

Causes of the disease

Little is known about the causes of the disease. Doctors are inclined to believe that sudden hormonal changes in the female body during the postpartum period can provoke the development of psychosis, complications during childbirth, and emotional stress from the birth of a child. The impetus can also be a constant lack of sleep, severe fatigue of the mother.

Women whose relatives suffered from postpartum psychosis, as well as women with a medical history of bipolar depression or schizophrenia, are at greater risk of getting sick. If a woman has already been diagnosed with postpartum psychosis after her first birth, there is a high probability of its recurrence after the second pregnancy.

Drug use before pregnancy can trigger the development of psychosis.

Anyone who is at high risk of developing the disease should definitely consult a psychiatrist in order to minimize the likelihood of the disease occurring.

Fortunately, postpartum psychosis is much less common than postpartum depression - it develops in approximately 0.1% of women giving birth.

Signs of postpartum psychosis

Contact a psychiatrist immediately if you notice the following symptoms in a woman who has recently given birth (literally in the first days after birth):

The woman becomes distracted and cannot clearly express her thoughts. Periods of talkativeness are replaced by reluctance to communicate;
Aggression or euphoria alternates with depression, and mood changes occur quite abruptly;
The perception of taste and smell changes. It is even possible to refuse food;
Insomnia. If a woman’s sleep is disturbed and she does not want to go to bed, this should also alert loved ones. She may develop delusions and visions, auditory hallucinations;
The woman develops obsessive ideas, it seems to her that the baby is in danger, they want to take his life, kidnap him. She doesn’t let anyone near the child, refuses to talk to people, is afraid to go outside;
Or vice versa, the child becomes hated by the mother, she is even capable of trying to kill him. Or he may show complete indifference to him. The same attitude can be towards people close to her.

The woman herself does not understand that she is sick and is completely inadequate, so her family should take care of her and show her to a psychiatrist.

This disease needs to be taken seriously. After all, a sick person, without receiving the necessary treatment, can not only harm herself and the child, but also deprive herself and his life.

Treatment

At the first suspicion of the disease Be sure to consult a psychiatrist. He will examine the patient and prescribe her the necessary treatment.

Most often, a sick woman is admitted to the hospital. If there are conditions in the clinic, then the baby is next to the mother. Mostly, there are no such rooms in the hospital, so the baby is at home with one of his relatives. If the child is with his mother, then breastfeeding the baby during treatment is prohibited, because his mother receives strong antipsychotic medications and various mood stabilizers (mood stabilizers).

Usually, after a couple of weeks, the patient’s condition improves so much that she can be discharged home for further treatment. The full course of treatment can last from six months to a year.

A lot of strength and patience will be required from family and friends:

It is necessary to provide the sick mother with comfortable conditions that promote recovery: peace, the opportunity to rest more;
The husband and other family members will have to take on most of the household chores;
One of the relatives must take care of the child during the course of treatment; the mother herself cannot do this yet;
Temporarily limit meetings at home with friends - this is not the time for guests.
Try to morally support the woman, talk to her calmly, kindly, without blaming her for what happened. After all, what happened was not the woman’s fault;
If possible, do not leave her alone;
Control your intake medicines, dosage and timing;
Get a full 8 hours of sleep.

Consequences

If treatment is not started on time, the consequences of this terrible disease can be disastrous. Being in a state of psychosis, a woman does not control her actions and is captive of obsessions. There are known cases when a mother who has just given birth, without receiving timely treatment and being in a manic-depressive state, she attempted suicide. And not all of them, unfortunately, were prevented.

A friend of mine who suffered postpartum psychosis remembers that time as a bad dream. Her birth was premature and difficult, which obviously contributed to the development of the disease.

She says that she suddenly became irritable, shouted at everyone, and everyone suddenly became enemies. I even got into a fight with my mother-in-law. She wrote some vague, incomprehensible notes. Everything around me became alien, life seemed over. It seemed to her that vitality left her. The sense of taste was completely gone. Because of this, she refused to eat in the hospital. They force-fed her from a spoon. I don’t remember at all how I ended up in the hospital. The treatment dragged on for six months.

Three years have passed, and she and her husband want a second child. But my friend is afraid of a recurrence of the disease. So she and her husband turned to the psychiatrist who treated her. Now the woman is following all the doctor’s recommendations and hopes that the terrible disease will not happen again.

If you could not avoid the disease, and postpartum psychosis still manifests itself, do not despair. Remember - life goes on. It is very important to be attentive to a woman who has recently given birth. Take care of her, help with household chores. Surround her with love. Give mommy the opportunity not to be overworked and to rest more often. And then the terrible illness will recede and will be remembered simply as a severe nightmare.

What you need to know about postpartum depression –