Deprecated: Creation of dynamic property wpdb::$categories is deprecated in /home/1/s/speilvendt/www/wp-includes/wp-db.php on line 668

Deprecated: Creation of dynamic property wpdb::$post2cat is deprecated in /home/1/s/speilvendt/www/wp-includes/wp-db.php on line 668

Deprecated: Creation of dynamic property wpdb::$link2cat is deprecated in /home/1/s/speilvendt/www/wp-includes/wp-db.php on line 668

Deprecated: Return type of WP_Theme::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 554

Deprecated: Return type of WP_Theme::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 595

Deprecated: Return type of WP_Theme::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 535

Deprecated: Return type of WP_Theme::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 544

Deprecated: Return type of WP_REST_Request::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/rest-api/class-wp-rest-request.php on line 952

Deprecated: Return type of WP_REST_Request::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/rest-api/class-wp-rest-request.php on line 972

Deprecated: Return type of WP_REST_Request::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/rest-api/class-wp-rest-request.php on line 984

Deprecated: Return type of WP_REST_Request::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/rest-api/class-wp-rest-request.php on line 995

Deprecated: Return type of WP_Block_List::current() should either be compatible with Iterator::current(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 151

Deprecated: Return type of WP_Block_List::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 175

Deprecated: Return type of WP_Block_List::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 164

Deprecated: Return type of WP_Block_List::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 186

Deprecated: Return type of WP_Block_List::rewind() should either be compatible with Iterator::rewind(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 138

Deprecated: Return type of WP_Block_List::offsetExists($index) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 75

Deprecated: Return type of WP_Block_List::offsetGet($index) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 89

Deprecated: Return type of WP_Block_List::offsetSet($index, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 110

Deprecated: Return type of WP_Block_List::offsetUnset($index) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 127

Deprecated: Return type of WP_Block_List::count() should either be compatible with Countable::count(): int, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 199

Deprecated: Creation of dynamic property ACF::$fields is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/fields.php on line 138

Deprecated: Creation of dynamic property acf_loop::$loops is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/loop.php on line 28

Deprecated: Creation of dynamic property ACF::$loop is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/loop.php on line 269

Deprecated: Creation of dynamic property ACF::$revisions is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/revisions.php on line 387

Deprecated: Creation of dynamic property acf_validation::$errors is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/validation.php on line 28

Deprecated: Creation of dynamic property ACF::$validation is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/validation.php on line 215

Deprecated: Creation of dynamic property acf_form_customizer::$preview_values is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-customizer.php on line 28

Deprecated: Creation of dynamic property acf_form_customizer::$preview_fields is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-customizer.php on line 29

Deprecated: Creation of dynamic property acf_form_customizer::$preview_errors is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-customizer.php on line 30

Deprecated: Creation of dynamic property ACF::$form_front is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-front.php on line 600

Deprecated: Creation of dynamic property acf_form_widget::$preview_values is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-widget.php on line 34

Deprecated: Creation of dynamic property acf_form_widget::$preview_reference is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-widget.php on line 35

Deprecated: Creation of dynamic property acf_form_widget::$preview_errors is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/forms/form-widget.php on line 36

Deprecated: Return type of WPCF7_FormTag::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/form-tag.php on line 395

Deprecated: Return type of WPCF7_FormTag::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/form-tag.php on line 387

Deprecated: Return type of WPCF7_FormTag::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/form-tag.php on line 381

Deprecated: Return type of WPCF7_FormTag::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/form-tag.php on line 399

Deprecated: Return type of WPCF7_Validation::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/validation.php on line 78

Deprecated: Return type of WPCF7_Validation::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/validation.php on line 72

Deprecated: Return type of WPCF7_Validation::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/validation.php on line 59

Deprecated: Return type of WPCF7_Validation::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-content/plugins/contact-form-7/includes/validation.php on line 82

