How do psychiatrists treat postpartum psychosis? Psychosis and neurosis in women after childbirth: causes, symptoms and diagnosis

is an acute mental disorder that develops in the first weeks after childbirth. Manifested by depression, insomnia, confusion, delusional ideas about the incurable illness of the child, delusions of persecution, hallucinations. The behavior of the patients becomes inadequate: they refuse to care for the newborn, harm him, and attempt suicide. Diagnosis is carried out by a psychiatrist, the main methods are clinical conversation and observation. Medical treatment, antipsychotics, antidepressants, tranquilizers are used. When the condition improves, sessions of psychotherapy and family counseling are introduced.

ICD-10

F53.1 Severe mental and behavioral disorders associated with the puerperium, not elsewhere classified

General information

Postpartum psychosis is also called postnatal. This disorder was first described by Hippocrates in 460 BC. e. Its origin was explained by large blood loss during childbirth. More accurate studies date back to the middle of the 19th century. French psychiatrists J.-E. Esquirol and L.-V. Marse described the psychoses of young mothers as the consequences of severe somatic complications of childbirth. Currently, the prevalence of psychotic disorders has decreased significantly. In economically developed countries, their frequency is 1-1.2 cases per 1,000 women who gave birth no more than 3 months ago. The peak incidence is observed within the first 30 days after the birth of a child.

The reasons

Official data confirm that more than half of women with postnatal psychosis have mental disorders (schizophrenia, depression, MDP) or a hereditary predisposition to them. The exact causes of the pathology are unknown, but several groups of triggers have been identified - factors contributing to its debut:

• Complications of pregnancy, childbirth. An acute psychotic state is often caused by the death of a newborn, premature birth, threatened miscarriage. The association of the disorder with massive blood loss and sepsis, revealed in ancient times, is confirmed.
• Hormonal disorders. The end of pregnancy is always associated with a change in the level of hormones in a woman's body. Mental disorders develop on the basis of a sharp decrease in the synthesis of progesterone, estrogen, thyroxine.
• CNS damage. Psychosis often occurs with neurological diseases, after brain injuries, neuroinfections, intoxications. Sometimes the disorder is provoked by the use of scopolamine in combination with lidol for pain relief in childbirth.
• Anxious personality traits. Women with high emotional tension, low adaptive abilities, and a tendency to predict failures are more prone to depression and the formation of delusional ideas. The process of childbirth becomes a stressful situation for them, triggering a mental disorder.
• Unfavorable psychosocial environment. Risk factors are unwanted pregnancy, rejection of the child by the mother, financial difficulties, unsettled life, divorce from a spouse. Psychoses are often diagnosed in parturient women leading an asocial lifestyle (drug addiction, alcoholism, prostitution).

Pathogenesis

According to the mechanism of origin, postpartum psychosis is reactive. It develops in response to a traumatic event - childbirth. It is based on the experience of fear of death, violation of the integrity of one's own personality, restriction of freedom, lack of love of others (shift of attention from a woman to a child). An unfavorable background for the onset of psychosis is psychophysiological asthenization - depletion of energy, a decrease in resistance to stress factors. There comes a state of decompensation of nervous adaptive mechanisms.

At the neurophysiological level, there is a violation of reciprocal inhibitory interactions between the cortex and subcortical brain structures, between the anterior and posterior hypothalamus - the highest centers of regulation of autonomic functions and emotions. The balance of activation of the sympathetic and parasympathetic nervous system, the ratio of the main neurotransmitters (serotonin, norepinephrine, dopamine, GABA) change. According to psychodynamic theory, postpartum psychosis results from a conflict between the mother's real desires and the situation of motherhood.

Symptoms of postpartum psychosis

Psychosis begins to manifest 2-3 days after the completion of childbirth, when a woman is aware of the changes that have occurred in her life. Symptoms may develop gradually or rapidly. Initially, there is insomnia, anxiety, restlessness, fatigue, fatigue. The emotional background is stably reduced. Then suspicion and alertness begin to grow. Overvalued ideas are formed about the state of the child's health, about the presence of diseases in him or in himself. Consciousness becomes confused, speech - abrupt, illogical.

Suspicion is constantly increasing. Often, mothers closely monitor the newborn during sleep and feeding, examining him, listening to his breathing and heartbeat, revealing imaginary incurable, fatal diseases. Patients begin to accuse doctors and close relatives of being indifferent to the condition of the baby, of deliberate unwillingness to treat him. Secretly from those around them, they give him various medicines, carry out “procedures” that can cause real harm (dip in cold water, leave him without clothes and diapers).

