According to some researches conducted on a world level, 15% of parturient women experience postpartum depression. Macedonia is not excluded in this percentage, but, at present, there is no comprehensive data on the number of female patients suffering from it on a state level. It is a topic rarely talked about, it is still a taboo and especially in small circles. Also, practitioners from the Department of Psychiatry in the Hospital in Kumanovo confirmed that female patients having symptoms of postpartum depression very rarely see them, although it happens for them to be called for a conciliar examination by the Department of Gynecology. However, it is usually before and rarely after delivery. They explained that there are cases when they are called by the Department of Gynecology to expresses their professional and expert opinion about a psychiatric symptomatology of a female patient.
Dr Adrijana Bogdanovska, a specialist in psychiatry in the General Hospital in Kumanovo stated “Symptoms of postpartum depression may appear among all categories of parturient women regardless of age, level of education and ethnicity. Depression makes no selection.”
She explained that the baby blue syndrome is very often, the feelings of sadness, fatigue, anxiety run from the first to the second week after delivery. On a world level, it occurs among up to 80% of parturient women.
Postpartum depression is a more serious condition which may seriously reduce the quality of life and functioning of a parturient woman and the family. The symptoms occurring in postpartum depression are from the emotional, behavioral and cognitive fields.
Dr Bogdanovska stated “When it comes to emotions, there are feelings of sadness, anxiety, bad mood, guilt, despair, frustration and irritation.” Female patients often have trouble bounding with the baby and feel concerned about them not being good mothers enough. In the behavioral field, a loss of interest for various social activities, changes in appetite and insomnia are signs of postpartum depression. In the cognitive field, the most common are poor concentration and memory, anxious thoughts and worry about the future. Dr Bogdanovska explained that postpartum depression as other types of depression may have mild, moderate and severe depressive episode, and psychotic may occur as well, but not necessarily.
Dr Bogdanovska said “When more severe psychotic symptoms occur, then there is an intense delusive feeling of despair, hopelessness and no perspective, and patients may start thinking how to hurt themselves or the newborn.”
There are risk factors to determine whether there may be a possibility to appear postpartum depression, such as patients who had symptoms of depression before a pregnancy, when a member of the family suffers from depression, women having more acute pre-menstrual syndrome both from a physical and mental point. In addition, risk factors in postpartum depression are previous history of psychological or physical trauma, moments of stress and history of abuse. Persons of little self-confidence may have greater chances to suffer from postpartum depression.
Dr Bogdanovska said “Low socio-economic status, Roma women may suffer more because of this factor and because a high percentage of them are in the socially vulnerable group.”
A woman’s close circle is a risk factor, whether the pregnancy is wanted or unwanted, accepting from the family, their relation to the pregnant woman and to the newborn.
Dr Bogdanovska explained “A call to all those who feel they lack will, interest, who have a feeling of chronic tiredness not to ignore these symptoms, but to ask for help because a great percentage of depressions are undiagnosed and untreated regardless of the period they occur. Every depression attack leaves a trace on the somatic plan and changes occur in the brain structures which are harder to repair afterwards.”
Early diagnosis not just improves health and psychological status of parturient women, but it is also a kind of prevention against next episodes of depression. Postpartum depression is treated with conventional and standard methods. Depending on the clinical features, the first are antidepressants, and if there are psychotic symptoms, then antipsychotics. When the patient is in stable condition, then psychotherapy is obligatory.