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assumed 'tags' in /websites/forum2008/viewthread.php(601) : regexp code on line 2 Notice: Use of undefined constant tags - assumed 'tags' in /websites/forum2008/viewthread.php(601) : regexp code on line 2 Notice: Use of undefined constant tags - assumed 'tags' in /websites/forum2008/viewthread.php(601) : regexp code on line 2 Notice: Use of undefined constant tags - assumed 'tags' in /websites/forum2008/viewthread.php(601) : regexp code on line 2 Notice: Use of undefined constant tags - assumed 'tags' in /websites/forum2008/viewthread.php(601) : regexp code on line 2 Notice: Use of undefined constant tags - assumed 'tags' in /websites/forum2008/viewthread.php(601) : regexp code on line 2 認識產後憂鬱症 (爸爸要看喔~) - 親子 - 噓!論壇 _ 無忌的論壇 ~ 歡迎芝麻小事,別聊國家大事 ~

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認識產後憂鬱症 (爸爸要看喔~)

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認識產後憂鬱症 (爸爸要看喔~)

「嬰仔嬰仔睏,一眠大一吋、嬰仔嬰仔睏,一年大一尺……」這是一幅慈愛的媽咪哄小寶貝睡覺的溫馨畫面,但是有很多的原因無法讓每位媽媽享受快樂母子行的經驗,而「產後憂鬱症」就是其中之一。

三十歲的美美(化名)一個月前好不容易生下一個重達3700公克的白胖兒子,但她卻無法感受到快樂,心裡始終被一種難以排遣的煩悶憂鬱折磨著。小孩剛出生時,她還因為得子不易而有著些許愉快,但欣喜過後,她覺得老公及公婆都因為喜歡孩子,而冷落了她;老公更在當了爸爸後失去了以前的幽默感,不再講笑話給她聽;更難以忍受的是兒子動不動就生病,三天兩頭要帶他去打針吃藥,從此美美變得抑鬱寡歡,身材也很快消瘦,還患上了嚴重的失眠症。最近她的眼圈老是黑黑的,一天下來說不到五句話,還經常無故地哭哭笑笑,最後家人陪她到精神科門診就醫,經診斷美美罹患了「產後憂鬱症」……



[B][color="green"]別輕忽產後憂鬱症[/B]

醫師指出,過去一般人並不認為「產後憂鬱症」是一種疾病,反而認為是產後身體虛弱造成的。不過,醫學界目前已證實「產後憂鬱症」是一種有著生理基礎的疾病,因此提醒媽咪們千萬別忽視這個疾病,因為這個病的發生率很高,一旦產後媽咪得了產後憂鬱症,不只可能會降低婦女的工作能力,影響家庭及社會經濟,另外對小孩也可能會有行為及認知異常的不良影響,甚至會影響家庭中其他成員的心智健康。



[B][color="green"]產後憂鬱症三部曲[/B]

一般而言,產後憂鬱症可以分成以下三種:

一、產後情緒低落(postpartum blue):

發生率非常高,約佔產婦的50%~80%,大多發生在產後 3~10天內,發作的時間很短暫,從幾分鐘至好幾天,但最多不會超過二個星期,主要的症狀是喜歡哭、容易疲憊、情緒不穩及食慾下降。在身體方面會出現頭痛、失眠及易做惡夢等症狀,對嬰兒會表現出喜怒無常的矛盾反應,認為自己沒有能力可以照顧剛出生的小孩。

二、產後沮喪(postpartum depression):

發生率約佔產婦的10%~20%,大多在生產完3天後左右出現,症狀跟「產後情緒低落」類似,只是表現更多樣化、更嚴重及發作的時間更久,嚴重的行為異常大多在產後幾週到幾個月後才會發生,平均的發作時間約6~9個月,有近一半的婦女甚至會超過一年。典型的症狀包括容易激動、莫名哭泣、易失眠、反應變遲鈍、出現強烈的罪惡感、甚至不停的產生自殺或是想死的念頭。

三、產後精神病(postpartum psychosis):

