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In this section, we will discuss symptoms and factors related to postpartum or postnatal depression. These will include characteristics, predispositions, emotional causes, external factors and consequences for the family. As you read, think of your client. Which of these symptoms does she struggle with?
♦ #1 Characteristics
-- 2. A second symptom may include a feeling of panic that is manifested by extreme anxiety, inexplicable panic attacks, physical reactions such as palpitations, hot flashes, trembling, dizziness, excessive sweating, numbness, and tingling in the hands and feet, or even an impression of suffocation. Panic attacks are sometimes brought on by a situation that reminds the new mother of a past trauma.
-- 3. A third symptom may include obsessive thoughts and fantasies. I have found that women suffering from postnatal depression usually know that they are fantasizing and can control themselves. However, a woman may feel extremely guilty about thoughts regarding harming herself or her baby, and may undertake complicated rituals to protect herself or her baby.
Shelby, age 29, described her postnatal depression as feeling "revved up." Shelby stated, "After my son was born, I could not sit down and relax for a minute! I felt like there was a motor inside that would not shut off! I just thought it was the excitement of having the baby we had wanted for so long. When I got home from the hospital, I couldn’t sleep at all. I got so tired and irritable that when he cried I wanted to yell, ‘Shut up!’ This only made me feel worse. I was worried that I was not going to be able to handle being a mother. I found myself avoiding taking care of my baby."
Shelby learned to relax and not to worry so much about minor problems like diaper rash. Shelby tended to "catastrophize." Small events took on life-and-death proportions in her thinking. Shelby learned to observe herself catastrophizing and to be more objective in her assessment of situations. After several sessions, Shelby was less anxious, was beginning to enjoy her son, and was able to sleep when the baby slept.
♦ #2 Predispositions
Five Characteristics that Put Women at Risk for Postnatal Depression
♦ #3 Emotional Causes
First, severe, negative reactions to birth by the mother may induce psychological tensions that are the major cause of postnatal depression. For example, a woman may be deeply disturbed by the feeling of "losing control" during her delivery. Part of Shelby’s depression was her reluctance to accept her powerlessness when faced with such an overwhelming physical transformation. Likewise, a woman who went through her pregnancy in a state of anger or frustration with her body may find that these feelings tend to persist after childbirth.
Second, a mother’s psychological past is yet another cause of depression. Unresolved grief, such as after a divorce or following the loss of a parent or loved one may resurface after childbirth. Psychological traumas dating from the mother’s childhood or adolescence, such as sexual or physical abuse or abandonment, may suddenly appear overwhelming to the mother immediately after childbirth, threatening her self-confidence and her ability to bond with her new baby.
♦ #4 External Factors
Social isolation can also contribute to postnatal depression. If a woman finds herself alone with her baby for more than eight hours a day, if she is housebound due to lack of transportation or severe weather conditions, if she has no extended family to give support, the woman may have no one with whom to share her feelings, no one to help in practical ways.
♦ #5 Consequences for the Family
Have you found, as I have, that women suffering from depression usually worry about the effect of their illness on the baby? The woman may need to be reassured that there is no time limit for establishing a strong mother-child bond, no critical point after which all is lost. It may be important to explain to any older children that their mother is not well, that she will get better, that it is not their fault, nor is it the fault of the baby.
In this section, we have discussed symptoms and factors related to postpartum or postnatal depression. These have included characteristics, predispositions, emotional causes, external factors and consequences for the family.
In the next section, we will discuss when a woman becomes a mother. This will include a feeling of suffocation, everything revolving around the baby, making motherhood the only source of fulfillment and the "icing on the cake" technique.
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