Mental state after childbirth. Postpartum psychosis can manifest itself as

A young mother after giving birth can be a real surprise and not necessarily pleasant. Safely returning home with a bundle of happiness in her hands, the woman begins to behave strangely: to talk to herself, to show a strange attitude towards the child, to throw tantrums from scratch. What's going on? Not each of the relatives will immediately be able to understand that these are manifestations postpartum psychosis..

What is postpartum psychosis?

Postpartum psychosis or the so-called postpartum onset of bipolar disorder is serious illnessconcerning mental problems of the woman who gave birth. According to statistics, from 0.1% to 0.2% of all women with children are susceptible to this type of disorder.

The risk of developing postpartum psychosis increases in those of the fair sex who have previously been diagnosed with bipolar disorder or schizophrenia.

Therefore, as soon as the fact of pregnancy is accurately established, a woman who has a personal or family history of meeting with these diseases should seek advice from a psychiatrist of the perinatal center.

For some families, neurosis after childbirth becomes a real shock, because in half of all recorded cases, the disease can develop in those women who have not previously encountered a mental disorder.

A woman suffering from psychosis is in extreme dangerous condition, which can threaten not only her life, but also the life of those around her, and first of all, a newborn child. The disease, like other types of mental disorders, heals faster and more successfully on initial stagebefore it had developed into a more terrifying form.

The main problem of the patient in this condition is the refusal to accept the fact that she has a mental illness, therefore, her relatives or friends should apply for qualified help. Treatment of postpartum psychosis should be started immediately, without taking into account all attempts to resist the woman herself: during psychosis, she may not realize that she is sick.

Causes of postpartum psychosis

The nature of the development or exacerbation of this type of neurosis has not been studied comprehensively, and there are more questions on this topic than answers to them. It is believed that the start for the development of postpartum psychosis is a powerful hormonal shift in a woman's body during pregnancy and immediately after delivery. For some people, heredity also plays a significant role.

So, let's try on the site site to highlight several main reasons for the development of this type of neurosis in women after childbirth:

1. Bipolar disorder or schizophrenia diagnosed before pregnancy.
2. Genetic predisposition. If your close relative, for example, mom or sister, have suffered from postpartum psychosis, then there is a high probability that the unpleasant situation may repeat itself with you.
3. Psychosis after the first birth. Women who have had postpartum mental disorder may have other children. And the risk of suffering postnatal psychosis again is very high.

Sometimes the mechanism of mental illness after childbirth can be triggered by serious brain infections, drug poisoning, or the combined use of scopolamine and lidol while carrying a child.

Alarms and in last weeks pregnancies associated with the birth of a child can become an impetus for the development of postpartum neurosis, but more often this occurs in combination with other, more serious factors: hidden diseases or heredity.

Experts also note that postnatal psychosis develops much more often in women with an unbalanced psyche, prone to irritation and hysteria.

Symptoms of the disease

Postpartum psychosis begins to manifest itself within two weeks after childbirth, the disease may develop later, but this is rare. Unexpected psychosis - this also happens when the first symptoms appear already several hours after the birth of a child.

It can be understood that a woman has begun postpartum psychosis, knowing the manifestations this disease:

1. Frequent mood swings: a depressed state may disappear after a minute, replaced by aggression, hysterical laughter or an instant feeling of joy and peace.
2. Manic manifestations: A woman may show overly active custody of her baby, while her extreme concern about his state of health borders on the manifestation of terrible hatred of him. She may blame the maternity hospital staff for having her baby changed. Pursued by the thought that she is holding someone else's child, she may try to kill him. Or be dissatisfied with the fact that she and the newborn are given too little attention and care, that doctors hide from her information about serious pathologies in the child.
3. General negative emotional background: the woman is aggressive, does not allow relatives or medical staff to approach her and the child, suffers from insomnia, anxiety, confusion of thoughts. Along with sleep disturbance, she may have no appetite, a woman may complain of fatigue, apathy and the meaninglessness of her existence.
4. Hallucinations: voices in the head that prompt it to take certain actions, smells or noise that doesn't really exist. Sometimes a woman believes that she has superpowers or unique healing powers. One gets the feeling that the personality has been changed: she can conduct conversations with herself or with “someone in her head”, answer questions asked to her incoherently and indistinctly, it is difficult for her to understand the order of things and phenomena.
5. Unawareness of her condition: the patient refuses any kind of help, because considers his behavior to be completely normal.