In another version of the course of psychosis, mothers lose interest in babies, do not show care and love. Overprotection turns into a feeling of hatred. Delusional thoughts are expressed about the substitution of the child, the infusion of evil spirits, demons into him, about the imminent inevitable death. In severe cases, auditory hallucinations are noted. Voices urge women to kill a newborn, attempts are often made to strangle him. Throughout the disease, the criticism of patients to their condition is disturbed - delusions and hallucinations are not recognized, they are not regarded as pathological.

Complications

Without timely diagnosis and treatment, postpartum psychosis is a danger to the life, health of the baby and mother. On the basis of hallucinations and delusions, inappropriate behavior is formed - patients try to commit suicide, having previously killed the baby. There are known cases of strangulation, falling from a height of a woman and a newborn. With a sluggish psychotic process, when indifference and detachment gradually increase, the child does not receive sufficient emotional and sensory stimulation, lags behind in physical and mental development, and suffers from neurotic disorders from an early age (enuresis, nightmares, phobias).

Diagnostics

Postpartum psychosis presents with classic signs of acute psychopathology, so making an accurate diagnosis can be difficult. An important role in the process of identifying the disease is played by the patient's relatives, it is they who most often pay attention to changes in the behavior and emotional reactions of a young mother. Professional diagnostics is performed by a psychiatrist, in addition, pathopsychological, gynecological and neurological examinations may be required to differentiate postnatal psychosis from schizophrenia, bipolar affective disorder, depression, hypothyroidism, Cushing's syndrome. Specific diagnostic methods include:

• Collection of anamnesis. The doctor examines medical documentation about the course of childbirth and pregnancy, finds out the presence of a hereditary burden for mental disorders, the patient's existing psychiatric diagnoses, postpartum depression, psychosis after previous pregnancies. The material and living conditions of life, the presence of a spouse, the patient's attitude to conception, pregnancy, and the birth of a child are taken into account.
• clinical conversation. In direct contact with the patient, the psychiatrist evaluates the productivity of contact, the purposefulness of thinking and speech, and the logic of reasoning. With a psychotic disorder, women express delusional ideas in detail, are concentrated on their own experiences, and do not always answer in accordance with the questions of a specialist.
• observation. During the conversation, the doctor observes the behavior and emotions, determines their adequacy, the safety of arbitrary control, motivation. Psychosis is characterized by alertness and distrust, inconsistency of reactions to the examination situation, the predominance of dysphoric and / or depressive affect, and the absence of a critical attitude towards one's behavior.

Treatment of postpartum psychosis

Therapy of an acute condition is carried out in a hospital setting. Quite often, women are sent to psychiatric departments and neuropsychiatric dispensaries from the maternity hospital. At the time of intensive treatment, the child is separated from the mother, entrusting care to close relatives. Comprehensive assistance includes the following areas:

• Pharmacotherapy. At the acute stage of the disorder, the main task is to relieve psychotic symptoms. Neuroleptics, normotimics, tranquilizers, antidepressants are prescribed. For the period of taking medications, it is necessary to exclude breastfeeding by choosing artificial mixtures for feeding the child.
• Psychotherapy. After the elimination of the symptoms of psychosis, a period of awareness of the patient of her actions, feelings, and the presence of the disease begins. This provokes depression, guilt and self-hatred. To stabilize the emotional state and correct negative attitudes, cognitive-behavioral techniques and psychoanalysis are used.
• Family support and rehabilitation. The support of loved ones and the correct organization of the daily routine are important. Relatives organize round-the-clock monitoring of the patient, perform baby care procedures together with the mother. It is important to spend time with a young mother, talk, distract from painful thoughts, control the regular intake of drugs prescribed by a psychiatrist.

Forecast and prevention

Postpartum psychosis has a favorable outcome, subject to successful recovery from depression, support from loved ones, and the absence of mental illness. Prevention is based on the correct physical and psychological preparation of a woman for pregnancy and the process of childbirth. Expectant mothers need to pay attention to planning to minimize the risk of complications. It is recommended to attend courses in childcare skills, master breathing and relaxation techniques in childbirth, share your experiences with your husband, parents, close friends, and if you have severe anxiety, seek help from a psychologist.

Description and characteristic manifestations of postpartum psychosis. How to deal with such a pathology. Basic methods of treatment.

What is postpartum psychosis?

Such a painful condition occurs in no more than two out of a thousand women in labor. Women who have their first childbirth are subject to postpartum psychosis 35 times more often than those who give birth again.

