Setembro Amarelo: como reconhecer uma mãe precisando de ajuda
Mesmo com o aumento do conhecimento sobre as dificuldades do puerpério, baby blues e depressão pós-parto, ter um filho ainda é considerado como um momento perfeito, de realização pessoal, em que a mulher está sempre feliz. A visão romântica pode fazer com que a mãe deixe de pedir ajuda quando sente que sua saúde mental está abalada.
“A idealização que se faz da maternidade dificulta o diagnóstico de depressão pós-parto e outros transtornos”, comenta Renata Pereira de Felipe, pesquisadora do Centro em Pesquisa Aplicada em Bem-estar e Comportamento Humano da Universidade de São Paulo (USP).
Discutir a saúde mental da mulher durante a maternidade e abrir espaço para que uma mãe que está sofrendo rompa o silêncio são os primeiros passos para diminuir os índices de depressão pós-parto, que chegam a 40% no Brasil. Ela é um dos principais fatores de risco para o suicídio materno, para o qual não existem dados nacionais.
Como flagrar o sofrimento
Logo depois do parto, algumas mães passam pelo baby blues, condição bem prevalente que causa uma melancolia passageira, que tende a regredir nas primeiras semanas de vida do bebê. A depressão pós-parto geralmente surge um pouco depois, até o quarto mês – período que pode se estender até um ano.
Mesmo antes do bebê nascer, a saúde mental deve ser observada. “A sociedade passa a ideia de que ela deve estar feliz grávida, e quando ela percebe que não está, pode omitir esse sentimentos para que não haja julgamento ou culpa”, afirma Marcella Sandim, psicóloga especialista em saúde mental materna, que compartilha dicas sobre o tema no perfil Aprimorar Materno. Essa tristeza fora do comum pode, por exemplo, se disfarçar de excesso de atividades.
As sutilezas continuam depois do parto. Diferente do que se pensa, nem sempre a mulher com depressão ficará mais distante do bebê. “Mesmo uma mãe com indicadores de depressão pós-parto pode ter uma boa interação com seu filho, sorrindo, tocando e falando com ele na mesma frequência que mães não deprimidas”, comenta Renata, que estudou o tema em seu mestrado. “O que muda é a qualidade dessas trocas”, explica.
Essas alterações são muito individuais e podem ser imperceptíveis a quem está ao redor, por isso vale prestar atenção a outros indícios de depressão. São eles:
- Perder o prazer em coisas e atividades que gostava antes
- Tristeza excessiva
- Falta ou excesso de apetite
- Insônia ou sono excessivo
- Desinteresse sexual
- Alterações bruscas do humor
- Deixar de ver sentido nas coisas
- Choro constante
- Tirar a prioridade de si e dedicar-se só aos outros, em especial ao bebê
- Sentimento de que não se reconhece mais
As alterações de humor e a falta de disposição/interesse são as evidências mais comuns – as outras nem sempre dão as caras. “O mais importante de tudo não é exatamente que sintoma aparece, mas a frequência do comportamento, atitude ou pensamento”, ensina Marcella.
Como reconhecer o risco de suicídio
Os sinais são semelhantes aos da depressão, mas com algumas diferenças. “Uma coisa muito característica é fala do esgotamento, quando mente e corpo estão no limite e a mãe verbaliza isso”, aponta Marcella. Frases como “eu não aguento mais”, “eu já tentei de tudo”, “eu não consigo mais”, “eu quero sumir” são motivo para entrar em estado de alerta.
Esse desejo de não viver pode se manifestar a nível físico: a pessoa começa a dormir demais ou usar substâncias lícitas, como álcool e medicamentos, e mesmo ilícitas. O comportamento pode ser de distanciamento das pessoas que ela ama, para evitar que elas sofram. “Ou, contrário, uma aproximação intensa de coisas e pessoas que ela gostou durante a vida, como uma despedida”, ensina Marcella.
O que leva ao suicídio, de fato?
Antever o problema é importante. Por isso, fique atento aos fatores de risco, como ansiedade durante a gravidez, eventos estressantes, como a morte de alguém querido, divórcio, dificuldades financeiras ou perda do emprego. “Tentativas prévias, histórico familiar e outros transtornos além da depressão, como o bipolar, também devem ser levados em consideração”, destaca Helena Aguiar, psicóloga da Perinatal Barra, no Rio de Janeiro.
Outros fatores como estar em um ambiente vulnerável, sofrer violências físicas ou verbais, não ter apoio do parceiro ou da família, além de sentimento de isolamento podem levar em casos extremos, à vontade de tirar a própria vida. “O suicídio é a consequência de algo que está acontecendo na vida da mulher, uma resolução para seus problemas”, aponta Marcella.
Como ajudar
A estratégia mais certeira é oferecer à mulher um espaço de fala, onde ela possa expressar o que está sentindo e quais são suas dificuldades. Para que isso ocorra, é importante não romantizar a maternidade. Nem sempre a mãe consegue dividir suas angústias, e isso pode ficar mais fácil se a cobrança social sobre ela diminuir.
E dá até para prevenir problemas emocionais e transtornos como a depressão. Existe o pré-natal psicológico, uma ferramenta de preparação da mulher – e diferente do que se prega por aí, os especialistas não acreditam na história de que todas nascem sabendo como ser mães.
Mostrar a ela que não está sozinha, oferecer ajuda em tarefas e atender necessidades também ajudam a diminuir um pouco da sobrecarga dos primeiros meses. “Mas quando a pessoa próxima percebe um grande risco, é necessário encaminhar essa mulher para um profissional adequado”.
Como procurar ajuda
Os especialistas comentam que o ideal é recorrer a especialistas que tenham conhecimento em saúde mental materna. O ginecologista também pode ajudar. “Há uma técnica para identificar de maneira rápida o risco de depressão pós-parto, que deveria ser usada por todos os ginecologistas e obstetras”, comenta Renata, citando a Escala de Depressão Pós-Parto de Edimburgo, um questionário simples, com 10 questões que avaliam os sentimentos e pensamentos recorrentes da mulher.
“Mas o que vimos é que essa prática não é utilizada amplamente, assim as mães acabam sujeitas a uma avaliação subjetiva”, diz a pesquisadora, que destaca o papel das políticas públicas para melhorar o cuidado com as mães. “A falta de financiamento impede a realização de estudos que sirvam de base para estratégias efetivas”, conclui.
O CVV – Centro de Valorização da Vida, oferece suporte para pessoas pelo telefone 141 ou acesse o site. O atendimento é gratuito, sigiloso e não é preciso se identificar. O site também oferece um material bem rico sobre como ajudar alguém que pensa em suicídio.
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