Introduction to perinatal depression

Perinatal depression is an affective condition that can occur at any time during pregnancy and extend into the first year after childbirth.

Initially, in previous diagnostic classifications (DSM-IV), the period considered was only up to four weeks after childbirth. However, recent studies have clearly shown that depressive symptoms can manifest during pregnancy and last significantly longer, up to twelve months after birth.

This condition affects the mother's quality of life, impacts child development, and profoundly alters family dynamics, requiring specialized clinical care.

Differences between baby blues (postpartum sadness) and postpartum depression

It is crucial to clearly differentiate between “baby blues” or postpartum sadness and postpartum depression. Baby blues affects up to 80% of mothers and is characterized by transient symptoms such as sudden mood swings, tearfulness, irritability, fear, and difficulty adjusting to motherhood.

These symptoms usually appear between the third and fifth day after delivery and resolve spontaneously within the next two to three weeks. Due to their brief and intermittent nature, they do not significantly affect daily functioning.

In contrast, postpartum depression has more intense, persistent, and generalized symptoms. Unlike baby blues, depressive symptoms in this condition last for weeks or months, significantly affecting the mother's daily functioning, quality of life, and care of the baby.

It is important to note that approximately 25% of cases of postpartum sadness can develop into clinical depression, so close clinical monitoring is essential for timely intervention.

Public health importance (epidemiology and prevalence)

Perinatal depression is a public health problem that deserves priority attention due to its high prevalence and serious consequences. Epidemiologically, about one in five women experience significant depressive symptoms during pregnancy or postpartum.

In addition, approximately one in nine women develop a clinically diagnosable depressive disorder during this period. This prevalence is alarmingly higher than that of more visible and treated diseases such as breast cancer, yet public policies often neglect perinatal mental health.

The importance of adequately addressing this condition lies not only in its frequency but also in its serious long-term effects. Perinatal depression is associated with a higher incidence of obstetric complications, premature birth, low birth weight, and infant psychomotor development disorders. In addition, it substantially increases the risk of maternal suicide.

Furthermore, the impact of this depression on the mother-child bond can lead to difficulties in establishing a secure and healthy relationship, affecting attachment and the mother's ability to respond to the baby's emotional needs.

Finally, it is also worth noting the underdiagnosed presence of depression in fathers, especially when the mother has depressive symptoms, which highlights the need for a comprehensive family approach to prevent severe emotional complications.