Having not really recovered from childbirth, the young mother becomes tearful, complains about general weakness, poor sleep. Constantly worried that she has little milk or may disappear altogether, then the child will remain hungry. It begins to seem to her that something hurts there, for example, his tummy, which is why he screams so much.

Groundless care leads to an excited state, fussiness. Suspiciousness develops, crazy ideas appear when it may seem that she has given birth to an unhealthy child or he will be taken away. Then suddenly she has a sharp mood swing: she becomes melancholic, dull - she falls into a stupor. The breakdown is accompanied by a loss of all interest in the child. Does not want to breastfeed him, refuses to take care of him.

When such symptoms appear even in the maternity hospital, doctors immediately try to stop them, prescribe a certain treatment to bring the woman in labor back to normal. Only after that they are discharged. It is much worse when postpartum psychosis develops at home. If the family did not notice the strangeness of the young mother in time, this could end badly for her, the newborn, or both together. There have been cases when the mother committed suicide with the baby.

Or here is such a case. A woman is holding a baby in her arms. Suddenly, something came over her: delusional thoughts appear, voices are heard that this is not her baby, he was thrown. In a confused mind, she screams loudly and throws the child to the floor. There is no need to call an ambulance and a psychiatric hospital here. Treatment may take a long time. The baby in such cases remains with someone close, this places a heavy burden on the family.

It is necessary to distinguish postpartum psychosis from depression, when, after childbirth, sad thoughts appear that the former carefree life is already in the past. As a rule, such a mood passes quickly, a woman understands that motherhood imposes a responsibility on her - taking care of a newborn.

The main causes of postpartum psychosis

Let's consider all these cases in more detail. Causes of postpartum psychosis can be:

• genetic predisposition. When, in the female line, one of the relatives suffered from mental illness, for example, schizophrenia.
• Affective insanity. Characterized by rapid mood swings. Despondency is replaced by elation, and vice versa, a cheerful mood is replaced by sadness.
• birth canal infection. During childbirth or in the postpartum period, staphylococcus aureus is introduced - bacteria that cause painful processes in the body of a woman in labor. Body temperature rises, tachycardia and muscle pain appear, mucous membranes dry. This provokes anxiety. The result is psychosis.
• Heightened emotionality. One of the factors in the development of postpartum psychosis. It can manifest itself in women who have not previously had mental disorders, but are very emotional, for example, during menstruation.
• Alcohol, drugs, psychotropic drugs. Abuse of alcohol, drugs and certain drugs that stimulate the central nervous system can cause the disease.
• Trauma during childbirth. Injuries caused by an oversight of the medical staff taking delivery can lead to a health disorder for the woman in labor, stress, when gloomy thoughts and moods appear.
• Hormonal shifts. The birth of a child is a big burden on a woman's body, which leads to its significant restructuring. Biologically active substances, hormones, regulate the rhythm of life processes, hormonal disruptions lead to serious illnesses, including mental ones.
• Fatigue. Chronic fatigue during pregnancy has a bad effect on mood and can be a factor that caused postpartum psychosis.
• Unsuccessful birth. Severe, with great loss of blood when a miscarriage occurs or a stillborn child is born.
• Various diseases. A diseased liver, high blood pressure, and other chronic ailments can trigger postpartum mental illness.
• Head injury. If this was during pregnancy, it is more likely that during difficult childbirth or after them, the mental health of the woman in labor will become upset.
• Unpreparedness for childbirth. A woman is not psychologically ready to become a mother. He does not understand that childbirth is a serious restructuring of the body, a completely new period of life. She is afraid of motherhood. This depresses the psyche, leads to a nervous breakdown and mental illness.
• Unhealthy family relationships. She was discharged from the maternity hospital, and her husband is not happy with the child, behaves rudely, does not care about the newborn. The woman is nervous, begins to scandal, her milk disappears. This condition can lead to psychosis.

Characteristic manifestations of postpartum psychosis

Warning factors in the behavior of a woman after childbirth can be as follows:

