It could all be so beautiful. At eight weeks old, little Stella-Sofie is a real bundle of joy. She cries very little, drinks well and is showing more and more interest in her surroundings. Nevertheless, mum Alexandra can't connect with her child. On the contrary - she feels very sad at the sight of her baby, around whom everything now revolves. She feels overwhelmed by everything and doubts that she is a "good" mother. At the same time, Alexandra feels guilty that she is simply not as happy as is expected of her as a mother. It's probably "only" the hormones that are to blame - isn't it? At some point, however, the suspicion of "postpartum depression" hangs in the air.
Around 10 to 20 per cent of mothers are affected by this diagnosis. And none of them need to be ashamed of it! This is very important to me: postpartum depression is a mental illness that needs to be treated and is very curable. In its manifestation, it is similar to Pregnancy depression and can vary in severity. Interestingly, postpartum depression can also occur in fathers. In the following, however, I will limit myself to affected mothers.
How can you recognise postpartum depression?
Postpartum depression must first be recognised by the so-called Baby blues can be distinguished. With the baby blues, 50 to 80 per cent of all new mothers suffer from a temporary low mood for a few days in the first week after the birth. They are then easily irritable, cry quickly and experience mood swings. This phase, also known as "crying days", is mainly caused by the enormous hormonal and physical changes in the female body after the birth. The baby blues go away on their own and do not require medical treatment.
The situation is different with postpartum depression.
This clinical picture is also characterised by the very rare postpartum psychosis must be differentiated. It is not only characterised by the pronounced symptoms of postpartum depression (see below), but is also accompanied by delusions or hallucinations.
The most common period for a Postpartum depression occurs in the first few weeks after birth. However, the disease can also occur months later or, in rare cases, into the second year of the child's life. It is characterised by the following symptoms that last longer than two weeks:
- The feeling of inner emptiness spreads through the mother.
- She loses interest in things that she previously enjoyed.
- Self-doubt increases and the affected mothers feel worthless.
- At the same time, feelings of shame and guilt grow at not being able to be as joyful a mother as is expected by those around them.
- The women affected feel overwhelmed in and by everyday life, including caring for the child and possibly their other children.
- Physical complaints such as loss of appetite, sleep disorders, reduced ability to concentrate or headaches are also typical.
- Mothers with postpartum depression often cannot feel love for their baby (which does not mean that they do not have these feelings - they just do not feel them) and/or suffer from ambivalent feelings for their child.
- In severe cases of the disease, those affected have obsessive thoughts of harming the baby - which, however, are not realised. These thoughts can also revolve around (extended) suicide (killing the child and oneself = extended suicide).
Reactions
The mother's environment often notices that "something is wrong" with her. At first, the father, relatives or friends blame the strange "sadness" on the hormonal changes after the birth or a longer than usual baby blues. Over time, confused questions and comments often follow along the lines of: "What's wrong with you? Your baby is so cute! Why don't you be happy!" However, such reactions or well-intentioned advice usually only make the postpartum depression worse.
That is why I am specifically addressing the mother's environment: Support her by relieving her (e.g. with housework, caring for siblings, providing meals, etc.). But refrain from giving advice or commenting on the woman's emotional state. Postpartum depression is a serious illness and must be treated. Encourage the mother to confide in a professional and seek treatment if necessary.
It is not uncommon for the affected women themselves to overlook or suppress typical signs of postpartum depression. They are often afraid to admit that something is wrong. Or they are ashamed of it.
I would like to expressly encourage those affected at this point: There is no reason to be ashamed of an illness. The bravest first step is to get help now. And help for you also means help for your baby. This can help to restore the mother-child bond that has been disrupted by postpartum depression. I have listed various contacts below.
What causes postpartum depression?
Researchers are still discussing the various physical causes. For example, the hormonal balance, which has to suddenly readjust after birth, is (partly) held responsible. Certain biochemical processes in the body may also play a role, involving messenger substances that transmit excitation from one cell to another (neurotransmitters).
