Carlson Karen, Mughal Saba, Azhar Yusra, Siddiqui Waquar
University of Nebraska Medical Center and Nebraska Medicine
Dow University of Health Sciences
Perinatal depression is a mood disorder that affects individuals during pregnancy or within 1 year after childbirth. According to the (), postpartum depression is now included in the term perinatal depression. A major depressive episode that begins during pregnancy or within 4 weeks after delivery is classified as peripartum depression. This term encompasses both prenatal and postpartum depression. The does not recognize postpartum depression as a separate entity. Instead, postpartum depression is included within the broader diagnosis of perinatal depression. Depression symptoms, including persistent sadness, lack of interest, low self-esteem, sleep disturbances, loss of appetite, anxiety, irritability with a hostile attitude towards infants, self-blame, and feelings of humiliation characterize perinatal depression. People with perinatal depression may also experience changes in sleeping and eating patterns, difficulty bonding with their baby, and feelings of hopelessness or worthlessness. In contrast, postpartum blues, also known as maternity blues or baby blues, includes mild, transient depressive symptoms and dysphoria during the first days to weeks after delivery. Symptoms of postpartum blues are similar to perinatal depression, including tearfulness, crying spells, sorrow, mood swings, irritability, insomnia, anxiety, poor appetite, fatigue, and inability to think clearly. However, unlike postpartum blues, which typically resolves within a few weeks, does not cause significant functional impairment, and is not considered to be a mental disorder, perinatal depression is more severe. It can last for months if untreated, resulting in significant mental health dysfunction. Recognizing and addressing perinatal depression is crucial for the health and well-being of the patient and their baby. If left untreated, perinatal depression can interfere with the ability to care for the child. It may contribute to long-term developmental issues in the child (eg, emotional and behavioral problems). Perinatal depression can also strain family relationships and increase the risk of suicide. Screening for perinatal depression should be a routine part of prenatal and postpartum care, utilizing tools such as the Edinburgh Postnatal Depression Scale (EPDS) to identify those at risk. Treatment typically involves a combination of psychotherapy, support groups, and medication, including antidepressants, which can safely be used during pregnancy and lactation. Up to 50% of perinatal depression cases remain undiagnosed due to patient reluctance to disclose symptoms, partly because of the stigma around perinatal depression, which includes fears of abandonment and lack of support upon disclosure. Raising awareness about perinatal depression, reducing stigma, and ensuring access to mental health resources are essential steps in supporting pregnant people and new parents to promote healthy family dynamics.
围产期抑郁症是一种情绪障碍，影响孕期或产后1年内的个体。根据（），产后抑郁症现在包含在围产期抑郁症这一术语中。在孕期或分娩后4周内开始的重度抑郁发作被归类为围产期抑郁症。该术语涵盖产前和产后抑郁症。（）并不将产后抑郁症视为一个单独的实体。相反，产后抑郁症包含在更广泛的围产期抑郁症诊断中。围产期抑郁症的症状包括持续悲伤、缺乏兴趣、自卑、睡眠障碍、食欲不振、焦虑、对婴儿有敌意的易怒情绪、自责和羞辱感。患有围产期抑郁症的人也可能经历睡眠和饮食模式的改变、与婴儿建立亲密关系困难以及绝望或无价值感。相比之下，产后情绪低落，也称为产褥期忧郁或产后忧郁，包括分娩后的头几天到几周内出现的轻度、短暂的抑郁症状和烦躁不安。产后情绪低落的症状与围产期抑郁症相似，包括流泪、哭泣、悲伤、情绪波动、易怒、失眠、焦虑、食欲不振、疲劳以及思维不清晰。然而，与产后情绪低落不同，后者通常在几周内自行缓解，不会导致明显的功能损害，也不被视为精神障碍，围产期抑郁症更为严重。如果不治疗，它可能持续数月，导致严重的心理健康功能障碍。认识和处理围产期抑郁症对患者及其婴儿的健康和幸福至关重要。如果不治疗，围产期抑郁症会干扰照顾孩子的能力。它可能导致孩子长期的发育问题（如情绪和行为问题）。围产期抑郁症还会使家庭关系紧张，并增加自杀风险。围产期抑郁症筛查应成为产前和产后护理的常规部分，利用诸如爱丁堡产后抑郁量表（EPDS）等工具来识别有风险的人群。治疗通常包括心理治疗、支持小组和药物治疗，包括抗抑郁药，这些药物在孕期和哺乳期可以安全使用。由于患者不愿透露症状，高达50%的围产期抑郁症病例仍未被诊断出来，部分原因是围绕围产期抑郁症的污名，这包括对披露后被抛弃和缺乏支持的恐惧。提高对围产期抑郁症的认识、减少污名以及确保获得心理健康资源是支持孕妇和新父母促进健康家庭动态的重要步骤。
