For the affected women, their own reaction is usually completely incomprehensible: instead of maternal happiness, they experience inner emptiness and deep sadness, despair, fear of failure and even panic attacks after giving birth. Even Hippocrates, the forefather of Western medicine, described “postpartum depression“. Hopelessness and guilt can lead to a vicious cycle of obsessions and suicidal thoughts in postpartum depression (PPS).
Postpartum clinical pictures
The mood states of women after the birth of a child fall broadly into three distinct categories:
- The postpartum low mood (baby blues),
- The postpartum depression and
- Postpartum psychosis (puerperal psychosis).
These are not isolated next to each other, but often merge smoothly, so that, for example, the baby blues can develop into depression. A baby blues is usually short-lived and occurs in the first days after delivery in 50-80% of all mothers. The signs are: Sadness, frequent crying, mood swings, fatigue and exhaustion, anxiety and irritability.
Since baby blues is a temporary phenomenon, it is considered relatively harmless. However, it would be wrong not to pay further attention to it. If the sadness lasts more than two weeks, it can develop into permanent depression. It affects about 10-20% of all mothers.
Symptoms
Postpartum depression can occur at any time during the first year after the baby is born. There are gradual gradations from mild to severe, and a gradual development is typical. In addition to the signs of the baby blues, postpartum depression is accompanied by general lack of interest, concentration, appetite and sleep disturbances as well as ambivalent feelings towards the child, which can even be accompanied by suicidal thoughts.
Postpartum psychosis occurs predominantly in the first few weeks after delivery and may develop due to depression. It is considered the most severe form of postpartum crisis and occurs in one to three out of every thousand mothers.
The range of the clinical picture varies from euphoria and motor restlessness to lack of drive and complete apathy. Hallucinations and delusions mean danger for mother and child. They may be religious in nature.
Postpartum anxiety as an independent clinical picture
Anxiety disorders are not necessarily siblings of depression. Anxiety symptoms usually appear during the first two to three weeks after birth and become apparent only after a few weeks have passed. Anxiety and worry about the baby’s well-being (I can’t love my baby, I’m not a good mother) are typical. Postpartum bouts of extreme anxiety with compulsive recurrent fearful thoughts, ideas, and images are referred to as severe forms of postpartum anxiety reactions.
