Recent studies have shown that childbirth is a potentially traumatic event and can lead to the development of post-traumatic stress disorder (PTSD) in postpartum life. Several markers are associated with the condition, some occurring before and some after its occurrence. These include a negative outlook on pregnancy and childbirth, impaired bonding with the child, depressive features, as well as deterioration in the marital relationship.
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In most cases of postnatal PTSD, the patient develops symptoms within one month of a traumatic delivery. Some women may experience a delay of months or even years before symptoms start to appear. Symptom severity may vary between women, with some constantly experiencing significantly troubling symptoms, whereas others report the waxing and waning of symptoms.
Symptoms
PSTD is characterized by three distinct sets of symptoms, namely intrusion, avoidance or numbing responses, and hyperarousal.
Intrusion
Intrusion refers to the occurrence of intrusive and unwelcome thoughts about the traumatic experience, which can come in many forms, some of which include:
- Flashbacks in which the patient actually relives the fear and horror of the trauma
- Troubling dreams or nightmares
- Seeing the images or feeling the sensations associated with the trauma repeatedly leading to re-experiencing the trauma
- Mental distress on coming into contact with the perceived cause or any stimulus or situation associated with the trauma
- Hyper-reactivity to such situations or associated stimuli
- Physical pain, sweating, nausea, or trembling
- Over-introspection and asking themselves useless questions such as “why did this happen to me?”, and “how could I have avoided it?” These questions, taken together, keep the trauma alive without resolving anything.
Avoidance or numbing responses
Patients with PTSD do not want to be reminded of the bad experience they experienced. In an effort to avoid these thoughts, individuals with PTSD often adopt various means, such as preventing any reference to the situation in which they suffered trauma. This may be through:
- Avoiding all thoughts or feelings, or talks, about the trauma
- Avoiding all activities, people, or settings that are linked to the trauma
- Experiencing amnesia around the traumatic situation in an attempt to tune it out
- Overworking or using hobbies as a form of avoiding dealing with the memories of the trauma
- Loss of interest in previously pleasurable activities or hobbies
- Disinterest or detachment towards people, objects, or settings that would ordinarily be of emotional value
- Feelings of being lonely, abandoned, alienated, or not having any friends
- Feelings of hopelessness about the future
Hyperarousal
The patient with full-fledged PTSD will have symptoms of increased alertness and tension, constantly ready to react to threats, or displaying overactive emotions, such as:
- Insomnia, difficulty in falling asleep or staying asleep
- Frequent outbursts of anger or irritability
- Lack of concentration
- Hypervigilance for signs of harm
- Overactive startle responses
These symptoms may be associated with depression and can last for more than one month. In addition, these symptoms are found to interfere with the mother’s normal functioning at home, with society, or in the workplace.
Post-traumatic stress in pregnancy and childbirth: City University London - shaping opinion
Associated problems
People with PTSD may also suffer from related feelings and disorders, such as:
- Mental health issues such as depression, anxiety, or even phobias
- Risky or self-destructive behavior including substance abuse and alcohol abuse
- Physical symptoms such as chest pain, abdominal pain, or headaches
Their emotional fragility or withdrawal may lead to their becoming unable to cultivate lasting friendships and to the severing of close relationships. This may add to the traumatic experience.
References
Further Reading