1. mood swings. When unreasonable gaiety, vanity, anxiety, that the child is poorly looked after, he is hungry, gives way to a gloomy mood and complete indifference. Often a young mother becomes anxious and suspicious, she has ridiculous thoughts, for example, that the child was replaced in the maternity hospital, she refuses to feed and care for him.
2. Loss of vitality. Difficult childbirth affected health. A weakened body struggles with its sores. This affects the mood. There is a feeling of anxiety, depression, causeless irritation, when a woman can scream at loved ones. All around seem to be enemies. Even your own child is not cute. Life looks dark and uncomfortable.
3. Insomnia. The woman complains that she constantly has nightmares, often wakes up at night or does not sleep at all. As a result of this, nervous, confused thoughts and speech, an incomprehensible anger arises at your baby. In this state, auditory and visual hallucinations develop. A young mother is practically unable to care for a child and even poses a danger to him.
4. Refusal of food. After giving birth, taste sensations disappeared, appetite disappeared, food became disgusting, in the hospital they were forced to eat a bowl of soup by persuasion and almost by force. This indicates that the woman does not adequately perceive reality, she has an unclear mind, which may mean the development of postpartum depression.
5. Ambiguous attitude towards the child. It can be exaggeratedly attentive to the point of lisping, when a newborn mother constantly shakes and kisses, or complete indifference to him. Suppose a child screams, demands attention, and this only causes anger.
6. paranoid thoughts. When after childbirth there is suspicion and distrust of others. All the time it seems that even loved ones are up to something bad, so you should not trust them. The attitude towards the born baby can be twofold. It seems to other women in labor that not everything is fine with him, he is in danger. All the time trying to save him from an invisible enemy. Some are disgusted with the newborn, because it seems that they did not give birth, they just threw someone else's child, so you should not take care of him.
7. Megalomania. A previously quiet, modest woman after childbirth suddenly began to overestimate her own capabilities. The birth of a child seems to her such an incredible event that everyone around her must bow before her. This is already an occasion to take a closer look, perhaps a woman in labor should be shown to a psychiatrist.
8. Suicidal thoughts. After childbirth, a woman becomes angry, starts scandals for every reason, and sometimes for no apparent reason. In fact, she has fear in her soul, fear of everything new that lies ahead with the birth of a baby. Gloomy thoughts fill the whole being, pushing to suicide. Often she decides to take this step together with the child.

It's important to know! Any of these symptoms indicates that the young mother should be shown to a psychiatrist. Otherwise, such odd behavior ends very sadly.

Treatment options for postpartum psychosis

In severe cases, postpartum psychosis is treated in a psychiatric hospital. It can take from one to two months to a year. To achieve the result, fixing therapy is carried out by a psychotherapist. Already at home, the patient needs careful care. Only in this case it is possible to speak with confidence about a stable positive result. Consider all the methods of therapy.

Treatment of postpartum psychosis with medications

To stop a mental disorder (delusions and hallucinations), neuroleptics of the latest generation are used. They are prescribed as prescribed by the attending physician in tablets or administered intravenously. These are potent drugs that have a sedative and hypnotic effect, improve memory, brain activity. These include Aminazine, Clopisol, Triftazin, and many others.

Antidepressants help relieve depression. A large group of such drugs includes Amitriptyline, Fluoxetine, Pyrazidol, Melipramine, and other antidepressant drugs.

To improve mood, mood stabilizers can be prescribed - mood stabilizers, for example, lithium salts (Kontemnol) or valproic acid (Depakine). All these drugs must be taken for a long time. As a maintenance treatment, it is recommended to take at home.

Along with medical treatment, patients are shown physiotherapy. These are massage, various water, electromagnetic procedures. In exceptional cases, an electric shock is prescribed.

It's important to know! Long-term use of drugs can cause unwanted side effects, such as tachycardia, heaviness in the stomach, dry mouth. But so far, medicine is not able to offer anything better.

Psychotherapy for postpartum psychosis

At psychotherapeutic sessions, the psychotherapist helps the patient to realize what happened to her, and suggests how best to get out of this state, what should be done so that this does not happen in the future.

Truly maternal care for a child - such a psychological attitude helps a woman tune in to a “healthy wave”: not to reject her child and endure all the hardships of family life, naturally, not forgetting about her health.

It's important to know! According to statistics, up to 75% of women in labor successfully cope with their mental disorders after childbirth. This is the great merit of psychotherapeutic procedures.

Support of loved ones

In no case should a young mother be left alone with a newborn! In the event of a recurrence of the disease, it can harm him. Let's say, accidentally or on purpose, drop it, leave it open in a draft. The husband will have to deal with the baby more, it’s good if someone close to him can help him.

A calm atmosphere should reign in the family so as not to provoke a woman to an emotional outburst. Quarrels cause nervous excitement, and this is a direct path to the return of psychosis.

Medications should be monitored. If she says that she is already well and no longer wants to take pills, this is her subjective opinion. Only the attending physician can cancel the drugs. And this means that for a long time the woman will be registered in a psychiatric dispensary. Family members should be sympathetic to this.