Deprecated: Creation of dynamic property Shortcodes_Ultimate::$about_menu is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/shortcodes-ultimate/includes/class-shortcodes-ultimate.php on line 207

Deprecated: Creation of dynamic property Shortcodes_Ultimate::$unsafe_features_notice is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/shortcodes-ultimate/includes/class-shortcodes-ultimate.php on line 229

Deprecated: Creation of dynamic property Shortcodes_Ultimate::$widget is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/shortcodes-ultimate/includes/class-shortcodes-ultimate.php on line 256

Deprecated: Creation of dynamic property Automattic\Jetpack\Connection\Manager::$error_handler is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/vendor/automattic/jetpack-connection/src/class-manager.php on line 91

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Instagram_Gallery::$is_wpcom is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/class-wpcom-rest-api-v2-endpoint-instagram-gallery.php on line 23

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Mailchimp::$wpcom_is_wpcom_only_endpoint is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/class-wpcom-rest-api-v2-endpoint-mailchimp.php on line 17

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Tweetstorm_Gather::$wpcom_is_wpcom_only_endpoint is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/class-wpcom-rest-api-v2-endpoint-tweetstorm-gather.php on line 21

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Tweetstorm_Gather::$is_wpcom is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/class-wpcom-rest-api-v2-endpoint-tweetstorm-gather.php on line 22

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Gutenberg_Available_Extensions::$wpcom_is_site_specific_endpoint is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/gutenberg-available-extensions.php on line 20

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Memberships::$wpcom_is_wpcom_only_endpoint is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/memberships.php on line 23

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Memberships::$wpcom_is_site_specific_endpoint is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/memberships.php on line 24

Deprecated: Creation of dynamic property WPCOM_REST_API_V2_Endpoint_Subscribers::$wpcom_is_wpcom_only_endpoint is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/_inc/lib/core-api/wpcom-endpoints/subscribers.php on line 15

Deprecated: Creation of dynamic property POMO_FileReader::$is_overloaded is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 21

Deprecated: Creation of dynamic property POMO_FileReader::$_pos is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 22

Deprecated: Creation of dynamic property POMO_FileReader::$_f is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 153

Deprecated: Creation of dynamic property MO::$_gettext_select_plural_form is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/translations.php on line 293

Deprecated: Creation of dynamic property Automattic\Jetpack\Sync\Queue::$random_int is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/vendor/automattic/jetpack-sync/src/class-queue.php on line 38

Deprecated: Creation of dynamic property Publicize_UI::$in_jetpack is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/modules/publicize.php on line 53

Deprecated: Creation of dynamic property POMO_FileReader::$is_overloaded is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 21

Deprecated: Creation of dynamic property POMO_FileReader::$_pos is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 22

Deprecated: Creation of dynamic property POMO_FileReader::$_f is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 153

Deprecated: Creation of dynamic property MO::$_gettext_select_plural_form is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/translations.php on line 293

Deprecated: Creation of dynamic property POMO_FileReader::$is_overloaded is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 21

Deprecated: Creation of dynamic property POMO_FileReader::$_pos is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 22

Deprecated: Creation of dynamic property POMO_FileReader::$_f is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 153

Deprecated: Creation of dynamic property MO::$_gettext_select_plural_form is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/translations.php on line 293

Deprecated: Creation of dynamic property CZR_resources_scripts::$_resouces_version is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/class-fire-resources_scripts.php on line 20

Deprecated: Creation of dynamic property POMO_FileReader::$is_overloaded is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 21

Deprecated: Creation of dynamic property POMO_FileReader::$_pos is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 22

Deprecated: Creation of dynamic property POMO_FileReader::$_f is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 153

Deprecated: Creation of dynamic property MO::$_gettext_select_plural_form is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/translations.php on line 293

Deprecated: Creation of dynamic property CZR_resources_styles::$_resouces_version is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/class-fire-resources_styles.php on line 35

