Puerperal depression (postnatal depression)

Those not affected may first stop - postnatal depression or Postpartum depression, Depression in Young Mothers? Does such a thing even exist and wasn't the mother looking forward to her child? But it's not that simple.

What is Postpartum Depression?

A Postpartum depression (in technical jargon: postnatal depression) affects an estimated 10 to 20 percent of mothers. Far more women, around 70 percent, suffer from a lighter form. This form is called colloquially "baby blues" and has no disease value.

Correct postpartum depression, on the other hand, manifests itself in a lack of energy, feelings of guilt, irritability, a feeling of hopelessness and sleep and concentration disorders. Sexual pleasure is restricted. Obsessive-compulsive thoughts occur in half of those affected.

Thoughts of killing can also play a role in postpartum depression. Yet only 1 to 2 in 100,000 mothers with postpartum depression actually kill their own child. Postpartum depression can occur within the first two years after giving birth.

causes

There are several factors that can cause a Postpartum depression can favor. These primarily include stressful living conditions such as a bad partnership, financial worries or traumatic experiences. Mental illnesses that were present before the birth can also promote the development of postpartum depression.

Social isolation is also a major risk factor. Working women who suddenly have to stay at home with their newborns are more likely to experience postpartum depression. Perfectionism, fear of failure and a false image of the mother ("the always happy mother") are also suspected of triggering postpartum depression.

Since thyroid diseases can also be the cause, women should have their thyroid examined after giving birth. Hormone fluctuations after childbirth favor postpartum depression.

Symptoms, ailments & signs

The symptoms of postpartum depression can develop immediately after birth, but can also appear for the first time weeks after delivery. Many mothers suffer from mental depression around the third day after giving birth. You are tearful, stressed, and overwhelmed.

This can be explained by the hormonal changes around the injection of breast milk and the drop in other hormones when the pregnancy is terminated. As a rule, however, this low is overcome after a very few days. Prolonged postpartum depression manifests itself mainly in the fact that affected women constantly appear depressed, unhappy and dissatisfied.

Some express this clearly and speak of excessive demands, a feeling of alienation and, in individual cases, of the feeling of not being able to love the child. Many new mothers cannot or do not want to express their feelings so clearly. They fear to attract mockery and misunderstanding of the environment and tend to suffer quietly.

This in turn can exacerbate the symptoms of postpartum depression. Affected people are also often noticeable because they believe that they cannot cope with everyday life with the child or that they can actually no longer manage a regular daily rhythm. Caring for the child can be neglected, as can personal hygiene. In extreme cases, suicidal thoughts are described.

Diagnosis & course

At a Postpartum depression a doctor makes the correct diagnosis. The first person to contact if you suspect postpartum depression should be your gynecologist. He discusses the procedure and may refer the patient to a psychologist or an outpatient clinic.

There is a specialized questionnaire to confirm the diagnosis. Once the diagnosis of postpartum depression has been established, the further course depends on the correct therapy. Postpartum depression can last for a few months. This leaves the mothers feeling hopeless. It also happens that postpartum depression goes undiagnosed. The later postpartum depression is treated, the worse the course. In the worst case, thoughts of killing arise. Furthermore, the woman suffering from postpartum depression can develop a disturbed relationship with the child.

Complications

If a depressive illness in the mother is not recognized early in the puerperium, this has fatal consequences for the relationship with the newborn or the father of the child. Even if the anticipation was great, it can now be that the mother rejects her child and is therefore insufficiently cared for. For example, the newborn is no longer breastfed and loses weight.

It also does not benefit from the antibodies that are contained in breast milk and protect against any environmental influences. The mother sometimes has a painful congestion, which further negatively affects the mood. The emotional bond between mother and child is also disturbed and often means that the baby is not paid any attention even when the baby is screaming loudly.

As a result, it develops fears, which are deeply rooted and affect relationship behavior in adulthood. If the depression is not treated in time, violence can be used, for example if the mother shakes the newborn child out of desperation or touches it too hard. In addition to the mother-child relationship, postpartum depression also affects the relationship with the child's father. If, for example, the sick mother is treated as an inpatient, this means either that he has been deprived of contact with the wife and child or that responsibility is completely transferred to him.