It's important to know! The support of her husband and loved ones is a guarantee that a young mother will forget about her postpartum stress and quickly return to normal life.

In the first days after childbirth, some women may experience a rare mental disorder - postpartum psychosis. The disease is severe, but treatable. It is important to recognize the signs of an incipient disorder in time. Moreover, it can be a big surprise for relatives, appearing suddenly. Although gradually developing psychosis is difficult to recognize immediately.

Postpartum psychosis is a rare mental disorder that usually occurs in the first 2-4 weeks after childbirth. With timely diagnosis and rapid initiation of therapy, a woman can get out of this rapidly developing condition in just a few weeks, and with a late diagnosis, recovery can be delayed for months. Often a woman suffering from postpartum psychosis is not aware of her painful condition. Source: Wikipedia

Causes of the disease

Little is known about the causes of the disease. Doctors are inclined to believe that a sharp hormonal restructuring of the female body in the postpartum period can provoke the development of psychosis, complications during childbirth, emotional stress from the birth of a child. The constant lack of sleep, severe fatigue of the mother can also serve as an impetus.

Women whose relatives had postpartum psychosis, as well as women with a history of bipolar depression or schizophrenia, are more at risk of getting sick. If a woman has already been diagnosed with postpartum psychosis after the first birth, it is likely that it will recur after the second pregnancy.

The use of drugs before pregnancy can provoke the development of psychosis.

Everyone who has a high risk of getting sick should definitely consult a psychiatrist in order to minimize the likelihood of the onset of the disease.

Fortunately, postpartum psychosis is much less common than postpartum depression - it develops in approximately 0.1% of women in labor.

Signs of postpartum psychosis

Contact a psychiatrist immediately if you notice the following symptoms in a woman who has recently given birth (literally in the first days after childbirth):

• The woman becomes distracted, cannot express her thoughts clearly. Periods of talkativeness are replaced by unwillingness to communicate;
• Aggression or euphoria alternate with depression, and mood changes occur quite abruptly;
• Changes in the perception of taste and smell. It is even possible to refuse food;
• Insomnia. If a woman's sleep is disturbed, she does not want to go to bed, this should also alert loved ones. She may develop delusions and visions, auditory hallucinations;
• A woman has obsessive ideas, it seems to her that the baby is in danger, they want to take his life, kidnap him. She does not let anyone near the child, refuses to talk to people, is afraid to go outside;
• Or vice versa, the child becomes hated by the mother, she can even try to kill him. And can show him complete indifference. The same attitude can be with people close to her.

The woman herself does not understand that she is sick, completely inadequate, so her relatives should take care of her and show her to a psychiatrist.

This disease needs to be taken seriously. After all, a sick person, not receiving the necessary treatment, can not only harm herself and the child, but also deprive herself and his life.

Treatment

At the first suspicion of a disease be sure to consult a psychiatrist. He will examine the patient, prescribe the necessary treatment for her.

Most often, a sick woman is admitted to the hospital. If the clinic has conditions, then the baby is next to the mother. Basically, there are no such wards in the hospital, so the baby is at home with one of his relatives. If the child is with his mother, then it is forbidden to breastfeed the baby during treatment, because his mother receives strong antipsychotic medications, various mood stabilizers (normothymics).

Usually the patient's condition after a couple of weeks improves so much that she can be discharged home for aftercare. A full course of treatment can last from six months to a year.

A lot of strength and patience will be required from relatives and friends:

• It is necessary to provide a sick mother with comfortable conditions conducive to recovery: peace, the opportunity to have more rest;
• Most household chores will have to be taken over by the husband and other family members;
• During the course of treatment, one of the relatives should take care of the baby, while the mother herself cannot do this yet;
• Temporarily limit meetings at home with friends - it's not the time for guests yet.
• Try to morally support the woman, talk to her calmly, kindly, without blaming her for what happened. Indeed, in what happened, the fault of the woman herself is not;
• If possible, do not leave her alone;
• Monitor medication intake, doses and timing;
• Get a full 8 hours of sleep.

Effects

If you do not start treatment on time, the consequences of a formidable disease can be deplorable. Being in a state of psychosis, a woman does not control her actions, is a prisoner of obsessions. There are cases when a mother who had just given birth, not receiving timely treatment and being in a manic-depressive state, made suicide attempts. And not all of them, unfortunately, were prevented.

A friend of mine who has had postpartum psychosis recalls that time as if it were a nightmare. She had a premature, difficult birth, obviously, this contributed to the development of the disease.