All these dire signs indicate that the woman is in a state of postpartum psychosis and needs urgent medical attention. A mother with a child should not be let out of control: she can harm herself or her child. A woman may try to strangle the baby or attempt suicide, obeying her delusional delusions.

Sometimes relatives can ignore these changes in the psyche of a woman in labor, believing that this is and relying on the fact that the unbalanced state will stabilize over time by itself. This is a very big mistake: postpartum psychosis, unlike depression, is much worse both in terms of manifestations and in terms of consequences.

Elimination of postpartum psychosis

Fortunately, postpartum psychosis in women is curable and treatment is mostly medication. By the decision of the doctor, a woman, depending on the severity of her condition, can be assigned the following types drugs:

1. Antipsychotics - means to eliminate imaginary perceptions and thinking disorders.
2. Antidepressants - to correct the depressive state of the patient.
3. Normotimics are mood stabilizers or agents that can smooth out and soften harshness in a person's character.

If, along with mental illness, other pathologies are present ( postpartum complications, aggravation chronic diseases), then the treatment should be comprehensive.

If the disease begins to manifest itself in the hospital, as a rule, treatment begins already there. After discharge, the patient is sent to the hospital to continue the treatment course, while the child must be isolated from communication with the mother during the exacerbation. If the patient is receiving medications, breast-feeding you must temporarily cancel and transfer the child to. But you can try to talk to her so that she expresses milk.

After your mom returns home, you can try to restore breastfeeding.

In order for a woman to "come to her senses" after the experience, it may take from two weeks to several months in the most severe cases.

It is very important to fix postpartum psychosis in women who have given birth as early as possible, then treatment will take less time and effort.

After the woman in labor returns home, her relatives must provide the most comfortable conditions for her. This also applies to household duties - relatives will have to take most of the housework on themselves and provide the mother with a favorable overall emotional background. Women who experienced severe neurosis after childbirth quickly got used to ordinary lifeif you received full support from family members. In no case should a woman be accused of behaving inappropriately: there is no fault of her in what happened.

Postpartum psychosis is a rare mental disorder that usually occurs between two and four weeks after childbirth. With timely treatment, a woman is able to get out of this painful state in a few weeks. In the case of delayed therapy, the disease may last for several months. Most often, the patient suffering from postpartum psychosis does not realize that she is sick.

This mental disorder is rarely diagnosed. In the first 1.5 months after giving birth, on average, one out of a hundred newly-made mothers is hospitalized with a diagnosis of postpartum psychosis. The peak incidence occurs in the first month after the birth of a baby. It is known that 50% of patients receiving treatment for postpartum mental disorder have not previously received treatment in a psychiatric hospital.

Causes of postpartum psychosis

The reasons provoking the development of the disease have not been reliably established. The most obvious hypothesis is that it is due to hormonal changes, including a decrease in the amount of estrogen. Substitution therapy these hormones are considered as additional method treating schizophrenia (with conflicting results). A study of 29 pregnant women with no established mental health problems found no significant efficacy for estrogens in preventing postpartum psychosis.

Factors provoking the onset of pathology can be problem childbirth, as well as malfunctions in the body due to labor (dehydration, changes in indicators blood pressure, impaired liver function). Have a negative effect on mental state women: lack of sleep, lack of support from loved ones, unpreparedness for motherhood. The development of the disease is promoted by suspiciousness, anxiety, and mental trauma.

Postpartum psychosis symptoms

Manic manifestations are an obvious sign of the disorder. A woman is haunted by obsessions and notions that are not associated with any real events. Sometimes the mania is paranoid. In addition, hallucinations occur in most cases (usually auditory, but visual in some patients).

The patient becomes depressed, ceases to take care of herself, loses the ability to think fully. It becomes difficult for her to formulate her own opinion. Others may notice that her speech has lost its logical component.

Self-esteem in postpartum psychosis is usually inadequate. A woman, as a rule, does not understand that she is sick, so her relatives turn to a specialist. She has a decrease in appetite, and in severe cases, suicidal tendencies and other unhealthy thoughts, including about her child.

