Pregnancy and psychiatry

– When do problems associated with pregnancy start?
Pregnancy is regarded in periods of 3 months. These are referred to “trimesters”. Medically, the problems associated with pregnancy start in the first trimester. Psychiatric symptoms usually surface during that period.

– What are the reasons for concerns before pregnancy?
Concerns relating to the first child and to further children thereafter, are different. Before the first child, the question “will I have a child” seems to be the main concern. Before the second child – if the first child was a boy – the question is more likely to be “will it be a girl this time, or will it be a boy”. This is an important question in sections of the population with a low socio-cultural level.

– With regards to experiencing problems associated with pregnancy, what are the differences between pregnancy at an early age and pregnancy at a late age?
Psychiatric problems, and particularly depression are more common in early pregnancies. In pregnancies at a later age, obsessive worries about the child’s health are more marked.

– Are pregnancies more problematic in motherhood candidates, who have tried for a long time and have failed to become pregnant?
Such pregnancies are often accompanied by some obsessive behaviour. Of course, if the mother has undergone certain traumatic medical interventions before the pregnancy, then there can also be post-traumatic stress.

– What do we have to look out for during pregnancy?
If there are depressive symptoms like sleep problems, inability to look after oneself, or thoughts of suicide, then a psychiatrist should be consulted without delay. Stress has to be avoided as much as possible.

– What emotional changes occur during pregnancy?
The changes are generally towards depression.

– What is the main reason why women are more sentimental and easily offended during pregnancy?
The pregnant mother is in a state of excessive awareness which serves to protect the foetus. Naturally this is a tiring state to be in. On the other hand, the hormonal balance is disturbed and serious physiological weaknesses have emerged. The pregnant woman easily loses her self-confidence. Due to all these factors there can be a certain degree of paranoia.

– Which emotions lie behind the pregnant woman’s increased need for sympathy and support from her husband?
When we look into the state of pregancy in more depth, we see that the body is programmed to protect the baby. She therefore primarily wants her husband to support her in the task of protecting the unborn. She also tries to protect herself from depressive tendencies, as she has an instinctive awareness that depression would harm the baby. She therefore expects her husband to take upon himself the specific task of keeping her emotional state high. In other words, she is not being capricious!

– What is the situation with pregnant women who are receiving psychiatric treatment for an ongoing condition?
Past psychiatric episodes like depression can flare up during pregnancy.

– What should pregnant women who are on antidepressants, do?
They should contact their psychiatrist immediately. Particularly during the first three months, in which the inner organs of the unborn develop, antidepressants can have a teratogenic effect on the organs. For example, although rare, a hole in the heart can result from this.

– Which psychiatric disorders would in your opinion be an obstacle to pregnancy?
Psychosis is a serious and controversial problem.

– How do certain problems experienced during pregnancy affect the unborn baby?
Problems directly affect the unborn. Particularly stress hormones like Cortisol deeply affect the development of the foetus. Early birth, developmental retardation, predisposition to certain serious illnesses are some of the undesired effects.

– What is the benefit of group therapy during pregnancy?
Drug treatment during pregnancy carries certain risks. Therefore more importance is placed on psychotherapy. One of the approaches used is group therapy. Educational group therapy sessions are particularly helpful in preventing depression and anxiety produced by certain prejudices.

– What is “maternity blues” that women experience towards the end of their pregnancy?
It is a short period of depression which is regarded as normal.

-Which mothers experience postpartum depression?
This condition that has an occurrence rate of 15%, goes beyond the picture of what we call maternity blues and reaches the level of a serious major depression.

– Is it a condition that will improve by itself or does it need treatment?
Postpartum depression is a serious disorder that required treatment.

– How is drug treatment implemented during breastfeeding?
Drug treatment has to be carried out under the supervision of a doctor. ECT or TMU may be considered instead of drug treatment.

– Is it important to support the treatment with therapy?
It is very important. There is a large amount of research that demonstrates the benefits gained from individual psychotherapy.