Deprecated: Creation of dynamic property WPCOM_Widget_Goodreads::$shelves is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/modules/widgets/goodreads.php on line 33

Deprecated: DateTime::__construct(): Passing null to parameter #1 ($datetime) of type string is deprecated in /home/1/s/speilvendt/www/wp-includes/script-loader.php on line 331

Deprecated: Creation of dynamic property POMO_FileReader::$is_overloaded is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 21

Deprecated: Creation of dynamic property POMO_FileReader::$_pos is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 22

Deprecated: Creation of dynamic property POMO_FileReader::$_f is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 153

Deprecated: Creation of dynamic property acf_field_oembed::$width is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/fields/class-acf-field-oembed.php on line 31

Deprecated: Creation of dynamic property acf_field_oembed::$height is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/fields/class-acf-field-oembed.php on line 32

Deprecated: Creation of dynamic property acf_field_google_map::$default_values is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/fields/class-acf-field-google-map.php on line 33

Deprecated: Creation of dynamic property acf_field__group::$have_rows is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/advanced-custom-fields/includes/fields/class-acf-field-group.php on line 31

Deprecated: Return type of Requests_Cookie_Jar::offsetExists($key) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Cookie/Jar.php on line 63

Deprecated: Return type of Requests_Cookie_Jar::offsetGet($key) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Cookie/Jar.php on line 73

Deprecated: Return type of Requests_Cookie_Jar::offsetSet($key, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Cookie/Jar.php on line 89

Deprecated: Return type of Requests_Cookie_Jar::offsetUnset($key) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Cookie/Jar.php on line 102

Deprecated: Return type of Requests_Cookie_Jar::getIterator() should either be compatible with IteratorAggregate::getIterator(): Traversable, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Cookie/Jar.php on line 111

Deprecated: Return type of Requests_Utility_CaseInsensitiveDictionary::offsetExists($key) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Utility/CaseInsensitiveDictionary.php on line 40

Deprecated: Return type of Requests_Utility_CaseInsensitiveDictionary::offsetGet($key) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Utility/CaseInsensitiveDictionary.php on line 51

Deprecated: Return type of Requests_Utility_CaseInsensitiveDictionary::offsetSet($key, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Utility/CaseInsensitiveDictionary.php on line 68

Deprecated: Return type of Requests_Utility_CaseInsensitiveDictionary::offsetUnset($key) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Utility/CaseInsensitiveDictionary.php on line 82

Deprecated: Return type of Requests_Utility_CaseInsensitiveDictionary::getIterator() should either be compatible with IteratorAggregate::getIterator(): Traversable, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/Requests/Utility/CaseInsensitiveDictionary.php on line 91

Deprecated: Creation of dynamic property POMO_FileReader::$is_overloaded is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 21

Deprecated: Creation of dynamic property POMO_FileReader::$_pos is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 22

Deprecated: Creation of dynamic property POMO_FileReader::$_f is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/streams.php on line 153

Deprecated: Creation of dynamic property MO::$_gettext_select_plural_form is deprecated in /home/1/s/speilvendt/www/wp-includes/pomo/translations.php on line 293

Deprecated: Creation of dynamic property WP_Block_Type::$plan_check is deprecated in /home/1/s/speilvendt/www/wp-includes/class-wp-block-type.php on line 284

Deprecated: Creation of dynamic property Jetpack_Shortcode_Unavailable::$shortcodes is deprecated in /home/1/s/speilvendt/www/wp-content/plugins/jetpack/modules/shortcodes/unavailable.php on line 19

Deprecated: trim(): Passing null to parameter #1 ($string) of type string is deprecated in /home/1/s/speilvendt/www/wp-includes/class-wp.php on line 173

Deprecated: Creation of dynamic property WP_Term::$object_id is deprecated in /home/1/s/speilvendt/www/wp-includes/class-wp-term.php on line 198

