Postpartum
Depression Anhang
[Amit Arora, Udesh Kumar]
Abbreviations: Postpartum depression (PPD)
Abstract: The birth of a baby brings new challenges for a mother. Sometimes
after the birth of the baby, the mother develops a mood disorder known as
postpartum
depression. This can have an adverse effect on maternal-infant bonding
and thus require special attention. Homoeopathic treatment with proper
emotional support and psychotherapy offers a solution to this complaint and
thus helps the mother to enjoy her motherhood.
Keywords: Depression, psychotherapy, talking therapy, baby blues
homoeopathy, organon, repertory
Introduction
The birth of baby brings many changes in the life of the woman. It is
associated with a flood of emotions that ranges from excitement and joy of
having a baby and
being a mother to fear and anxieties for care of the baby. But sometimes
it results in something unexpected, and that is depression.
Adjusting to being a new mother can be stressful. The newborn needs lot
of care and for this it is mainly dependent upon the mother. All the priorities
of life of a woman
shift toward her baby after birth. It seems as if her world is only the
new born.
She is full of emotions, excitement and joy but sometimes because of
constant overwork, lack of social life, (as she needs to take care of the baby
at home) and anxieties related to care of the child, she experiences mood
changes like sadness, irritability, crying spells, trouble sleeping, poor
appetite.
These changes may be short lasting and gradually they become better. These
are termed “Baby Blues” and without treatment they disappear spontaneously. But
when these changes become long lasting, severe and interfere with the mother’s
ability to handle the newborn, it requires special attention, as these can be
signs of “postpartum depression”.
Postpartum Depression
It is a type of mood disorder which appears in some women after
delivery. It commonly appears within 6 weeks after childbirth but may begin up
to 1 year after birth.
Signs and symptoms
Characteristic features of PPD includes mood swings, excessive crying,
indifferent to baby, lack of social interaction, indifferent toward family,
inability to sleep, fatigue,
lack of interest in routine activities of activities which she used to
enjoy, intense irritability with the child or family members, anger,
hopelessness, helplessness, guilt feeling that she is not a good mother or
wife, severe anxiety or panic attacks and inability to handle the new born.
Causes and risk factors: There is no specific cause of PPD but physical
and emotional factors may play a great role.
Hormonal: Pregnancy and
delivery is the time when hormonal levels vary greatly. During pregnancy there
is surge of oestrogen and progesterone hormones and after delivery their levels
decline drastically and there is an increase in oxytocin. The drastic changes in these
hormones contribute to PPD. After childbirth, the activity in the amygdala
nuclei (a set of neurons located deep in the medial temporal lobe) increases. It
has receptors for the oxytoxin. The greater the response of the amygdala, the
more
the mother feels affection for her baby and understands the needs of the
baby by the baby’s cries. It has been
seen that symptoms of PPD are associated with
lesser
amygdala response.
Emotional: The newborn is
completely dependent upon his mother for all his needs. He needs constant care
and affection. As a result of that, sleep deprivation and anxieties about
health develop in the mother. Also, she becomes conscious of her body image,
her social life declines, she struggles for her identity, her career halts as
she may needs to take leave from a job. There may also be lack of support from
other family members. All these factors may contribute to PPD.
History of depression after
previous pregnancy.
Family history of depression.
Unplanned pregnancy
Medical complications after childbirth
may also lead to PPD.
General Management: In order to treat PPD, we need to understand the
mother’s emotions. She is going through a changed phase of life with new
responsibilities.
She needs love, care and family support, so that she does not feel
isolated and can find time for herself also.
The following changes may help her in dealing with depression
Include physical activity like
walking with your baby in a natural environment like in park.
Keep social life active. You
also need time for yourself. Interact with your friends.
Do not pressure yourself with
household chores.
Take a healthy diet. Include
fruits in your diet. There is positive relationship found between healthy diet
and healthy mind. Research shows people who eat fruits, vegetables, whole grain
are less likely to have depression.
You can join different groups
of mothers on social media and can share your concerns with them.
Bring in yourself a sense of
acceptance.
Follow your hobbies. Do what
makes you feel joyful. Spending time on an activity that you enjoy can improve
your mental health and wellbeing.6
Homoeopathic approach in PPD
Homoeopathy with its holistic approach proves to be one of the effective
systems of medicine for dealing with cases of PPD. Dr. Hahnemann, the Father of
homoeopathy
was well versed with mental disorders.
In Organon of Medicine, he has clearly defined how to take the case, the
origin and treatment of mental disorders and their management (from aphorism
210-230).
The detailed case taking as defined by Dr. Hahnemann clearly describes
the need to understand the patient’s feeling, her emotions and her
circumstances and factors that derange health.
