What can you do?
If there are indications of pregnancy depression, it is recommended to consult a doctor in any case. This doctor can clarify whether the symptoms are only a temporary mood sway or already a real pregnancy depression. The doctor has various questionnaires (such as the BDI) at his disposal for differentiation and diagnosis.
Depending on the severity of the depression, the therapy is finally adapted. If it is only a mild depressive disorder, a consultation with a doctor or a counseling center (e.g. Pro Familia) is usually sufficient. Pregnant women learn more about their illness and how a good social environment can help. In severe cases, psychotherapy would be advisable, which can be combined with medication, so-called antidepressants, depending on the severity of the illness. There are a number of good and approved drugs that can be used in consultation with a psychiatrist.
Therapy
Enlightenment and psychoeducation (this is the psychic training for dealing with the illness) contribute enormously to alleviating feelings of guilt and shame in the mother. The knowledge that her lack of drive and her insensitivity towards the child can be justified with the clinical picture pregnancy depression, calms the mother. There is a willingness to seek a conversation with a psychotherapist.
The affected patient can assign her condition to an illness that can be treated and openly addressed. A 100% diagnosis of a depressive illness cannot be made yet. However, as soon as there are signs of PPD, the interaction between family, social workers and the midwife should be sought.
All these limbs can make the effort to relieve the depressed woman from her new duties as a mother for the time being. The aim is to create a calm atmosphere around the woman so that she can become aware of her new role as a mother within a psychotherapeutic treatment and can accept it for herself. She is all the more likely to do this if she learns a different approach to her baby.
“Mother-Child Play Therapy” and “Baby Massage” are one of many programs that put the mother-child relationship under a different light and thus strengthen it. Attempts to separate the child from its mother should be avoided, because this only increases feelings of guilt and alienation towards the child. In order to prevent the woman suffering from PPD from getting the impression of being stigmatized as mentally ill, she should not be admitted to a psychiatric clinic.
A treatment option within a hospital is better. Light therapy is primarily used for patients suffering from seasonal depression. Seasonal depression occurs mainly in the dark autumn and winter months and is triggered by the lack of daylight, among other things.Light therapy also shows some success with patients suffering from non-seasonal depression.
Straight one in the pregnancy in which a medicamentous treatment of the depression is made more difficult due to the risk for the unborn child, a light therapy can be thus a good idea for a therapy attempt. The effect of hormones such as estrogen on pregnancy depression is currently being investigated. There have already been indications that a transdermal (through the skin) administration of 200 micrograms of estrogen daily in PPD patients led to an improvement in mood.
To confirm this assumption, further studies must follow. Severe depression usually requires drug treatment with an antidepressant. However, these have been viewed with suspicion since the incident with thalidomide (a sedative), which, taken during pregnancy, caused malformations in the babies.
Even after birth, the use of psychotropic antidepressants has the disadvantage that the drug is detectable in breast milk and thus enters the baby’s body during breastfeeding. It is important that the doctor informs the patient about the chances and risks of psychotropic antidepressants. The psychotropic drugs of today (SSRI) have much fewer side effects than classic benzodiazepines or tricyclic antidepressants.
Infants tolerate the small amounts of serotonin reuptake inhibitors (SSRIs) well because the drug is below the detection limit in serum levels or in breast milk. Sertraline and paroxetine belong to the well-known SSRIs ́s. Sertraline is administered in a dosage range of 50-200mg, while for paroxetine 20-60mg is already sufficient.
The initial phase of intake can be accompanied by side effects such as restlessness, shakiness and headaches in the mother. The patient should be aware that always a small amount of the drug enters the child’s circulation through breast milk. The smaller the baby, the more difficult it is to metabolise the active ingredients of the medication.
In addition, the active ingredient accumulates in the CNS (central nervous system) to a greater extent than in children, because the blood-cerebrospinal fluid barrier in babies is not yet fully developed. In summary, it can be said that the effectiveness of psychotherapeutic treatment is much more productive than that of drug therapy. In difficult cases, where there is no guarantee for the safety of the mother and her child, it is not possible to do without psychotropic antidepressants. You can find more information about drug treatment under our topic: Antidepressants
