The diagnosis is made if a depressive attack occurs within 4
weeks after birth. There are 3 depressive diagnoses related to the postpartum
period.
The first is "maternal
melancholy", which is the most common pregnancy-related psychiatric
disorder in more than half of the mothers. It typically starts on the 3rd or
4th day after birth and usually lasts less than 1 week. The symptoms
encountered are crying attacks, insomnia, depressed mood, weakness, irritability,
headache and confusion. No specific hormonal changes could be demonstrated to
explain this situation.
Second, the fatigue of the baby and the difficulties of a new
individual joining the family are common sources of complaints. This situation
resolves on its own. No medication is required.
The third and more rare but serious condition is "postpartum depression". It is more
common in those who have had postpartum depression and those who have had
depression or anxiety during pregnancy.
Symptoms: The patient
states that he is unhappy in most of the days, or those around him say he looks
unhappy. Postpartum depression symptoms are decreased interest in activities or
not enjoying pleasure, significant weight loss or increase, excessive sleep or
not being able to sleep, feeling worthless, weak, guilty, decreased attention,
and suicidal thoughts. If the patient is considered to be at risk of suicide,
he should be hospitalized in a psychiatric clinic where he can be kept under
observation for 24 hours. Tricyclic antidepressants and SSRIs, which are used
for depression, can be used safely. Electroconvulsive therapy can be applied in
patients who do not respond to the drug.
The most serious form of postpartum depression is postpartum
psychosis. It is very rare. It is seen only in 0.1-0.2% of births. It is
characterized by a sudden onset of delusion. The patient is depressed or very
cheerful. It develops strange and previously unattractive behavior.
Hallucinations begin and show the difference together. At this stage, the
treatment of the patient should be arranged by psychiatrists.
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