Deprecated: Creation of dynamic property CZR_header_model_class::$mobile_nbwrapper_class is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_header_model_class::$primary_nbwrapper_container_class is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_header_model_class::$topbar_nbwrapper_container_class is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_logo_model_class::$src is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_related_posts_model_class::$excerpt_length is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_related_posts_model_class::$media_cols is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_related_posts_model_class::$content_cols is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_related_posts_model_class::$element_width is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283

Deprecated: Creation of dynamic property CZR_Model::$inner_container_class is deprecated in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/fmk-ccat.php on line 283
diagnosespalte (stygt): Fødselsdepresjon – Speilvendt
Deprecated: Implicit conversion from float 35.400000000000006 to int loses precision in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/functions-ccat.php on line 1638

Deprecated: Implicit conversion from float 35.400000000000006 to int loses precision in /home/1/s/speilvendt/www/wp-content/themes/customizr/core/functions-ccat.php on line 1639

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diagnosespalte (stygt): Fødselsdepresjon


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Illustrasjon Annie Eline Lundgren

Fødselsdepresjon er en relativt vanlig, men underkommunisert og underdiagnostisert svangerskapskomplikasjon som rammer mellom 5-10 % av friske fødende. Fødsels- og barseldepresjon omfavnes per dags dato ikke av ICD-10, og er derfor ikke en selvstendig diagnose (FHI, 2018). I DSM-5 kategoriseres fødselsdepresjon (postpartum depression) som en subtype av alvorlig depresjon (major depressive disorder: MDD) som fremtrer omkring fødsel (peripartum). I Norge omfatter begrepet depressive symptomer samt alle alvorlighetsgrader av klinisk depresjon som oppstår i forbindelse med graviditet og fødsel. Fødselsdepresjonsdiagnosen i DSM-5 og fødselsdepresjonstermen favner altså om litt ulike fenomener. Denne teksten vil ta for seg postpartum depression (PPD)  som omfavnes av DSM-5, og basere seg på de empiriske funnene som er gjort på diagnosen de siste 10 årene. 

Hva er egentlig fødselsdepresjon og hvordan oppleves det for de som rammes av det? Hva er forskjellen på fødselsdepresjon og barseltårer? Hva er risikofaktorene og beskyttelsesfaktorene for å utvikle en fødselsdepresjon, og hvordan kan man behandle det? Dette skal vi prøve å svare på i denne utgaven av Diagnosespalten. 

Psykopatologi

PPD og MDD deler de samme diagnosekriteriene og har et relativt likt symptombilde med depressivt stemningsleie, manglende interesse for eller glede av tidligere lystbetonte aktiviteter. Mange opplever også søvn- og appetittforstyrrelser, nedsatt konsentrasjonsevne, utmattelse, økt skyldfølelse og nedsatt selvfølelse. For å klassifiseres som PPD og ikke MDD, skal symptomene oppstå under svangerskapet eller i løpet av de første fire ukene etter fødsel. I klinisk praksis bruker man likevel et intervall på 4-52 uker postpartum. PPD skiller seg også fra MDD ved at diagnosen omfavner angstsymptomer, følelseslabilitet og tvangstanker knyttet til barnets velvære og helse. Noen få sliter også med påtrengende tanker om å skade barnet. Omkring 20 % av de med PPD rapporterer om selvmordstanker. PPD-diagnosen omfatter altså en rekke symptomer og symptomtrykk, og man vil derfor kunne forvente å se relativt ulike tilstandsbilder i klinisk praksis (Stewart & Vigod, 2019). I tillegg er det mange mødre som vil oppleve nedstemthet og emosjonell labilitet i etterkant av fødsel. Men barseltårer er i motsetning til fødselsdepresjon en normal og forbigående tilstand som kan vare et par døgn til noen få uker. Dersom den følelsesmessige tilstanden til mor forverres, og barseltårene blir hemmende for mor og relasjonen til barnet eller får alvorlig karakter, kan man begynne å mistenke en begynnende fødselsdepresjon (FHI, 2018). 