She says that she suddenly became irritable, shouted at everyone, everyone suddenly became enemies. I even got into a fight with my mother-in-law. She wrote some slurred, incomprehensible notes. Everything around him became alien, life seemed over. It seemed to her that her vitality had left her. The taste is completely gone. Because of this, she refused to eat in the hospital. She was force-fed with a spoon. She doesn't remember how she ended up in the hospital. The treatment was delayed for six months.

Three years have passed, and she and her husband want a second child. That's just a friend is afraid of a recurrence of the disease. Therefore, she and her husband turned to a psychiatrist who treated her. Now the woman is following all the recommendations of the doctor and hopes that the terrible disease will not happen again.

If it was not possible to avoid the disease, and postpartum psychosis nevertheless manifested itself, do not despair. Remember - life goes on. It is very important to be attentive to a woman who has recently given birth. Take care of her, help with household chores. Surround her with love. To give mommy the opportunity not to be overloaded, to rest more often. And then the formidable illness will recede and will be remembered simply as a severe nightmare.

What you need to know about postpartum depression –

After the birth of a child, sometimes a woman becomes nervous, refuses to go out, constantly worries about her baby and is even afraid to let anyone near him. This condition is called postpartum psychosis.

This is a fairly rare mental disorder that occurs in young mothers who have experienced difficult childbirth. A feature of the postnatal symptom may be that in the process of manifestation of the disease, a woman reveals some mental abnormalities that do not manifest themselves before pregnancy. Often it is, a little less often, schizophrenia.

Who is at risk and why?

The reasons for the development of postpartum psychosis in some women have not been fully studied until now, but there are such factors predisposing to the appearance of the disorder:

• difficult childbirth (in some cases - pregnancy);
• large blood loss during the birth process or sepsis;
• hereditary predisposition;
• the future mother has mental disorders even before pregnancy.

Based on the factor that provoked the occurrence of postpartum psychosis, its varieties are distinguished:

• manic-depressive;
• depression after childbirth;
• schizophrenia;
• mixed schizoaffective state.

What does a typical patient look like?

After discharge from the hospital, a woman with postnatal psychosis is already a little depressed and unbalanced. She may refer to a child. indifferent or express dislike. The attitude towards everyone around also changes dramatically. Not listening to the maternal instinct, a young mother may ask her relatives to take her child to a baby house, claiming that she is not able to raise and educate him.

There is also a radically opposite situation, when a woman takes care of the baby too much: she worries for no reason, looks for non-existent diseases in the baby and tries to cure them, not listening to specialists who say that everything is in order with his health.

Such a patient does not allow absolutely anyone to see the baby, she is constantly afraid that the child will get sick and die.

Features of symptoms

Postpartum psychosis can be mild or severe, the main symptoms of any of them are the following:

Giving help

The selection of medications for the treatment of postnatal psychosis is carried out depending on the symptoms of a mental disorder.

During the treatment of postpartum psychosis in women, the following may be prescribed:

• to save the patient from delirium and hallucinations (,);
• , capable of eliminating a depressive state ( , );
• helping to make the patient's mood stable (sodium valproate,).

In exceptional situations, electroconvulsive therapy is used.

If a young mother has any other diseases, it is necessary to carry out their therapy in parallel so as not to aggravate the course of the disease.

What should relatives do?

The main thing that is required from relatives is to be there in time and give a woman who is faced with a postpartum mental breakdown their love, support and care.

If a woman suffers from this disease and behaves inappropriately, aggressively towards her baby, it is necessary to isolate her.

It is extremely important that at this moment there is always a person nearby who controls her actions. If a woman tries to accept attempts to harm herself or others, she will have to urgently call an ambulance for psychiatric help.

In cases where the patient takes medication to eliminate the symptoms of the disease, you will have to make sure that the baby switches to artificial feeding.

Possible dangers

If postnatal depression often goes away on its own, without consequences for the body, then postnatal psychosis is a great danger.

If therapy is not started on time, postpartum psychosis can have irreversible consequences. The most terrible of them is that a sick woman can harm herself, as well as her baby. There were cases when, after childbirth, women and girls tried to commit suicide or take the life of a newborn child, absolutely not realizing their actions.

Forewarned and armed

In order to protect herself as much as possible from possible postpartum mental and psychological problems, a woman needs to prepare for childbirth both physically and psychologically even during pregnancy.

It is recommended to enroll in courses for expectant mothers, where the pregnant woman will be taught the correct breathing technique and care for the unborn baby. Also, these courses provide an opportunity to communicate with women who have already taken place as mothers, and to the maximum tune in to the upcoming appearance of their own baby.

