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The exact causes of postnatal depression are unknown, but it is considered that there are different vulnerabilities that can precipitate it.
The hypotheses that try to explain the appearance and persistence of postnatal depression are included within the general stress-vulnerability model. This model considers giving birth as a neurohormonal and immunological stress factor, and the transition to motherhood as a psychosocial stress factor. Both factors demand an adaptive effort from the body in order to respond to the demands of motherhood. The depression may be a result of the different types of psycho-biological vulnerability.
This vulnerability arises due to several factors:
Genetic vulnerability. Genes associated with serotonin and tryptophan depletion, the response to stress, and oestrogen receptors, have been implicated.
Cognitive vulnerability. The impact of perinatal experiences is different depending on personality traits, cognitive style and the coping strategies used and family, social and logistic support.
Neurohormonal vulnerability. The sudden decrease in oestrogens during birth and the immediate postnatal period bring about a sharp decrease in brain neurotransmitters, which contribute to the presence of the depressive symptoms in the postnatal period.
Psychosocial vulnerability. The changes in the transition and in the combining of roles together with other psychosocial factors can affect the mood during this period: physical changes and self-image, loss of occupational status, penalisation of professional or working life, loneliness or social isolation, lack of time, and loss of freedom.
Risk factors of Postnatal Depression
Previous history of the disorder. This is the factor that has shown a greater risk of developing a postnatal depression in pregnancy, in previous postnatal periods or in depressions in other times of life. Together with the family history of depressive illness and, especially, depression in the postnatal period in mothers and sisters.
Premenstrual syndrome. Women with this syndrome are vulnerable to present with depressive symptoms due to the changes in the reproductive hormones that are produced in the postnatal period.
To experience stressful life events. During the pregnancy like, for example, an illness, death, or suffering of a loved one, a difficult or emergency delivery, not having planned the pregnancy or to have contradictory feelings, or chronic stressful situations, such as a lack of, or problems with a place to live, financial problems or to be responsible for the care of relatives.
Situations of abuse or violence. Both as a child as well as in adulthood and, especially, women exposed to partner violence during the pregnancy.
Extreme personality traits. Such as an elevated emotional instability and a tendency to worry, to low self-esteem, or to excessive perfectionism, or lack of family support, friendships, or a partner.
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Substantiated information by:
Alba RocaPsychiatristPerinatal Mental Health Unit
Anna Torres GiménezClinical PsychologistPerinatal Mental Health Unit
Lluïsa García EstevePsychiatristPsychiatrist. President of the Intrafamily and Gender Violence Commission
Susana Andrés PerpiñáPsychologistPerinatal Mental Health Unit
Published: 7 May 2019
Updated: 7 May 2019
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