Melancholy: Depression during pregnancy and in the postpartum period

V Welcome and bounding

In 16th and 17th century Europe, medical publications described melancholy as a disease. The two main symptoms were extreme fear and sadness caused either by an excess of «black bile» or by the influence of the devil. It was therefore an evil with a physical and spiritual origin and had to be treated as such.

During pregnancy the two main causes of what would later be called perinatal depression were, first, fear of pain and death in childbirth. In 1587, Luisa Oliva de Sabuco wrote about «sudden fears» provoked by her imagination in her Nueva filosofía de la naturaleza del hombre. And second was the fear of not only losing the baby, but that it would die without receiving the saving waters of baptism. As described in a work on the life and miracles of Saint Nicholas Tolentino, a woman«whose children were all stillnorn», «was heartbroken and very sad», unable to overcome the experience because she could not baptize them. After a baby was born, postpartum depression could lead to psychosis, as in the case of a documented parturient woman who «went crazy and lost her mind after giving bith» and did such things that her relatives had to chain her until she was able to overcome her depression by praying a novena to Saint Diego of Alcalá.

To address the problems of pregnant women and those affected by depression in labour, various alternatives were offered. Doctors recommended pharmacological and psychological solutions such as walks through orchards and along riverbanks, music, or a good conversation. For their part, theologians encouraged prayer, praying to holy intermediaries, and trusting in divine action through miracles. In both cases, understanding, support, and comfort were essential to overcoming bouts of depression. [Jesús María Usunáriz Garayoa]