Konsekvenser for mor og barn

Fødselsrelaterte depresjoner, psykoser og angstlidelser er et betydelig folkehelseproblem som koster samfunnet dyrt, både økonomisk og i menneskelig lidelse. En rekke studier og kunnskapsoppsummeringer viser at fødselsdepresjon hos mor kan utgjøre en risiko for en rekke utviklingsmessige og tilknytningsmessige komplikasjoner hos barnet. En systematisk kunnskapsoppsummering fra 2019 fant at barn av mødre med PPD hadde betydelig høyere risiko for fysiske komplikasjoner, søvnplager, forstyrret språkutvikling og usikker tilknytning samt kognitive, emosjonelle og sosiale vansker (Slomian et al., 2019). Det forebyggende og helsefremmende arbeidet starter allerede i mors liv (Mascali, 2022), og svangerskapskomplikasjoner kan ha langvarige konsekvenser for både mor, barn og øvrige familie. 

Mulige risikofaktorer

Risikofaktorene for PPD omfatter både sosiale, økonomiske, biologiske og livsstilsmessige forhold. Vi vet at personer som har en sykdomshistorie med tidligere depressive episoder, angstlidelser, bipolar lidelse, traumelidelser, PMDD og alvorlig PMS har en forhøyet risiko for å utvikle PPD. Ytre stressorer som gir økt risiko er  dårlig økonomi, lav sosial støtte, å være enslig gjennom svangerskapet eller oppleve partnervold. Slike ytre faktorer kan også ha betydning for depresjonens alvorlighetsgrad og varighet. Dårlig tilgang på medisinsk informasjon, å ha gjennomført et risikofylt svangerskap og/eller en traumatisk fødsel øker også sjansen for å utvikle en fødselsdepresjon (Ghaedrahmati et al., 2017). 

Behandling

Behandlingsløpet for PPD avhenger av mange individuelle faktorer som alder, livssituasjon og andre kjente lidelser hos mor. Behandlingsformen vil også variere med depresjonens alvorlighetsgrad. I mildere tilfeller vil man fokusere på å gi mor verktøy til å opprettholde god søvnhygiene, regelmessige måltider samt sosial støtte og avlastning fra viktige nøkkelpersoner i mors liv. Ved moderate fødselsdepresjoner vil man se på mulighetene for behandling med psykofarmaka i form av SSRI-er eller SNRI-er, gjerne i kombinasjon med psykoterapi, oftest i form av kognitiv adferdsterapi eller interpersonlig terapi. Ved alvorlige og behandlingsresistente fødselsdepresjoner med psykotiske og suicidale symptomer, kan ECT-behandling vurderes. Uavhengig av alvorlighetsgrad og symptomuttrykk er det viktig at mor opplever å bli møtt med forståelse, uten fordømmelse, og at man som helsepersonell i møte med nye mødre tar seg tid til å utrede for fødselsdepresjon når betydelige risikofaktorer er tilstede (Stewart & Vigod, 2019). 

Kilder
Helsedirektoratet. 2018. Fødselsdepresjon. Hentet fra: https://www.helsenorge.no/ 
Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M. (2017). Postpartum depression risk factors: A narrative review. Journal of education and health promotion, 6, 60. https://doi-org.ezproxy.uio.no/10.4103/jehp.jehp_9_16
Mascali, F. (2022). Helse under svangerskap, fødsel og i nyfødtperioden.
Folkehelserapporten-FHI. https://www.fhi.no/nettpub/hin/grupper/svangerskap/
Stewart, D. E. 2019. Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics. Annual Review of Medicine Vol. 70:183-196. https://doi-org.ezproxy.uio.no/10.1146/annurev-med-041217-011106 
Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s health (London, England), 15, 1745506519844044. https://doi-org.ezproxy.uio.no/10.1177/1745506519844044


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