La depressione post-partum è una forma di depressione che si può manifestare subito dopo il parto e che può incidere negativamente sulla salute e sul funzionamento quotidiano delle neomamme. Secondo studi clinici, infatti, tale forma depressiva può compromettere l’attaccamento madre-bambino, esercitando un’ influenza negativa sul rapporto coniugale e sulla serenità familiare. La depressione post-partum viene spesso confusa con una condizione fisiologica, denominata maternity blues e con una condizione psicopatologica grave, denominata psicosi post-partum.

Il maternity blues (anche detto blues del post-parto o baby blues) è una condizione fisiologica, molto frequente, riferita dall’80% delle neomamme entro i primi 5 giorni dal parto. I sintomi lamentati dalle mamme che soffrono di maternity blues (tra i quali ansia, labilità emotiva, stanchezza, irritabilità, vuoti di memoria) solitamente si risolvono entro 10 giorni dal parto.

La psicosi post-partum, invece, è una condizione psicopatologica seria caratterizzata generalmente da confusione, agitazione, insonnia, deliri e allucinazioni per i quali è fondamentale rivolgersi immediatamente allo psichiatra in quanto potrebbe mettere a repentaglio la salute o la vita della mamma e del neonato.

La depressione post-partum è definita da tre caratteristiche:

  • i sintomi depressivi iniziano dalle quattro alle sei settimane dopo il parto e continuano per almeno due settimane;
  • sono presenti generalmente più di 5 sintomi depressivi tra i seguenti: umore depresso, scarso appetito, perdita di piacere e di interessi, labilità emotiva, irritabilità, insonnia, rallentamento o agitazione psicomotoria, disorientamento o confusione;
  • la depressione post-partum compromette in maniera marcata il funzionamento quotidiano delle madri rendendo complesso per loro occuparsi dei neonati e concentrarsi sulle attività quotidiane (Lee et al., 2015).

La storia di Alessia, un caso di depressione post-partum. Video pubblicato su Youtube dal Centro Psiche Donna:

Tra le cause possibili di depressione post-partum vengono segnalate alterazioni endocrine durante la gravidanza che nel periodo successivo al parto comporterebbero un aumentato rischio di insorgenza di episodi depressivi. Alcuni studi hanno individuato nelle neomamme delle alterazioni neurobiologiche, responsabili di un deficit nella regolazione emotiva (aumentata reattività dell’insula, del giro frontale mediano e del giro frontale inferiore nei primi giorni dopo il parto). La reattività dell’insula sembrerebbe correlata positivamente con la presenza di ansia nel periodo precoce del post-parto e con la presenza di sintomi depressivi nel periodo tardivo del post-parto. L’aumento della reattività di aree cerebrali come l’insula, il giro frontale mediano ed il giro frontale inferiore sarebbe frutto di un normale adattamento dopo il parto che, se associato alla presenza di depressione o ansia, potrebbe rendere le donne nel post-partum suscettibili ad un aumentato rischio di depressione (Gingnell et al., 2015).

Una ricerca ha valutato l’associazione tra gravidanze indesiderate e l’insorgenza di depressione post-partum. Dallo studio è emerso che le donne con gravidanze indesiderate presentavano una maggiore probabilità di soffrire di sintomi depressivi nel post-partum (Brito et al., 2015).

La terapia della depressione post-partum è preferibilmente di tipo psicoterapeutico. Si preferisce, infatti, limitare l’uso di farmaci ai casi gravi per permettere alle mamme di proseguire l’allattamento.

La psicoterapia interpersonale di gruppo nelle donne in gravidanza sembrerebbe utile nella prevenzione della depressione post-partum data l’importanza del sostegno sociale e della costruzione di capacità interpersonali durante il periodo di maternità (Kao et al., 2015).

Riferimenti:

Brito CN et al (2015). Postpartum depression among women with unintended pregnancy.Rev Saude Publica. 49:1-9.

Gingnell et al (2015). Emotion Reactivity Is Increased 4-6 Weeks Postpartum in Healthy Women: A Longitudinal fMRI Study. PLoS One. 10(6). eCollection 2015.

Kao JC et al (2015).The Positive Effect of a Group Intervention to Reduce Postpartum Depression on Breastfeeding Outcomes in Low-Income Women. Int J Group Psychother. 65(3): 445-58.

Lee PJ et al (2015). [Concept Analysis of Postpartum Depression]. Hu Li Za Zhi. 62(3): 66-71.

Di Tiziana Corteccioni

Dott.ssa Tiziana Corteccioni
Medico chirurgo, Specialista in Psichiatria, Psicoterapeuta   

Medico Psichiatra e Psicoterapeuta ad orientamento clinico cognitivo-comportamentale.
Da Ottobre 2010 collabora con il Centro Ricerche Musicali di Roma nel progetto “Musica Emozioni” rivolto a soggetti con difficoltà sul piano emotivo. E' coautrice di pubblicazioni scientifiche.
Da Novembre 2013 collabora con l'Associazione di Clinica Cognitiva del Lazio.
Esercita attività come psichiatra e psicoterapeuta presso vari centri clinici a Roma ed a Perugia nei quali si occupa prevalentemente del trattamento farmacologico e psicoterapeutico di disturbi del sonno, depressione, disturbo bipolare, attacchi di panico, fobie, disturbo ossessivo-compulsivo, disturbi alimentari, disturbi di personalità, dipendenze e schizofrenia.

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