At the initial stage, postpartum psychosis manifests itself as a constant depressed mood, especially in the morning hours. The patient suffers from feelings of guilt. Her appetite is noticeably reduced, negative thoughts are spinning in her head all the time, her interest in life is lost, thoughts of suicide appear. With a child, a woman behaves inappropriately: instead of rejoicing at his birth, she yells at him and may even harm him. Sometimes she is not able to concentrate, make any decision.

A newly-made mother develops anhedonia, that is, a loss of a sense of joy. Anxiety comes to replace it. Nervous excitement and irritability are observed. In addition, problems arise with sleep, excessive fatigue, loss of interest in life. A woman can refuse intimacy with your partner for fear of getting pregnant again.

Types of postpartum psychosis

Acute postpartum psychosis usually results from difficult birthsuch as passing too long time... Obvious mental disorders do not appear immediately, but after a few days or even weeks. After being discharged from the family home, the woman looks depressed. She is overwhelmed with negative emotions, up to a lack of joy about the birth of a baby. She may even experience aggression or indifference towards her own child, as well as change her attitude towards relatives.

The patient has sleep disturbances and strange behavior. So, she may not approach the baby at all or, on the contrary, not leave him a single step. Sometimes strange beliefs appear that have no real basis, for example, that the relatives of the baby want to steal, take away or harm him. Mom can treat a child from a disease she invented, actively using various drugs.

Hallucinations occur very often in postpartum psychosis. This symptom is dangerous, as it deprives a woman of the ability to reason reasonably and be responsible for her actions. As a result, she is capable of doing something stupid. The patient's relatives should see a doctor as soon as possible in order to prevent the aggravation of her condition.

Postpartum schizophrenic psychosis is especially dangerous for the patient and her relatives. Usually, a woman suffering from this disorder has negative thoughts about her own baby, fears and hallucinations. She may be thinking about how to get rid of him.

Diagnosis and treatment of the disease

To make a diagnosis, the doctor takes into account the presence / absence of the patient's genetic burden, however, in half of the cases, postpartum psychosis develops against the background of favorable heredity. In addition, a physical examination is carried out. The specialist evaluates the severity of the symptoms. The patient takes general analysis blood, which allows you to determine the state of her body. In the process of talking with a woman and questioning her relatives, the clinical picture of pathology becomes clear.

Treatment of postpartum psychosis in most cases is carried out in a hospital. The child is usually left to relatives of the patient. To normalize the patient's condition, she is prescribed mood stabilizers and antipsychotic medicines... How quickly a woman recovers depends on the severity of the pathology, the adequacy of the therapy. Support from relatives matters. With timely treatment, severe symptoms are smoothed out within 2-12 weeks.

Usually the patient is prescribed antidepressants, psychotropic drugs. The therapy is carried out under the supervision of a physician. With increased anxiety and agitation, pyrazidol and amitriptyline are used. Adynamic symptoms are usually corrected with citalopram, paroxetine. It is advisable to start treatment with the use of minimum dosages, gradually increasing them as needed. It is important to consider that all drugs have serious side effects and contraindications for use.

Folk remedies for the treatment of postpartum psychosis

Postpartum psychosis is considered a serious mental disorder, therefore, seeking medical attention cannot be delayed. Use folk remedies allowed at your own peril and risk, when the signs of the disease are unexpressed. In the case of a schizophrenic episode, it is not worth postponing the visit to a specialist.

When mild form pathology, you can regularly take baths with poplar leaf infusion. For their preparation, it is enough just to pour a handful of plant materials with boiling water, and then pour the finished infusion into the bathroom and sit in it for several minutes.

To relieve nervousness, you can drink mint tea or infusion (½ cup in the morning and in the evening). Facilitates nervous tension chicory root, which must be boiled with boiling water at the rate of: 1 tbsp. l. vegetable component in a glass of water and take 1 tbsp. l. funds 6 times a day.

To mitigate the manifestations of psychosis and eliminate nervousness, knotweed infusion will help. For its preparation, 1 tbsp. l. pour 500 ml of boiling water over the vegetable component and leave for thirty minutes. Little healing composition must be drunk before every meal.

Soothes nervous system infusion of thyme. To prepare this product, you need 5 g of the main ingredient, pour ½ liter of boiling water, and then leave for about half an hour in a closed container. The finished composition should be consumed twice or three times a day in small portions for one week, after which - take a two-week break, and then repeat the course.

With timely treatment, postpartum psychosis resolves quickly. Delay in seeking the help of a specialist can lead to an aggravation of the patient's condition and the need for prolonged and serious therapy.

