DW: What exactly is postpartum depression? What happens to women who fall into this state?
Stella Haralambova: There is very little talk about postpartum depression and the conditions of women after childbirth in general. In Bulgaria and worldwide. Usually, what people are drawn to is rather the joy of childbirth, positive emotions. People somewhat belittle or do not understand why a woman can be sad, unhappy after childbirth.
Postpartum depression is a psychological and emotional state that almost any woman can fall into. It is not determined by social status, whether she has support from her family or what her general health is. When we talk about postpartum depression, we must distinguish it from the so-called "baby blues", which is a condition typical for many women, but it lasts shorter - for example, in the first two weeks after giving birth, women are more sensitive, more melancholic. Postpartum depression continues after this period and usually deepens. The woman feels sad, often blames herself, feels guilty that she cannot enjoy the child, cannot be happy, cannot be what people expect a mother to be during this period. It is often difficult for her to take care of the baby herself, because she herself feels emotionally in a bad place.
DV: And how can the symptoms be most easily recognized?
Stella Haralambova: Usually, when a woman has difficulties in the postpartum period, she gives signals in one way or another. It is good for the people around her - partner, parents, friends - to be attentive if they seem concerned. That is, if it seems to them that the woman is isolating herself more, is more silent, does not share, is more closed in on herself, it is difficult for her to take care of the baby, for example. She may even express some self-accusations out loud - for example, saying that she is not coping, that she is not a good mother, that she is not like others. All of this is a signal that the woman has difficulties in adapting to this period, to the new role. It is good to talk to her, to be supported.
Often, relatives, in their desire to encourage or help, give advice that further aggravates the situation - they somewhat deny her feelings, sensations and experiences. They tell her, for example: "what's wrong with you", "everything is fine", "you must be very happy, you have a child". Or the comparisons: "there are many other families who don't have children, and you do", etc. In this way, they actually do not validate, but deny the woman's experience, which puts her in a position to feel even more inadequate, guilty that something is wrong, that she herself clearly cannot cope with being a mother. There are also other factors here - the hormonal balance after childbirth, fatigue, lack of sleep. Of course, the environment is also very important - the people who are around the woman herself. Are they understanding, are they supportive, what are their requirements, their expectations for it?
DV: Do many or few women seek help for postpartum depression? What is your experience?
Stella Haralambova: I work very closely in this area - with reproductive problems, and then in the postpartum period. There are women who seek help - and that is good. Sometimes there are partners of these women who notice that there is a problem, that something is wrong. And they contact me to seek help for the woman. But there are many other women who silently and in silence experience this situation and at some point begin to feel that somehow the fault lies with them.
Sometimes postpartum depression begins even during pregnancy - the first symptoms are then. It is not always immediately after birth - sometimes this anxiety-depressive symptomatology can begin even during pregnancy. And if preventive measures are taken during this period, it is possible to avoid this condition after birth.
DV: Is there a problem in Bulgarian society with recognizing the seriousness of these problems?
Stella Haralambova: I think that in general, situations related to mental health are not talked about enough in society. There is also a stigma. There is also a stigma on families that have reproductive problems - it is not talked about much. There is also a stigma around the role of the mother - usually what is portrayed in society are happy women, satisfied mothers, joyful, hopeful. The reality is very rarely shown - that becoming a mother requires time: for a woman to gain experience, confidence, to adapt to the new requirements of the role she is entering.
Very often, perhaps, this is exactly what happens - we enter this role of motherhood with a certain attitude and certain understandings. And when we are faced with another reality, a person finds it difficult to accept it and usually turns to himself and says: I can't cope, I have a problem. Precisely because society talks little - that it is difficult, that it requires time for adaptation, that not only the woman, but the entire family structure should participate in this process. Sometimes we focus too much only on the mother - how she copes. And in fact, the child is born into a family.
DV: What advice would you give to a person who has fallen into such a state, so that he can cope more easily?
Stella Haralambova: To seek help. To seek support - be it from a professional, from a partner, from parents, from friends. To talk, to share. This is a condition that can be overcome with timely measures. A woman who suffers and has fallen into postpartum depression can get out of this situation. But it is difficult to cope on her own. That is why we need help and support at this moment.
Author: Mina Kirkova