Postpartum depression: symptoms and treatment

Postpartum depression (PPD) or postnatal depression is a specific form of depression. It occurs following the birth of a child, and can affect both women and men. But what exactly is postpartum depression? PPD is a mental illness that expresses itself through low mood, among other symptoms. Postpartum depression is widespread in Switzerland. According to the “Postpartale Depression Schweiz” association, it affects around 20% of new mothers. 10% of fathers are also affected.

It can sometimes be difficult to distinguish between the causes and symptoms of postpartum depression. Disrupted sleep can be both a trigger and a symptom of postpartum depression, for instance.

Please note that the following list of causes is not exhaustive.

Hormonal causes

A person’s hormones change after giving birth. The link between hormones and postnatal depression has not been exhaustively researched. We do know, however, that hormonal changes can be a factor in mental illness.

Mental causes

New mothers who already suffered from depression before getting pregnant are at greater risk of experiencing postpartum depression. Unprocessed mental strain from the past can resurface after the birth of a child. A person’s genetic predisposition can also play an important role: women from families with a history of mental illness are more likely to develop postpartum depression.

Environmental causes

Parents’ lives change following the birth of a child, and this turning point poses the danger of a crisis in their relationship.

• Previous roles change. A working woman suddenly becomes a mother and housewife, for example. It takes some time for her to become accustomed to these changes and the new situation. In extreme cases, this challenge can precipitate an identity crisis.
  
• As well as roles, relationships can change too, and not just between the parents. Relationships with other family members or friends can also evolve. The new approach to meet-ups takes some getting used to.
• Mothers often have high expectations of themselves, and feel that they are not up to the new situation. This can give rise to feelings of guilt.
• The parents’ needs often fade into the background after the birth of a child. But energy supplies quickly run out when you’re neglecting yourself and not getting any rest.

A lack of support from those around you can also trigger postpartum depression. A mother needs emotional as well as practical support. If this is not forthcoming, the risk of depression increases. In the early days in particular, parents suddenly find themselves stuck at home, parts of their social network disappear and they feel alone. Stressful situations such as financial or work-related problems increase the risk of mental illnesses.

Causes relating to the birth

Complications during pregnancy and unwanted pregnancies increase the risk of postnatal depression. Traumatic events during the birth are another risk factor. The severity of the events is subjective here. Even a very quick birth can be disruptive to the mother; she feels blindsided and like she has lost control. Caesarean sections also make postpartum depression more likely. There are a number of other problems that can occur soon after the birth of a child, from physical ailments to problems with breastfeeding, that place an additional burden on the mother.

And that’s not all. Endorphin levels in the body drop when the mother stops breastfeeding. These hormones have a mood-lifting effect. A drop in endorphins can therefore trigger an episode of depression in certain circumstances.

There is a wide range of symptoms of postpartum depression:

• Mental and physical exhaustion
• Lack of drive, feeling of emptiness
• Mood fluctuations, irritability
• Sadness
• Lack of self-confidence
• Lack of libido
• Concentration problems
• Problems with appetite
• Sleep disorders
• Anxiety through to panic attacks
• Social withdrawal
• Physical ailments such as headaches, digestive problems or muscle tension

Postpartum depression often develops gradually, and can start at different times. It usually develops in the first year following the birth of a child, but it can also take up to two years to begin.

Postpartum depression: how long it lasts

How long does postnatal depression last? Postpartum depression generally lasts for four to six months. Sometimes the condition can persist for more than a year. The prospects of recovering from postpartum depression are good, and most sufferers make a full recovery.

Postpartum depression also affects the child. If it is left untreated, it can have the following consequences:

• Weakening of the bond between mother and child
• Delayed cognitive and emotional development
• Insecurity and restlessness
• Sleep problems
• Sensitivity to stress

The way that postnatal depression is treated varies depending on what form it takes. Sufferers’ friends and family always play an important role, and their support and understanding are crucial.

Postpartum depression: tips for sufferers

Plan your daily life accordingly when your mood is low after the birth of a child. You can alleviate mild depression by doing the following:

• Accept that you are ill. This is the only way that treatment can succeed.
• Be patient with yourself and don’t set targets that are too ambitious. Try to keep your expectations as low as possible.
• Take time for yourself. Take regular breaks. Sleep as much as possible. Whenever possible, try to make relaxation part of your everyday. Try out different breathing techniques, yoga or meditation.
• A balanced diet will help, too. You should also eat regularly.
• Keep active. Exercising as part of your daily routine and playing sports help with depressive moods. This is particularly true for low-impact endurance sports such as walking or stand-up cycling. You should avoid conventional cycling due to the risk of falls or accidents. You can also start doing postnatal gymnastics around six to weeks after giving birth. However, you should talk to your doctor before planning any sporting activities.
• Get organised. Plan your day. And organise support with housework or food shopping, for example.
• Speak openly about your feelings. Whether with your partner, your friends or other people in the same boat: talking helps.

You must talk to your doctor or midwife if your postpartum depression symptoms get worse. Psychotherapy is sometimes required. This can take the form of cognitive or interpersonal behaviour therapy, for example. If necessary, your doctor will prescribe antidepressants.

Postpartum depression: what helps?

If your partner is suffering from postpartum depression, you can support him or her by

• Showing patience and understanding.
• Listening. Working out solutions to problems together.
• Focusing on the positives. Praising your partner and showing gratitude.
• Take some of the load off your partner or organise support.
• Do not force your partner to make important decisions if they are overwhelmed by the situation.
• Go to the doctor’s office with your partner and talk about treatment and progress together.

Postnatal depression cannot be avoided entirely. But there are some things you can do to reduce your risk of this kind of depression.

• If you are at increased risk of postpartum depression, seek out help well in advance. You should ideally speak to a psychotherapist before you get pregnant or during pregnancy. Describe your worries and anxieties to him or her.
• You should get help early if you have financial problems, as well. The same applies in the event of conflict with your partner.
• Make sure in advance that you have enough support at home and assistance with caring for your baby. This will give you time to get used to the new situation after the birth.
• Regular visits from your midwife can also prevent postpartum depression.
• You can reduce the risk of postpartum depression by breastfeeding, too. Talk to your midwife or doctor if are having difficulty breastfeeding.
• Getting enough exercise during pregnancy can reduce the risk of postpartum depression. The HEPA network promoting health and physical activity in Switzerland (hepa.ch) recommends doing 20 to 30 minutes of moderate exercise every day during pregnancy, such as stand-up cycling, brisk walking or swimming. Not only will this help with backache and leg pains, but you will also sleep better and the exercise will trigger the release of hormones that boost your mood. While pregnant, avoid any sport that involves lying on your back or a risk of collisions or accidents (cycling, martial arts, tennis etc.), deep sea diving or mountaineering.

Postpartum depression can be treated. Get support from family, friends and specialists. Take care of yourself and your needs. With the right help, you can find your way back to a more balanced life. Talk openly about your feelings, and get the support that you need.

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