Expecting a child is usually one of the moments of joy and excitement. The dream of motherhood begins during pregnancy, with the idealization and expectations that will come with the birth of the baby. However, real life may turn out to be a little different from what was planned: the obligations and responsibilities on the mother increase, not to mention the see-saw of hormonal transformations that the process demands.
These sudden changes can have emotional consequences – it is estimated that between 20% and 25% of women will have postpartum depression and around 80% will experience the symptoms of the so-called baby blues. But, after all, what is the difference between them?
The baby blues are a set of feelings that almost every woman who has a child will experience. It is multifactorial and has symptoms that can be easily confused with depression, such as constant crying, sadness, oversensitivity, irritability and anxiety. The manifestations, however, are transitory and insufficient to cause harm to the woman, since they usually appear soon after childbirth and tend to disappear spontaneously within 21 days.
“People say that the baby blues is a moment for the woman to adapt to the new reality. From this perspective, we have to consider the sudden hormonal changes that occur at the end of the pregnancy and can generate some affective-emotional conflict. The baby blues manifests itself in in many ways and usually comes with sleep deprivation, physical exhaustion, difficulty breastfeeding, fear, guilt, insecurity and lack of control. But it is a completely transient phenomenon and recovery, in most cases, sometimes it is complete and without the need for pharmacological treatment”, says psychologist Damiana Angrimani, specialist in perinatal and parental psychology.
According to the psychologist, the baby blues makes the woman have emotional peaks that alternate between despair and enchantment with the baby.
Depression requires treatment
Postpartum depression, on the contrary, is more complex because it requires special care. The disease causes damage to women’s health, who will need specialized, prolonged medical follow-up and, most likely, associate psychotherapy with the use of medications.
Cases are more common in women who have a history of psychiatric disorders, such as anxiety, panic and depression, for example. Psychosocial risk factors can also interfere, such as not having planned the pregnancy; getting pregnant as a teenager; having an unstable relationship with the baby’s father; having problems at work (or being unemployed); having problems in family relationships, among others.
Most cases of postpartum depression intensify after the sixth week of birth, although symptoms can appear as early as the first few days after delivery and last for months. Manifestations include deep sadness, lack of interest in daily activities, insomnia, extreme tiredness, anxiety, loss of sexual interest, excessive weight loss or gain, feelings of incompetence, low self-esteem, social isolation and, in more severe cases, even ideation suicidal.
In addition to remaining for a prolonged period of time (postpartum depression does not disappear on its own like the baby blues), it also has another complicating factor, which is the lack of connection between the mother and the baby.
“Many women with postpartum depression can be completely operational in terms of caring for the baby, but without emotional and affective connection. It is as if she acted in a more mechanical way with the obligations with the baby, but with much less bond”, explained the psychologist.
First-time mother in the pandemic
Editor and writer Isabel Machado Branco de Souza, 31, mother of Kala, 3, was diagnosed with postpartum depression in 2020 and is undergoing medical and psychological treatment to this day. She says that since childhood she wanted to be a mother. When she became pregnant, she had a careful prenatal care and prepared for a normal and humanized delivery.
“When Kala was born, she came straight into my lap. I had the birth I had envisioned and the first few days were wonderful”, she says.
But adapting to the new motherhood routine in her life had a catch: Kala was born on March 18, 2020 – exactly in the week in which the government of the state of São Paulo decreed quarantine and complete social isolation as a result of the Covid-19 pandemic. 19. “For the first 30 days I cried every day,” she says.
The symptoms of depression began to appear, but the editor was not aware of the problem. Being a first-time mother and experiencing a pandemic, she thought they were part of the moment. As time went on, the symptoms got worse. The most intense crying spells came, the desire to die and the feeling of disconnection with the daughter, as if it were a rejection, in addition to the feeling of inability to care.
With encouragement from her husband, she went to the psychiatrist and was diagnosed with postpartum depression, associated with the prescription of medication. She also sought help from a group of women who were in the puerperium and began psychotherapy. The two processes, he says, were essential for her recovery.
“In eight months of treatment I think I achieved a significant improvement. And I came to understand that each woman has her time, her body, her story. Some recover faster, others don’t. My daughter is three years old and only now do I feel like a woman and a wife again”, she says.
Postpartum depression is a disease that can be prevented and treated, as long as there is adequate monitoring. Approaching pregnant women during prenatal care should include a good interview about personal clinical history with mental disorders and family members so that possible interventions can be made early.
“Many women feel this gap because motherhood is a huge change in life. It is a major milestone of change in a woman’s life – physical, psychic, emotional. The life before, no longer exists. The moment the baby comes out of the womb changes everything. But it is possible to prevent and treat”, says the psychologist.