After the birth of a child, women, as well as men, can suffer from psychological upsets, even psychosis. The best-known postpartum mood crisis is postpartum depression. Treatment is provided on an outpatient or inpatient basis using self-help and professional help from a psychologist or psychiatrist.
What are postpartum mood crises?
Postpartum is the term used to describe the period between delivery and the regression of pregnancy-related body changes. Characteristically, the postpartum period lasts between six and eight weeks. During this time, the mother recovers from the pregnancy. Sychic disorders or behavioral disorders may occur during the postpartum period. The ICD-10 distinguishes between mild mental disorders and severe postpartum disorders. The term postpartum mood crisis summarizes mental states and disorders that occur in temporal relation to the postpartum period. Mood crises can range from mild sadness to severe depression and even psychotic states. In addition to the mother herself, the father of the newborn can also be affected by postpartum mood crises. Broad distinctions are made between postpartum mood depression, postpartum depression (PPD), and postpartum psychosis (PPP). The causes of postpartum mood crises usually consist of several factors, and the weighting depends on the individual case.
Causes
Childbirth is a physically tremendous effort for the mother, which can result in states of exhaustion. The mother’s abdomen, breasts, metabolism and digestion change significantly after birth. In addition, progesterone levels drop suddenly and can provoke depression-like states. The drop in estrogen levels causes sleep disturbances at the same time. Often, a thyroid hormone deficiency is added, which can trigger anxiety or panic attacks. From a biological point of view, the mother thus suffers from a lack of strength, exhaustion and possibly depression after giving birth. In addition to the physical factors, there are psychological factors. Childbirth often confronts the mother with fear of failure or pain and prompts the woman to say goodbye to her own childhood. New social structures emerge and can become a psychological burden, such as the change in role from career woman to mother and housewife. Apart from that, many mothers feel pressured by the mother image from advertising, movies, literature or their own environment. So there are enough causes for the postpartum mood crisis. From an evolutionary biological point of view, postpartum also signals an impending loss of fitness to the mother.
Symptoms, complaints and signs
The symptoms of a postpartum mood crisis depend on the type of condition. The low mood or baby blues is the mildest form and subsides within hours or days. Mood lability, mild sadness, crying, irritability, worry about the baby, and exhaustion characterize the clinical picture. In addition, there is irritability, anxiety, appetite disorders as well as sleeplessness or restlessness and concentration problems. The main cause of the baby blues is the hormonal changes. Postpartum depression or postpartum depression is characterized by gradual development and is accompanied by physical symptoms. In addition to a lack of energy, an inner feeling of emptiness, feelings of guilt and an ambivalent attitude towards one’s own child, disinterest, absence and hopelessness may be indicative of PPD. Thoughts of killing, headaches, cardiac arrhythmias, numbness and tremors are also common symptoms. The same is true for dizziness and concentration and sleep disturbances. Postpartum psychosis is a severe complication of the puerperium and is associated with paranoid-hallucinatory symptomatology, which may be characterized by anxiety, agitation, and confusion. Mania and schizophrenia during the postpartum period are considered mixed forms.
Diagnosis and course of the disease
In many cases, postpartum upset or mood crisis is not recognized until physical symptoms appear. Many sufferers are ashamed of their mental state and try to hide thoughts of killing in particular from those around them. Because of the feelings of shame, most women with mood crisis do not turn to the outside world by themselves.In individual cases, family members recognize the mental upset and consult a psychologist or psychiatrist. The prognosis depends on the subtype of the disorder. Baby blues is characterized by an extremely favorable prognosis. Postpartum depression should be treated immediately, as in this case there is a risk of suicide. Postpartum psychosis requires prompt admission to a psychiatric institution and is associated with the least favorable prognosis. Sometimes this disorder does not fully heal even after years.
Complications
The birth of a child, especially the first, is an exceptional situation in life for virtually all women. No matter how desired the child was, the complete restructuring of everyday life and the orientation entirely to the needs of the child are a challenge for every mother. In this respect, postpartum mood crises are basically not particularly unusual or worrisome. Nevertheless, the course of such a mood crisis must be well observed. Even an initial mood crisis can sometimes become a full-blown depression. Especially when a mother feels overwhelmed in her individual life situation and does not get the help she needs, a mood crisis grows rapidly. If left untreated, this can lead to major complications. Once a woman has entered a tangible depression after childbirth, it is usually difficult to leave the illness behind without specialist help. Severe depression as a complication interferes with everyday life. Many mothers affected by depression are barely able to manage their daily lives and care for the child on their own. Sometimes an inpatient exception is necessary. The first signs of a postpartum mood crisis should therefore be taken seriously and well observed in their course.