When should you go to the doctor?

The state of emotional overload often occurs in young mothers. In many cases, a doctor is not required because the condition regulates and harmonizes itself. Immediately after delivery, there is a hormonal change in the organism. This can lead to strong mood swings, whiny behavior and diffuse fears. If the social environment is stable and there is sufficient understanding, the symptoms will be alleviated after a few days or weeks.

Healing often occurs completely independently. If the existing irregularities increase in intensity, however, consultation with the attending physician or midwife should be sought. If the young mother has the feeling that she cannot adequately care for her offspring, it is advisable to consult a doctor. If there is a feeling of deep dissatisfaction, uselessness or apathy, medical help should be sought.

If symptoms such as loss of appetite, neglect or unending sadness appear, a doctor should be consulted. In the event of hypersensitivity, severe mood swings and the inability to cope with everyday life, the consultation of a doctor is indicated. If suicidal thoughts develop or if the victim reports plans to end their life, immediate action must be taken. Relatives or close confidants are obliged to get help.

Treatment & Therapy

The treatment options a Postpartum depression are very good. As a rule, it heals up without any problems. But in most cases self-help is not enough. If the symptoms persist for more than two weeks, the mother must seek help. If the postpartum depression is severe, professional help must be sought immediately. Sometimes a stay of several weeks in a special clinic is necessary to stabilize the mother again. In some clinics, the baby is allowed to be taken so as not to disturb the relationship.

Depending on the severity and cause, several methods of treatment are used: psychotherapy, hormone therapy, systemic family therapy or music therapy. In many cases, psychotropic drugs are given as support. Naturopathic procedures can also relieve postpartum depression. Acupuncture deserves special mention here.

Over-the-counter drugs should be used with caution. They can pass into breast milk and harm the child. In the case of lighter forms, it is possible that even a chat with other affected persons can alleviate postpartum depression.

You can find your medication here

prevention

So that it doesn't become one Postpartum depression comes, the mother can take some precautions before the birth. She can provide a social network and help after the birth. So the partner should take a vacation to start the first time with the baby together. If there are siblings in the house, the mother should get support here as well. Grandma or a friend can play with the older child while the mother breastfeeds the baby. So it's about relieving the burden so that you don't get the feeling: I can't do any of this!

Aftercare

The symptoms of postpartum depression and its course can express themselves very differently in the women affected. It is therefore not possible to make general statements about possible follow-up measures. In most cases after a postnatal depression it is advisable to at least continue to see your family doctor regularly.

This is especially necessary if those affected are treated with medication. In addition, patients who have suffered from depression or postpartum depression in the past should receive intensive medical care even after healing, as they are at a particularly high risk of relapse. We strongly advise against discontinuing psychotropic drugs or reducing the dose.

A doctor should always decide about this. It is also advisable to continue to receive psychotherapeutic or psychiatric treatment. However, whether this is necessary should be clarified in consultation with the attending physician. Such treatment is particularly advisable for patients who have already suffered from mental illness after postpartum depression.

In a few cases, medical care for follow-up care after postpartum depression is not necessary. The women affected should nevertheless avoid psychological stress and should definitely consult their family doctor or a psychiatrist in the event of a relapse.

You can do that yourself

With postpartum depression, support from partners, family members and friends is important for many women. In some cities, those affected organize themselves in self-help groups to meet regularly and to discuss postnatal depression. The participants support each other emotionally and help each other to find solutions to specific problems. This form of social support from others can have benefits, but is not an equivalent substitute for proper treatment. In rural areas there is usually a lack of self-help groups for postpartum depression, so online groups are a possible alternative.

Some women with postnatal depression find it helpful to indulge in pleasant moments again and again, for example taking a warm bath or listening to relaxing music. Small breaks in everyday life can help to reduce the overall psychological stress. Some patients benefit from setting small goals that they can realistically achieve - such as taking a walk or doing a specific household chore. Such behavioral activation can lead to a sense of achievement in everyday life that is motivating. Long to-do lists, on the other hand, are often counterproductive as they can lead to frustration.

Some experts recommend eating a healthy diet, exercise, and getting enough sleep to prevent further deterioration in mood. Various studies show that exercise can reduce depressive symptoms.