The patient needs to talk in detail about her feelings (as defined in
aphorism 84), This individualizing concept of homoeopathic case taking is
similar to a psychotherapy
known as “talking therapy” where a patient can talk about her feelings
and thought and relieve her stressful emotions.
In aphorism 94, it is clearly mentioned that the physician should try to
enquire the circumstances which have made the patient sick. The physician
should enquire about the patient’s mode of living, diet, and her domestic circumstances.
Understanding of circumstances that are causing disease will help the
physician in to counsel the mother as well as her family members.
Aphorism 226 is related to the concept of psychotherapy. It states that
display of confidence, friendly exhortations, sensible advice and appropriate
diet and regimen help the patient to achieve a healthy state of mind.
Thus, the subjective and objective understanding of the case along with
the consideration of underlying causes helps in selection of the simillimum.
Miasmatic analysis of PPD
In Organon of Medicine, aphorisms 210, 222 and 228, mental diseases are
said to be of Psoric origin and are to be treated with antipsoric medicines.
Commonly used homoeopathic medicines:
Remedies which are often indicated in treatment of PPD are:
Sepia officinalis: Diseases of
women; especially those occurring during pregnancy, childbed and lactation or
disease attended with fatigue. Great sadness and weeping. Indifferent, even to
one’s family, one’s occupation, to those whom she loves most. Indolent and does
not want to do anything, either work or play. Irritable, easily offended.
Psorinum: Hopeless, despair of recovery.
Melancholy, deep and persistent. Anxious, full of fear. Very depressed, sad,
suicidal thoughts.
Lilium-t.: Profound depression of
spirits, can hardly avoid weeping. Indifferent about what is being done for
her. Anxious about disease. Fears insanity. < Consolation.
Actea spicata: Puerperal mania,
thinks she is going crazy. Great depression with dream of impending evil.
Ignatia amara: Changeable mood,
silently brooding. Melancholic, sad and tearful. Sighing and sobbing. Not
communicative. Desire to be alone.
Anacardium orientalis:
Sadness after delivery. There is anxiety, apprehension, and fear of approaching
death. Fear and mistrust of the future, with discouragement and despair. Fixed
idea that there is no reality in anything, all appears like a dream; delusion
that her husband is not her husband, her child is not hers. Gets offended
easily.
Pulsatilla pratensis: Fear
of being alone. Weeps easily; almost impossible to detail her ailments without
weeping. Easily discouraged. Silent mood; inclined to silent grief; submissive.
Mania from suppressed menses.
Lachesis: Mental dejection and
melancholy. Looks upon the dark side of everything, and thinks she is
persecuted, hated and despised by acquaintances. Sadness when awaking in the
morning. No desire at all to mix with the world. Sadness and disgust to life.
Loquaciousness. Women who have never recovered from changes of life,
“have never felt well since that time.”
Platina: Sadness, especially
in the evening, with strong inclination to weep often. Thinks she stands alone
in the world. Anxiety with great fear of death. Pride and self-conceit, with
contempt for others, even for those who are usually most beloved and respected.
Impulse to kill her own child and husband.
Phosphorus: Weary of life, full of
gloomy forebodings. Melancholy sadness, sometimes with violent weeping. Great
apathy; very sluggish; dislikes to talk; answers slowly
or not at all. Hypochondriacal sadness. Disgust for life. Great
indifference to everything, and even to patient’s own family.
Veratrum album: Melancholy with
stupor and mania. Sullen indifference. Melancholy dejection, sadness, and
inclination to weep. Inconsolable affliction, with howling and crying, imaginary
misfortune. Discouragement and despair, hopelessness of life. Cannot bear to be
left alone; yet persistently refuses to talk.
Natrum muraticum: Depressed.
Irritable, gets a into passion about trifles. Marked disposition to weep
without cause and consolation from others aggravates her troubles.
The repertorial approach provides a better solution in homoeopathy to
reach the simillimum in a particular case of PPD. The repertorisation of the
following symptoms from Synthesis Repertory gives a group of remedies, from
which the simillimum can be selected on the basis of individual characteristic
symptoms related to constitution, mental generals, modalities, sensation and
concomitants in a particular case.
Conclusion
If after childbirth a woman feels low mood, social isolation,
irritability, sadness and is unable to handle the newborn, she should openly
share these symptoms with her doctor, so that early diagnosis can be made and
proper treatment can be started if required. Homoeopathic treatment, proper
counseling and general management can help the new mother to overcome PPD and
enjoy her motherhood.
Vorwort/Suchen Zeichen/Abkürzungen Impressum