The diagnosis is made if an attack occurs within 4 weeks after birth. There are three depressive diagnoses related to the postpartum period.
The first is "maternal melancholia", which is the most common psychiatric disorder related to pregnancy, seen in more than half of the mothers. It typically begins on the 3rd or 4th postpartum day and usually lasts less than 1 week. Symptoms encountered include crying attacks, insomnia, depressed mood, weakness, irritability, headache and confusion. No specific hormonal change has been shown to explain this situation.
Secondly, the fatigue caused by the baby and the difficulties caused by the addition of a new member to the family are a common source of complaints. This situation resolves on its own. No medication is required.
The third, more rare but serious condition, is "postpartum depression". It is more common in those who have previously had postpartum depression and those who had depression or anxiety during pregnancy. Symptoms: The patient expresses that he is unhappy most of the day, or those around him say that he seems unhappy. Loss of interest in activities or lack of pleasure in doing them, significant weight loss or gain, excessive sleeping or inability to sleep, feeling worthless, powerless, guilty, decreased attention, and suicidal thoughts are present. If the patient is considered to be at risk of suicide, he should be admitted to a psychiatric clinic where he can be observed for 24 hours. Tricyclic antidepressants and SSRIs, which are drugs used for depression, can be used safely. Electroconvulsive therapy can be applied to patients who do not respond to medication.
The most serious form of postpartum depression is postpartum psychosis. It is very rare. It is seen in only 0.1-0.2% of births. The patient is either depressed or very cheerful. He develops strange behaviors that he hasn't done before. Hallucinations begin, showing different emotions together. At this stage, the patient's treatment should be organized by psychiatrists.
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