Experts note that those women who take courses for future mothers significantly reduce the risk of postpartum psychosis, because they prepare in advance for the difficulties of motherhood.

Pregnant women who are at risk of developing the disease are advised to consult a psychotherapist for prevention purposes. This will help minimize the risk of its occurrence.

The above prevention methods are extremely important, because until today there is no one hundred percent method for preventing postnatal mental failures.

In addition, you should always listen to your doctor, avoid emotional upheavals, and provide the body with proper sleep and rest.

If a woman is at risk of developing a disease, it is better to warn the father of her unborn baby about this in advance. This will help him be mentally prepared, provide his support in time and seek help from competent doctors if postpartum psychosis overtakes his wife.

Childbirth is a colossal stress for the body, physical overload for organs and systems. The postpartum period has many difficulties for a young mother: the formation of lactation, rapid involution (reverse development) of the reproductive organs, restructuring of the endocrine glands, painful sutures and ruptures, and the consequences of blood loss. After a natural childbirth or a caesarean section, a woman feels weak and tired. But she does not have the opportunity to rest, relax, recover: a baby requires maximum attention and care 7 days a week, 24 hours a day.

Lactation depletes the mother's body, valuable nutrients and biologically active substances are excreted from the body with milk. A young mother is forced to follow a strict diet, to deny herself her favorite dishes. She feels an increased responsibility in connection with motherhood. A woman may not get enough sleep for a long time; not be able to lead a normal life: meet friends, devote time to your appearance, travel; forced to forget about their own desires and needs for the good of the child. The kid is not yet able to appreciate all the mother's sacrifices: he cries, is naughty, sometimes falls into hysterics. All these factors negatively affect the state of the nervous system of a young female body. If the health is strong, the psyche is stable, then there are no problems. Otherwise, postpartum neurosis develops, which, if the situation worsens, can develop into psychosis.

Previously, in maternity hospitals, a separate stay of the mother and the newborn was practiced. The woman had the opportunity to recover after childbirth, take care of her well-being and hygiene, get enough sleep, and calmly communicate with relatives. Now co-habitation is practiced. The baby is brought to the mother a few hours after natural childbirth. Milk arrives only for 2-3 days, before that, babies may experience hunger and scream and cry for a long time.

Important! If a woman in labor feels overwhelmed and tired, it is better to temporarily entrust the newborn to nurses who will bring it only for feeding.

There is no need to be afraid of the condemnation of others, the child needs a healthy and full of strength mother. Nervous strain leads to sad consequences, and the mother's neurosis and psychosis affect the health and development of the baby.

Classification of neuroses

There are the following clinical forms of neurosis:

1. neurasthenia - increased irritability against the background of weakness and fatigue;
2. hysteria, the condition is accompanied by violent external reactions: screaming, tears, tantrums, a desire to cause physical pain to loved ones;
3. obsessive-compulsive disorder is characterized by anxious thoughts, obsession, fears, behavioral disorders, inadequacy in actions.

Most of the neuroses are mixed. Often a young mother cannot critically assess her condition and admit her illness. Only the attentive attitude and support of family members helps to cope with neurosis, which, with timely correction, is a reversible condition.

Features of the course of neurosis after childbirth

The main symptoms of postpartum neurosis: increased anxiety, fear, sleep disturbance, loss of appetite. A young mother is emotionally worried and winds herself up for the slightest reason, it is hard for her to endure the crying of a baby. If the baby is sick, then fears go off scale.

A common form of neurosis is neurasthenia. The woman becomes whiny, irritable, it is difficult for her to cope with caring for the baby and routine housework. Over time, asthenia develops - exhaustion, the patient loses weight dramatically and looks exhausted.

Important advice for new mothers! Use the baby's sleep time for your rest. Simplify your daily homework by preparing simple meals and convenience foods. Walk as much as possible with the baby in the fresh air. Use the help of a husband, older children, relatives and friends. Take a break from your child at least once a week.

Classification of psychoses

Psychoses are serious mental disorders that bring great suffering and are difficult to correct. Some forms of pathology are not cured completely and require the regular use of potent drugs.

Depending on the provoking causes, psychoses are divided into 2 groups:

• exogenous, caused by external causes: the intake of toxic substances (alcohol, drugs, potent drugs), infections, stress and psychological trauma;
• endogenous, caused by disorders in the functioning of the nervous or endocrine system, tumors in the brain.

There are acute and reactive psychosis. The acute form develops at lightning speed and requires relief in a dispensary. Reactive - is formed gradually as a result of a long traumatic situation.