In the first days after childbirth, some women may experience a rare mental disorder called postpartum psychosis. The disease is severe, but treatable. It is important to recognize in time the signs of an incipient disorder. Moreover, it may turn out to be a big surprise for relatives, appearing suddenly. Although gradually developing psychosis is difficult to recognize immediately.

Postpartum psychosis is a rare mental disorder that usually occurs in the first 2-4 weeks after childbirth. With timely diagnosis and a quick start of therapy, a woman can get out of this rapidly developing state in a few weeks, and with a belated diagnosis, recovery can take months. Often, a woman suffering from postpartum psychosis is not aware of her painful condition. Source: Wikipedia

Causes of the disease

Little is known about the causes of the disease. Doctors are inclined to believe that a sharp hormonal change female body in postpartum period can provoke the development of psychosis, complications during childbirth, emotional stress from the birth of a child. Constant lack of sleep, severe fatigue of the mother can also serve as a push.

Women whose relatives suffered from postpartum psychosis, as well as women with a history of bipolar depression or schizophrenia, are more at risk of getting sick. If a woman has already been diagnosed with postpartum psychosis after the first birth, there is a high probability of its recurrence after the second pregnancy.

The use of drugs before pregnancy can provoke the development of psychosis.

Everyone who has a high risk of getting sick should definitely consult a psychiatrist in order to minimize the likelihood of the disease.

Fortunately, postpartum psychosis is much less common than postpartum depression — approximately 0.1% of women in labor develop it.

Signs of postpartum psychosis

Contact a psychiatrist immediately if you notice the following symptoms in a woman who recently gave birth (literally in the first days after childbirth):

• A woman becomes absent-minded, cannot clearly express her thoughts. Periods of talkativeness are replaced by unwillingness to communicate;
• Aggressiveness or euphoria alternates with depression, and mood changes occur quite abruptly;
• The perception of taste and smell changes. Even refusal to eat is possible;
• Insomnia. If a woman's sleep is disturbed, she does not want to go to bed, this should also alert loved ones. She may develop delusional ideas and visions, auditory hallucinations;
• A woman has obsessions, it seems to her that the baby is in danger, they want to take his life, kidnap him. She does not allow anyone to approach the child, refuses to talk to people, is afraid to go out into the street;
• Or, on the contrary, the child becomes hated by the mother, she is even able to try to kill him. And he can show complete indifference to him. The same attitude can be towards people close to her.

The woman herself does not understand that she is sick, completely inadequate, so her family should take care of her and show her to the psychiatrist.

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It is necessary to take this disease seriously. After all, a sick person, without receiving the necessary treatment, can not only harm herself and the child, but also deprive herself and his life.

Treatment

At the first suspicion of a disease be sure to consult a psychiatrist. He will examine the patient and prescribe the necessary treatment for her.

Most often, a sick woman is admitted to the hospital. If there are conditions in the clinic, the baby is next to the mother. Basically, there are no such wards in the hospital, so the baby is at home with someone from his family. If the child is with his mother, then breastfeeding the baby during treatment is prohibited, because his mother receives strong antipsychotic medications, various mood stabilizers (normotimics).

Usually the patient's condition improves in a couple of weeks so much that she can be discharged home for follow-up treatment. The full course of treatment can last from six months to a year.

A lot of strength and patience will be required from relatives and friends:

• It is necessary to provide for the sick mother comfortable conditions conducive to recovery: peace, the opportunity to rest more;
• Most of the household chores will have to be taken over by the husband and other family members;
• During the course of treatment, one of the relatives should take care of the baby, the mother herself cannot yet do this;
• Temporarily limit meetings at home with friends - it is not time for guests.
• Try to morally support the woman, talk to her calmly, kindly, without reproaching what happened. After all, what happened is not the woman's fault;
• If possible, do not leave her alone;
• Monitor medication intake, dosage and timing;
• Get a full 8 hours of sleep.

Effects

If you do not start treatment on time, the consequences of a formidable disease can be dire. Being in a state of psychosis, a woman does not control her actions, she is in captivity of obsessions. There are cases when a mother who has just given birth, without receiving timely treatment and being in a manic - depressed state, attempted suicide. And not all of them, unfortunately, were prevented.

