MENTAL DESPONDENCY.
When we consider how important an epoch the period of pregnancy is in a woman’s life, we cannot be surprised that her mind should sometimes fall into a state of depression, out of which it is not in her own power, or that of any who are about her, to recall it. In the first pregnancy especially, the mind is apt to become thus affected. Shall I be able to survive the period? Shall I bring forth a well-formed, or a diseased, misshapen, deformed child? Will it not present badly at birth? Shall I not have twins, or triplets, perhaps? What new and untold agonies must I be brought to endure? These, and the like questions, must suggest themselves to the mind of every sensible and reflecting woman, and more particularly so when she is carrying her first child. And so it should be; for, say what we will about the safety of labor, about its being a natural process, etc., there are yet the pains and perils which belong necessarily to it, and which all of your sex who bear children must inevitably, to a greater or less extent, be subject to. I have not, I trust, heretofore, in my medical lifetime, been wholly unmindful of my duty as a physician, in endeavoring to instruct and to encourage your sex in these matters. But I have never wished to conceal my conviction that I regard pregnancy and childbirth as things of very serious moment in a woman’s life; and he who can trifle with them is almost worse than a very fiend. Bear witness, then, I respectfully ask of all of you, that I, for one, have no sympathy with that nonsensical foolishness which would lead some people to tell you that pregnancy and childbirth are matters which need cause you no trouble, no agony, and no pain. I repeat, then, considering the truth in these things, it is not at all surprising that the pregnant woman should feel a good deal of concern in consequence of what she is to pass through.
But I must tell you also, that this mental solicitude is often increased to an unnecessary extent by the inadvertent remarks which are sometimes made respecting some unfavorable case. One tells of one sad accident, and one of another. Now all this is both unkind and unjust. Only place yourselves in the case of the pregnant woman. Would you like to have those strange and horrible stories told you, some of which may be true, and some not? Would you not rather that your sisters would speak to you, generally, at least, of pleasant occurrences, and of pleasant things? If they could not speak to you in a hopeful manner, certainly you would rather they would not speak to you at all.
Did you ever think of one of your sisters who is pregnant with an illegitimate child? If you who have kind husbands and kind friends to take care of you, become low-spirited in pregnancy, what must be the feelings of her who knows that she must constantly be looked upon as an object of shame? What think you of her who has been led astray by the profligate from virtue’s paths of pleasantness and peace? of her who is compelled to consider her pregnancy as a curse instead of a blessing, and who has, in addition to the troubles of this state, to bear up against the agony of her disappointed hopes, her sorrows, and her grief. She must live in anticipation of a shame from which she can find no antidote, no retreat. How often, alas! has such a state of mind ended in a state of disease which has, in a short period, terminated life. Believe we that Jesus of Nazareth would treat such a one as we too often have done, when we know that He said, kindly and affectionately, to a woman who had been caught in the very act of adultery, “Go, and sin no more!” Many a one has been thus disowned who might have been a loving mother and an affectionate companion through a long and happy life, and whose death-agonies were only the more embittered by the reflections of her fallen and deserted state.
In ordinary cases depression of the spirits is most apt to come on during the earlier months of gestation. Dr. Montgomery speaks of a curious fact connected with the state of mind in pregnant women, when their bodily health is at the same time good, namely, that however depressed or dispirited with gloomy forebodings they may have felt in the early part of their pregnancy, they in general gradually resume their natural cheerfulness as gestation advances; and a short time before labor actually commences, often feel their spirits rise, and their bodily activity increase to a degree they had not enjoyed for months before. This, however, does not always take place, for in some cases the despondency continues to the very end of the period, at which time it generally disappears, but not until the pains of labor have actually commenced. With some, likewise, the despondency continues even after the labor has been passed through, and amounts almost to a fit of mental derangement.
Treatment.—It should always be remembered, that in most cases of the kind I have been considering, the state of health is not good. In some cases the deranged state of the body operates, doubtless, to depress the spirits and to derange the mental manifestations. In other cases the mind appears to become first affected, and afterward the body suffers in consequence thereof. In some cases, also, it is to be supposed that the action is reciprocal, and probably pretty fairly balanced between the two.
This explanation will enable us to form an opinion as to what the course of treatment should consist in, which is, as far as possible, to remove the causes of the difficulty.
In the slighter cases of mental depression a little improvement of the general health is often sufficient to work a radical change in the patient’s feelings. In the more persistent cases we should do all in our power to tranquilize the mind and restore the bodily health.