Severe forms of the disease are referred to as genetic psychotic disorders. These are: schizoaffective psychosis, manic psychosis and schizophrenia. Motherhood for women with these diagnoses is an unbearable burden.

Features of the course of psychosis after childbirth

Psychosis after childbirth often develops in women who have a burdened history of this pathology. It can be exacerbated in the chronic course of the disease. Many drugs that are used in the treatment are potent and are contraindicated during pregnancy and breastfeeding. Women take them for a long time and cancel them at the planning stage of conception, which is a factor that provokes an exacerbation.

Primary psychosis is called symptomatic, it develops as a result of infection of the birth canal. Postpartum psychosis often has an endogenous character and develops as a result of rapid endocrine changes in the body.

Speaking of postpartum psychosis, they mean a disorder that manifests itself during the first few months after childbirth.

Important to remember! A mother in a state of psychosis is potentially dangerous for the baby; for health reasons, she cannot always control herself. Relatives are obliged to take care of the safety and adequate care of the baby.

Symptoms and signs of mental disorders

Symptoms of neurosis after childbirth include mental and somatic manifestations. Mental symptoms include the following:

• emotional instability: tearfulness, irritability, resentment;
• sudden mood swings for no apparent reason;
• excessive anxiety, fearfulness, phobias;
• obsession with a situation that traumatizes the psyche;
• decreased efficiency, attention, brain activity;
• violent tantrums;
• changes in behavior, isolation, indecision, difficulty with the formulation of thoughts;
• sudden weight loss;
• indifference to the child;
• intolerance to certain sounds, photophobia;
• sleep disorders: insomnia or drowsiness;
• lethargy, apathy, depression.

Somatic disorders are added to mental and behavioral disorders. The young mother is concerned about: pain in the heart, temples, symptoms of vegetative-vascular dystonia (dizziness, convulsions, pre-syncope), disorders of the gastrointestinal tract (loss of appetite, nausea, vomiting).

With psychosis, more severe complications are added to the described symptoms:

• strange phobias and thoughts: about a possible substitution of a child, about your incurable illness, about a conspiracy or a special mission;
• loss of interest in the newborn up to the complete refusal to care for him;
• visual and auditory hallucinations - "voices";
• megalomania;
• obsessive thoughts about suicide;
• amental clouding - the sick person does not realize where she is, speech is disturbed, she falls into a "stupor";
• periods of depression for no apparent reason are replaced by excitement and activity.

The condition affects the appearance, the young mother becomes unkempt, does not take care of herself and does not notice this. She stops housekeeping, housing looks neglected. The social circle is sharply narrowed, in a number of cases, a sick mother stops going out and “falls out” of society.

It's important to know! A woman is often unable to adequately assess the severity of her condition. The initiative for diagnosis and treatment falls on the shoulders of close relatives.

Running mental and nervous disorders lead to serious complications. Protracted neurosis develops into psychosis, which is dangerous for the life of a woman and her child. A young mother exhausts herself with fears, she has thoughts of suicide, which can be accompanied by active actions.

Diagnosis of mental disorders in home and clinical settings

Relatives may notice the first alarming symptoms immediately after the young mother is discharged from the maternity hospital. The woman complains of weakness, feeling unwell, it is difficult for her to take care of the baby and perform household chores. The patient expresses many concerns and fears about the newborn. Apathy may occur, the mother stops approaching the child, even if he cries heart-rendingly. If relatives notice changes in behavior, the woman should be referred to a psychologist or psychotherapist.

Important information! The sooner you seek medical help, the easier it is to get rid of the obsessive condition. With alarming symptoms, you can self-diagnose using online tests. Frank answers to questions help identify disorders and assess their severity.

When contacting a medical diagnostic institution, a comprehensive examination is carried out. The doctor examines, listens to complaints, prescribes tests and tomography of the brain. You should contact narrow specialists: a neurologist, psychologist, psychiatrist, psychotherapist.

In the arsenal of a psychologist, there are techniques for identifying and relieving anxiety. For example, color diagnostics. If a woman repeatedly chooses gray, black and brown from a range of colors, this indicates a neurological personality disorder. The classic test - "Rorschach blots", was created more than 100 years ago but is still relevant and informative. The attention of the subject is offered 10 cards with ink spots of various shapes, some of them are colored, the rest are black and white. Cards can be flipped. The patient examines the blots and answers questions related to the associations seen. The test allows you to identify the mental characteristics of the individual and identify pathological changes. The interpretation of the results should be made by a specialist psychologist who calculates the scores and draws conclusions.