Brief overview
- Symptoms: Dejection, loss of interest, joylessness, sleep disturbances, anxiety, guilt, in severe cases: Suicidal and infanticidal thoughts.
- Treatment: simple measures such as relief offers, psycho- and behavioral therapy, sometimes antidepressants
- Causes and risk factors: Propensity to depression, social conflicts and worries.
- Diagnostics: doctor’s consultations, postpartum depression test EPDS
- Course and prognosis: Postpartum depression usually heals completely; therapy and support from partner and family improve prognosis.
- Prevention: Eliminate risk factors already during pregnancy.
What is postpartum depression?
Postpartum depression (PPD) is a mental illness that affects many mothers, but also some fathers, after giving birth. Affected individuals find themselves in a low mood, feel hopelessness, and increasingly isolate themselves from their social contacts.
Overall, three major postpartum mental health crises and illnesses can be distinguished:
- Postpartum low mood, also called baby blues or “crying days
- Postpartum depression
- Postpartum psychosis
The three postpartum mental crises and illnesses differ in cause, time of onset, and type and severity of symptoms. Both postpartum depression and postpartum psychosis set in a few weeks after birth.
The difference between the two conditions is that the symptoms of postpartum psychosis are usually even more severe than those of postpartum depression. In addition, many sufferers develop hallucinations and delusions.
Baby blues manifest a few days after birth due to hormonal changes.
Baby blues is a phase of increased psychological sensitivity after birth. It usually passes after a few days. Read more about this in the article Baby Blues.
Postpartum depression in men
Postpartum depression also affects fathers. The causes of postpartum depression in men are still relatively unclear. However, the particular psychological and physical stresses of the new life situation are likely to play a central role: Lack of sleep, less time for hobbies, friendships or the couple relationship.
Many fathers are also burdened by the feeling that they now have to assume great responsibility. An idealized idea of the role of father and the feeling of not being able to live up to it also promote depression.
- Previous depressive illness
- Problems in partnership
- Financial worries
- High expectations of the father role
There is also a particular burden on fathers if the child is born prematurely.
The risk of postpartum depression is particularly high for men whose wives have developed postpartum depression.
Alarm signals for postpartum depression in men include exhaustion, listlessness and a feeling of inner emptiness. Some men become irritable, suffer from mood swings and sleep poorly. Others develop feelings of guilt (for no reason), worry more and feel anxious.
In most cases, depressive symptoms do not appear immediately after birth in the form of “baby blues” in men, but rather creep in after two to six months. If the symptoms persist, it is important to seek help early on. After all, there is a great risk that the depression will become chronic and then all the more difficult to treat.
How do you recognize postpartum depression?
In addition, postpartum depression triggers other symptoms such as:
- lack of energy, listlessness
- Sadness, joylessness
- Inner emptiness
- Feeling of worthlessness
- Feelings of guilt
- Ambivalent feelings towards the child
- Hopelessness
- Sexual unwillingness
- Heart problems
- Numbness
- Trembling
- Anxiety and panic attacks
In addition, mothers with postpartum depression often show a general lack of interest – both in relation to the child and its needs, and to the family as a whole. Affected persons often neglect themselves during this time. They take proper care of the child, but treat it like a doll and have no personal connection.
In severe cases, thoughts of killing come to the mind of those affected by postpartum depression. These refer not only to themselves (suicide risk), but sometimes also to the child (infanticide).
Observe these thoughts in yourself, do not hesitate to confide in someone. You are not alone with these feelings.
Where can you get help?
Treatment of postpartum depression
Individual treatment of postpartum depression depends on its severity. In a mild form, practical support with baby care and household chores is often enough to alleviate symptoms. At best, this support comes from family members, friends, or the midwife. Sometimes a household helper or nanny is useful. This relieves the burden on all family members and gives them more freedom to work on family cohesion and planning for the future.
In more severe cases of postpartum depression, psychotherapeutic treatment is necessary. Self-help is usually no longer sufficient in this case. Depending on their own preferences and the doctor’s recommendations, those affected are given the opportunity for talk or body therapy.
At best, the partner and other family members are included in the therapy. Among other things, they learn how to develop more understanding for the affected person, how to cope better with the disease, and how best to support the affected person.
If necessary, women with postpartum depression also receive drug therapy using antidepressants.
What causes postpartum depression?
The causes of postpartum depression in women are not yet fully understood. There is evidence that hormonal changes play a role in influencing postnatal depression. However, hormones probably don’t play as big a role as they do, for example, in baby blues.
There are, however, other factors that are known to promote the onset of the mental disorder:
These include, for example, family circumstances and the social situation. A difficult financial situation as well as a lack of support from the partner favor postnatal depression. Symptoms and extent depend in many cases on how much of a burden it is on the affected person and to what degree she is left to her own devices.
Mental illnesses that existed in the woman before pregnancy or that run in the family also increase the risk of postpartum depression. The duration and symptoms are then often influenced by the extent of the mental illness. These disorders include depression, obsessive-compulsive disorder, anxiety disorders, panic disorders and phobias.
How is postpartum depression diagnosed?
To date, there is no generally accepted procedure for diagnosing postpartum depression. In many cases, the diagnosis is subjective. It is suspected by relatives or the affected person themselves. In discussions with the family doctor or gynecologist, a clearer picture usually emerges.
The Edinburgh Postnatal Depression Scale (EPDS) has proven to be the most helpful diagnostic tool to date. This questionnaire is a kind of postpartum depression test. If postpartum depression is suspected, those affected fill it out together with their doctor. In this way, the severity of the postpartum depression can be determined.
What is the course of postpartum depression?
Postpartum depression develops at various times throughout the first year after childbirth and extends over several weeks to years. The onset of postpartum depression is usually gradual. Affected persons and relatives often recognize this disorder late.
During postpartum depression, sufferers and family members often lose hope that the illness will ever heal. However, the prognosis for postpartum depression is good. As a rule, those affected recover completely.
How can postpartum depression be prevented?
Expectant mothers or fathers who notice risk factors such as a tendency to depression, low financial resources or partnership conflicts in themselves are recommended to seek help even before the birth.
Support in the household and in caring for the newborn relieve the burden on the young mother and ensure that she recovers from the birth and settles gently into the new life situation.