When should you go to the doctor?
After the birth of a child, women as well as men may experience emotional or mental fluctuations. The entire course of life changes due to the new arrival. This circumstance represents a new situation that triggers stress in many people. Medical assistance is not always needed during this phase. As a first step, those affected should seek an exchange with people who have also had offspring and are familiar with the situation. Helpful tips can be exchanged, which in many cases lead to an improvement. There are numerous contact points on the Internet that point out the changes in advance and thus prepare the parents-to-be for the new situation. However, if the complaints persist or increase in intensity, a visit to the doctor should be made. Severe weepiness, a persistently depressed mood or excessive demands should be discussed with a doctor or psychologist. If everyday demands cannot be met or if adequate care for the offspring cannot be provided, professional support is needed. In case of a strong dissatisfaction, sleep disturbances, exhaustion or an inner weakness, a doctor should be consulted. In case of aggressive behavioral tendencies, disinterest or a lack of care towards oneself and the newborn, action is needed.
Treatment and therapy
Self-help plays an important role in the treatment of postpartum depression. Equally important is help from the partner, family, and friends. The sufferer may also benefit from professional help with household chores of caring for the infant. In addition to self-help, postpartum mood depression usually requires professional care. Severe postpartum depression or psychosis is delivered into the hands of professionals as soon as possible. Hospitalization may be necessary in this case to save the life of mother and child. For professional treatment, measures such as psychotherapy, music therapy and systemic family therapy are available. Usually these measures are combined with conservative medicinal steps such as psychopharmacotherapy, naturopathic therapy or hormone therapy. For those affected, there are special outpatient clinics such as the Mother-Child Outpatient Clinic for Postpartum Mentally Ill Mothers. These special outpatient clinics arrange inpatient treatment in case of doubt and are open not only to the mother but also to observing family members for seeking help.
Prevention
Experience has shown that some contexts can be considered risk factors for postpartum mood crises. These risk factors include, for example, social isolation. In addition, lack of support from a partner or family and friends can increase the risk for a postpartum mood crisis. The same applies to perfectionism and an exaggerated maternal image of the pregnant woman. In order to prevent mood crises, the above-mentioned correlations should be counteracted before the birth of the child. A psychologically stable general situation should be aimed for.
Aftercare
A postpartum mood crisis should not be taken lightly even after the actual treatment. Especially if depression already existed after previous births. In addition to providing support during the actual birth, trusted people such as midwives should also be available after the birth to offer their professional knowledge to help with any problems. Both doctors and midwives should definitely be confidants and provide emotional support in the course of discussions or home visits. Complementary medicines can also provide support after the mood crisis, without having to suffer from side effects. In order to remain free from symptoms such as fatigue, irritability and sadness in the long term, regular Reiki coaching is suitable, for example. As an alternative healing method, Reiki can help to work on the causes of malaise so that those affected can feel happiness and contentment in the long term. Reiki coaching provides holistic support and has a positive effect on the body, mind and spirit. Reiki can be used while sitting, lying or standing and can also be done in couple sessions. This alternative method supports the mother’s self-confidence, releases fears and emotional blocks and improves communication with the child. In the course of couple sessions, parents can do something for themselves together, which will certainly have positive effects on the child.
This is what you can do yourself
To cope with postpartum mood crises, it is first helpful to learn about their cause and origin in a conversation with your doctor or midwife: Knowledge about the hormonal, but also psychologically caused background can already provide relief to the young mother. The partner, trusted family members or a good friend can also serve as the first point of contact during a low mood – if the exchange with them is not sufficient, professional help or contact to a self-help group should be considered. Those affected should pay attention to a healthy diet: In the case of loss of appetite, it is important to eat small meals regularly. Fresh fruit and vegetables provide the body with necessary vitamins and trace elements, carbohydrates serve as energy suppliers. Adequate fluid intake should also be emphasized. In everyday life, it may be necessary to limit oneself to the most necessary tasks for a while and temporarily postpone anything less important. Those affected should do this without a guilty conscience and not be afraid to accept help in the household and with childcare. Sufficient sleep and regular recovery phases also help to get out of the postpartum mood crisis more quickly. Exercise also has a positive effect on physical and emotional well-being: Even a daily walk in the fresh air can contribute to recovery.