An acquaintance of mine, who suffered from postpartum psychosis, recalls that time as bad dream... Her childbirth was premature, difficult, obviously, this contributed to the development of the disease.

She says that she suddenly became irritable, shouted at everyone, everyone suddenly became enemies. I even had a fight with my mother-in-law. She wrote some vague, incomprehensible notes. Everything around him became alien, life seemed over. It seemed to her that the vitality had left her. Gustatory sensations have completely disappeared. Because of this, she refused to eat in the hospital. She was forced to spoon-feed her. How she ended up in the hospital - she doesn't remember at all. The treatment lasted six months.

Three years have passed, and she and her husband want a second child. But a friend is afraid of a recurrence of the disease. So she and her husband went to a psychiatrist who treated her. Now the woman fulfills all the doctor's recommendations and hopes that the terrible disease will not recur.

If the disease could not be avoided, and postpartum psychosis still manifested itself, do not despair. Remember - life goes on. It is very important to be considerate of a woman who has just given birth. Take care of her, help with household chores. Surround her with love. Give mommy an opportunity not to be overwhelmed, to rest more often. And then the terrible illness will recede and will be remembered simply as a severe nightmare.

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Postpartum psychosis is a rather rare mental disorder. It is also sometimes referred to as postpartum-onset bipolar disorder. A similar condition usually develops suddenly some time after childbirth (most often the disease makes itself felt in the first month after the birth of the child).

This type of psychosis can be quickly stopped if a woman does not ignore the pathological symptoms and seek help from a doctor so that he prescribes appropriate treatment.

Postpartum psychosis occurs more often in women whose pregnancy has proceeded with pathologies, after complicated childbirth, and also after birth dead child or a miscarriage. According to statistics, the described mental disorder occurs in one or two out of a thousand women in labor.

Interestingly, in women suffering from postpartum psychosis, no signs were found during pregnancy to suspect the occurrence of such a severe psychotic state in the future. It should be noted that qualified assistance for postpartum psychoses is not always provided to women on time. The fact is that some patients themselves are not aware of their pathological condition and blame everything on ordinary fatigue. In this case, it is important that relatives and friends are able to recognize the signs of a serious illness.

Provoking factors

It is widely believed that postpartum psychosis is a consequence of hormonal changes and vegetative shifts that inevitably occur in a woman's body during pregnancy and childbirth. Besides, generic activity associated with heavy physical exertion, which can also lead to illness. However, scientists have found that there are other reasons that can provoke a mental disorder, including hereditary ones. So, many patients with postpartum psychosis had close relatives with a similar diagnosis. It was also found that various psychological and social factors practically do not affect the mechanism of development of mental disorders, although, according to some experts, women should also be included in the risk group, in whose families an unfavorable situation is observed.

The risk of psychotic disorder after childbirth is almost doubled in women who have previously been diagnosed with schizophrenia or bipolar disorder, as well as other mental illness and traumatic brain injury. Also at risk are patients who have already experienced postpartum psychosis. In other cases, statistics show that the disease is more often diagnosed in primiparous women. As an indirect cause of the disorder, the personal qualities of the patients can also be considered, since the described mental illness is more often found in overly suspicious young mothers or women in labor who are not morally prepared for replenishment in the family. Drug addiction is also a risk factor for the development of postpartum psychosis.

Clinical picture

Postpartum psychosis always develops suddenly, and its first symptoms may appear just a couple of days after childbirth. If therapy is not started during this period, the disease will progress and lead to violations of the higher nervous activity women. The manifestations of pathology are always individual, it can proceed in a mild and severe form with a rather varied clinical picture... In some cases, the condition of the patients is so bad that they cannot take care of either themselves or the child.

There are key symptoms by which you can guess about the illness of a loved one:

With all this, the woman herself does not see anything strange in her behavior, since she simply does not realize that she is sick. This is what is most difficult, since the patient is extremely difficult to persuade to see a specialist. After some time from the beginning of therapy, the young mother herself will begin to understand how irrational and painful her behavior was, and what terrible consequences it could cause. Everything the above symptoms should not be ignored by the patient's relatives, since until the moment of complete recovery, the woman should always remain under their constant control.

It is worth mentioning that postpartum psychosis should not be confused with postpartum depression, despite somewhat similar symptoms. Apathy, melancholy, depression, lack of interest in all areas of life and your own child, thoughts of suicide are typical symptoms postpartum depression, which, moreover, are accompanied by a strong sense of guilt. In postpartum psychosis, all these clinical manifestations depression combined with signs of manic syndrome.