發生率約千分之一至千分之二,這類患者較常出現在精神科門診。大多在生產2天以後才開始發作,不過最容易出現在產後1~4週發作,症狀經常會持續好幾個月以上。產後精神病又可分成兩種型態,一種是早發型,在產後3週內發作,容易發生在第一胎、較年輕或有類似情感性精神病的婦女身上。另一種為晚發型,在產後3週以後才發作,大多發生於有生產經驗、較年長、未婚、社經地位較低的患者,有類似精神分裂症狀,預後較差。典型症狀包括情緒躁動不安、意識混動、人格解離、妄想、看起來像「木頭人」,對外界沒有任何反應,也會有罪惡感、無力感及產生一些誤認胎兒已死亡,甚至懷疑小孩被掉包等幻覺。



[B][color="green"]產後憂鬱症的發生原因[/B]

一、荷爾蒙的變化:

在生產完後,產婦血液中的動情激素及黃體脂酮會突然減少,容易造成荷爾蒙失調,使產婦元氣大減,造成情緒不穩定。

二、產婦睡眠不足:

產婦在懷孕末期需要更多的睡眠,但因為常被胎動吵醒,或心情緊張、興奮而難以入睡,或無法維持一個好的眠眠姿勢而產生失眠。接著又必須渡過生產過程的煎熬,所以一個初產婦在生產前後往往容易造成睡眠不穩定,結果就容易出現煩燥不安、頭痛、情緒起伏,甚至產生憂鬱狀態。

三、產後壓力增加:

產婦常會因為嬰兒的喂哺及日常照顧問題造成日夜巔倒,加上如果小孩有常出現身體不適而吵鬧,容易造成產婦的身體及心理壓力。

四、媽媽產前曾有情緒障礙問題。



[B][color="green"]產後憂鬱症的治療[/B]

醫師指出,丈夫和家人的關心與支持是產後憂鬱症最好的治療方法。
另外產婦也可以在坐月子期間做一些自己喜歡做的事,找個適合的朋友,把心裡的不安和不滿都說出來和對方分享,千萬別壓抑情緒。在坐月子時也可以嘗試起床慢步行走,這樣不但有助於血液循環,也能讓傷口復原的比較快。除了休息及做簡單的產後運動外,日常生活也應該要注意飲食習慣,每天最好喝2至3公升的水,並選擇多吃含高纖的蔬菜水果,及含高蛋白質的白肉。如果在育嬰方面出現問題或疑問,也應不恥下問,多問長輩或朋友,甚至醫護人員。最後和老公要保持良好的溝通,也可多安排一些親友聚會,交換彼此育嬰心得,建立支持系統。畢竟想要寶寶成為開心活潑的孩子,父母親也必需要是快樂健康的人。



[B][color="green"]結語[/B]

大部份的產婦在生產後的情緒低落,只要有家人的支持及照顧,都可以順利痊癒,不過如果嚴重到達產後憂鬱症的標準,這時就需要接受精神科的治療。醫師在確定診斷後,除了會給予抗憂鬱劑外,還可以由護理人員教導產後的自我生理照顧及如何注意嬰兒發展上的可能問題;心理師也可以針對產婦的失落感及負向認知方面想法,提供適當之心理輔導;在家庭及社會支持方面,則由社工師在評估與了解後,適時地利用外在資源來協助媽媽的角色扮演。因此在各方面的配合治療下,大多數的母親都能夠免除產後憂鬱症的困擾。


[B][color="green"]容易產生產後憂鬱症的族群:[/B]

1.有憂鬱症病史的產婦

2.有憂鬱症家族史的產婦

3.對體內荷爾蒙變化敏感的人,如有經前緊張症候群的女性

4.第一次生產的女性

5.有過產後憂鬱症病史的產婦等


[B][color="Green"]預防產後憂鬱症DIY[/B]

1.要保持精神愉快、開朗,對任何事情不要鑽牛角尖。認真觀察小孩,但不要精神敏感,草木皆兵。

2.給自己適應寶寶的時間,對自己不要太苛刻,不需要求自己馬上做到一百分媽媽。

3.注意清潔衛生,可化些淡妝,噴些香水,這樣會精神飽滿。

4.屋內可放些鮮花,經常開窗通風,保持清潔整齊。

5.適當參加一些體育運動,注意產後恢復。

6.家人的體貼很重要,夫妻間應多交流、多溝通


專家/新店耕莘醫院精神科主任 楊聰財醫師
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