Postpartum depression: feeling low after birth
Postpartum depression – also known as postnatal depression – occurs after the birth of a baby. It affects both mothers and fathers. The triggers are varied. This is why is requires individualised treatment.
Postpartum depression is widespread in Switzerland. According to the “Postpartale Depression Schweiz” association, it affects around 15% of new mothers. But many people don’t dare talk about the issue. They feel like they should be happy and they feel ashamed of their low mood. A diagnosis is essential in ensuring that the depression is treated and the symptoms can be alleviated.
Although “postpartum” and “postnatal” depression are both used to mean the same thing, there is in fact a difference. “Postnatal” refers to the period after birth but it relates to the child. “Postpartum” refers to the time after childbirth and focuses on the mother. So the correct term is postpartum depression.
What triggers postpartum depression?
It is sometimes hard to differentiate between the causes and symptoms of depression. Disturbed sleep can be both, for example. Triggers tend to be varied, so treatment also needs to incorporate different levels.
Please note: The following list of causes is non-exhaustive.
- If a new mother has already suffered from depression or another mental illness, she has a greater risk of postpartum depression. Genetic predisposition therefore plays a significant role.
- A person’s hormones change after giving birth. Research has not yet been concluded on the correlations. It does however appear that hormonal changes contribute to mental disturbances.
- Physical deficiencies can trigger an episode of depression. If someone loses a lot of blood when giving birth, this can lead to a lack of vitamins or minerals, for example. An unbalanced diet also increases the risk of depression.
- Insufficient sleep not only leads to extreme exhaustion but also to biochemical changes in the body. A lack of sleep therefore impairs the metabolism and the operation of the glands.
- After giving birth, it takes a while for the mother’s body to get back to normal. Visible physical signs such as extra weight or stretch marks can easily wear a person down.
- There is a risk that mothers will not eat regularly, or eat a balanced diet, in the first few weeks. Once a fixed daily routine is in place, this risk usually decreases again. After giving birth, a person’s blood sugar starts to fall as soon as three hours after their last meal instead of the usual four to five hours. If the body does not receive any carbohydrates, it will release adrenaline. This can increase the symptoms of postpartum depression.
After the birth of a child, the parents’ lives are usually turned completely upside down. This milestone makes them susceptible to crises.
- Previous roles change. A working woman suddenly becomes a mother and housewife, for example. Parents have to firstly get used to these changes and find their way in the new situation. In extreme cases, this can lead to an identity crisis.
- As well as roles, relationships change too. This impacts not only the relationship between the parents but also their relationships with their families or friends. New parents need to get used to these new types of interactions.
- Unprocessed mental strain from the past can resurface after the birth of a child. But negative experiences during or shortly after childbirth also increase the risk of postpartum depression.
- If the mother has high expectations of herself and feels that she is not up to the new situation, feelings of guilt can develop.
- 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.
- Complications during pregnancy increase the risk of postpartum depression. An unwanted pregnancy can also trigger an episode of 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.
- There can also be various problems after giving birth. These range from physical complaints to problems with breastfeeding.
- 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.
- A mother needs emotional as well as practical support. If this is not forthcoming, the risk of depression increases.
- At the early stages in particular, parents are suddenly cooped up at home. Their social network falls away and they may feel alone.
- Relationship problems are common too. Roles change. There is little or no time to be together.
- Stressful situations such as financial or work-related problems increase the risk of mental illnesses.
What are the symptoms of postpartum depression?
Low mood – also known as the baby blues – is normal after giving birth. It usually goes away again after a few days. But if the symptoms continue for over a week, this could indicate postpartum depression. Symptoms include:
- 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
Postpartum depression can however also trigger physical complaints such as headaches, digestive problems or muscle tension.
Postpartum depression also affects fathers. Prior illness in the mother is one of the risk factors for this. Depression often occurs later in the case of fathers. The symptoms are also different. Whereas women are often sad, men tend to feel angry and socially isolated.
How is postpartum depression treated?
The type of treatment is just as individual as the triggers and symptoms. The affected person needs to find out what is most helpful. They may need professional support with this.
What steps you can take yourself
- You firstly need to accept the illness. This is the only way that treatment will be successful.
- 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. And – whenever possible – try to make relaxation part of your everyday.
- Eat a balanced diet. Make sure that you’re eating regularly.
- Stay active. Exercising as part of your daily routine and playing sports helps with depressive moods.
- Get organised. Plan your day. And organise support for 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.
What you can do to help as a partner
- Show patience and understanding.
- Listen. Work out solutions to problems together.
- Focus on the positive. Praise your partner and show gratitude.
- Try to 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.
- Accompany your partner at the doctor’s office and talk about treatment and progress together.
What specialists can do
If an affected person can no longer cope with the situation on their own or feel like they need support, it’s a good idea to consult external specialists. The first point of contact should be the GP, the midwife or a family counselling centre, for example. Treatment is then taken over by a psychologist or a psychiatrist.
Do you require any further information or have any questions about postpartum depression? Our health consultation advisors are happy to help you.
Various types of therapy are used for postpartum depression. Specialists work with the affected person to assess the most suitable type of treatment:
- Individual therapy
- Couples’ therapy
- Group therapy
- Hormone therapy
- Light therapy
- Complementary medical treatment such as acupuncture or homoeopathy
In the case of serious illness, inpatient treatment should be considered. There are special clinics with mother and child spaces for this.
The psychiatrist or doctor can prescribe medication that supports healing. However, these should always be combined with other therapy types. The following medications are used for postpartum depression:
- Antidepressants
- Anxiety-reducing medication
- Sleep remedies
- Anti-psychotic medication
- Natural medicine
Who covers the costs for the treatment?
Basic insurance covers the costs of medical psychotherapy if a corresponding diagnosis has been made and the treatment has been prescribed by a doctor. The same applies to any non-medical psychotherapy provided by an independent psychotherapist, provided the statutory conditions are met.
Many alternative treatments are covered by corresponding supplementary insurance. For instance, COMPLETA covers 75 per cent of treatment costs where recognised therapists and methods of complementary medicine are used.
Can mothers who previously experienced postpartum depression have more children?
Yes. However, it’s important to remove the triggers as far as possible. The depression should have also subsided before becoming pregnant. All specialists who support the mother during the next pregnancy should be informed of her previous depression. It sometimes also makes sense to undergo therapy during the pregnancy or after the birth.
Julia Pieh (doctorate in pharmacy and toxicology, pharmacist, naturopath) works as a health consultation advisor and quality coach at Helsana. She is committed to providing health advice to our customers. Ms Pieh provided the editorial team with advice and input for this article.
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