What is the threat of the disease?

If the treatment was not prescribed on time, postpartum psychosis, like any other disease, can end rather badly. Most dangerous consequences pathologies lie in the fact that a woman can harm both herself and the child. There are cases when young mothers made suicidal attempts or even tried to kill a newborn without realizing their actions.

Therapy

Diagnosis of the disease should be carried out by an experienced neurologist and psychiatrist, and consultation of other narrow specialists may also be required. Very often, the causes of a psychotic disorder lie in physical health a woman, which means that it is necessary to identify any existing violations, and take measures to eliminate them. As a rule, with postpartum neurosis, women are assigned drug therapy, which includes sedatives, antipsychotics and other drugs that can relieve pathological symptoms. In severe cases, a young mother may require hospitalization.

An extremely important point in the treatment of a difficult ailment is working with a psychotherapist. Psychotherapy should begin after a course of drug therapy, when the "acute" condition has already passed. A combination of individual and family psychotherapy can be effective depending on the specific situation. This is important not only for the patient herself, but also for her family members, who need to understand what is happening and what is the reason for the inappropriate behavior of the woman who has just given birth.

A competent psychologist will also help the patient to overcome the inevitable feeling of guilt in front of her own baby. The woman will gradually begin to realize that she was not near the child during her illness and, perhaps, even wanted to harm him, all this has a very depressing effect on the psyche, however good doctor will help the patient to understand himself and teach him to relate to the situation correctly. In most cases, the full course of therapy will lead to recovery.

If a woman has all the signs of postpartum psychosis and does not adequately treat the child, you need to isolate her from him. At the same time, someone should always be near the patient and monitor her actions. If she begins to make attempts to harm herself or others, urgent health care - it is best in this case to call the emergency psychiatric team. When the patient passes drug treatment, it is required to stop breastfeeding and transfer the baby to artificial formula.

One of the most important moments on the path of a young mother to recovery is the love and support of her family. If a woman is given the necessary care in the "acute" period of postpartum psychosis, her recovery will go much faster.

Prevention

Prevention of postpartum psychosis includes, first of all, psychological and physical fitness future mother for the upcoming birth. Women are advised to attend special courses for pregnant women, where future women in labor are taught breathing techniques and child care, communicate with already established mothers, that is, prepare themselves as much as possible for a meeting with a future baby. The effectiveness of such measures has been proven, since the ailment in question is extremely rare in women who are fully prepared for motherhood.

Those expectant mothers who are at risk of developing postpartum psychosis should consult in advance with a psychotherapist who will help minimize the likelihood of developing the disease.

In this article:

Postpartum psychosis is a mental disorder that manifests itself several days after the birth of a child. This condition can also manifest itself in a woman who has given birth to a still child or after a miscarriage. Sometimes a woman can get it even a few weeks after giving birth. Fortunately, this disease is quite rare: it affects 0.1-1.2% of women in labor.

Symptoms and Causes

Postpartum psychosis can take over a woman who has never suffered before mental disorders... But still, an increased risk threatens those women in labor who have previously suffered from schizophrenia and other mental illnesses, as well as those who have already suffered from postpartum psychosis.
The symptoms of this disease are characterized by variety and variability.

Postpartum psychosis can manifest itself as:

• depression and tearfulness;
• anxiety and worry;
• excitement and irritability;
• suspicion and fear;
• incoherent speech and impaired appetite;
• increased care for the child or indifference to him;
• excessive sociability and talkativeness;
• attempts to avoid communication with other people;
• alternation of the two previous symptoms;
• euphoria and extreme vivacity;
• a sharp change in mood and insomnia;
• confusion and lack of focus;
• hallucinations and unusual behavior;
• lack of adequate self-esteem;
• lack of ability to realistically assess the situation;
• delusional ideas and abnormal thinking;
• manic manifestations: paranoia or megalomania;
• thoughts of murder or suicide.

What are the causes of this disease? So far, no one has been able to identify them. But it is reliably known that family problems do not affect the development of the disease. Among the reasons most often called complications during childbirth, emotional stress from the birth of a child, genetic predisposition, changes in hormonal background, changes in sleep patterns, drug use, mental illness.