There are also certain psycho-social factors that increase the risk of a mother suffering from postpartum depression after the birth of her child. These include
Pre-existing mental illnesses of the mother (e.g. depression in previous years or pregnancy depression)
traumatic experiences: Such experiences can date back to the woman's own childhood (e.g. experiences of any form of psychological and/or physical violence), but they can also be from the recent past or have been suffered during pregnancy or childbirth.
Lack of support from the partner of the affected woman and from the immediate social/family environment
stressful life situations: e.g. financial worries, worries about the future, problems in the partnership or wider family or even an unwanted pregnancy
changed self-image: For the woman, it can feel as if she has lost her self-efficacy after giving birth and is reduced to being a mother. In addition, she may have a new perception of her changed body after giving birth and doubt its attractiveness.
Perfectionism/ too high demands on yourself: If the woman always wants to do everything "right" after the birth, this inevitably leads to bitter disappointment and deep frustration if the goals set are not (or cannot be) achieved. Perfectionism means, for example, wanting to get everything right: caring for the child, promoting its development, household chores, the role of the partner, your own "styling", etc. This also includes "wrong role models". This also includes "false" role models such as celebrities who, shortly after giving birth, present themselves in public looking radiantly beautiful and super slim.
social pressure: The media likes to convey (through advertising, films, etc.) the ideal image of "younger mothers" in terms of appearance, behaviour, desired feelings, partnership, etc. The same applies to expectations/comments made by the woman's social environment. Both are a great burden for the mother and create pressure.
Who helps with postpartum depression?
If you recognise yourself in some of the signs of postpartum depression described above or simply have the feeling that "something is wrong", then don't hesitate to get support!
Various Contact persons are:
- Your caring midwife
- your gynaecological or general practitioner's practice or your maternity clinic
- all pregnancy advice centres (they remain responsible for you until your child's third birthday)
- the self-help organisation Schatten & Licht e. V., which is there especially for women in emotional crises around childbirth: https://schatten-und-licht.de/
- the Alliance for Depression: www.buendnis-depression.de
- the social psychiatric service in your area
- local support services offered by the Early Help Network: https://www.elternsein.info (you can find out more about early help here on my blog)
- a psychotherapeutic or psychiatric practice
In the first Counselling sessions The next step will be worked out with the women. Which form of individualised treatment should follow also depends on how severe the postpartum depression is. In mild cases, greater support and relief for the mother can bring success and alleviate the symptoms.
If a Psychotherapeutic treatment If necessary, the woman can take part in counselling therapies, for example. Sometimes the treatment is combined with the prescription of antidepressant medication supports you. If you are breastfeeding, your therapist will pay close attention to the composition and dosage of the medication so that there are no health risks for your baby.
If the disease is particularly severe, a Inpatient stay in an appropriate clinic may be necessary. Some facilities admit mother and child together for this purpose.
In any case, for the mother concerned, any kind of Support from the social environment necessary and helpful. Ideally, your partner, family and friends can provide relief in everyday life. This means, above all, in the household and in caring for the baby. It may also be possible to organise paid domestic help or childcare.
Under certain conditions, a Domestic help can also be prescribed by a doctor. In this case, your health insurance will cover the costs. And as part of the early help programme Family midwives and trained volunteers Family helpers the young family or mother free of charge.
It is particularly important for the affected mother that family and friends are patient with her, show her understanding and take her seriously. I cannot say it often enough: postpartum depression is not hypersensitivity, it is an illness. This is precisely why terse sentences in the form of "Oh, it'll be fine ..." are not helpful. Instead, a loving pampering programme with delicious meals, a cosy atmosphere or gentle activities can provide relief. Experience also shows that it is often helpful if the partner takes part in the counselling sessions.
What can you do yourself?
Mothers themselves can also do a lot for their health. Many things can reduce the risk of developing postpartum depression in advance.
- Talk to someone you trust.
- Eat a healthy diet. You can find more information on my blog here. What was healthy during pregnancy is also a good form of nutrition now. Fortunately, there are fewer restrictions for you now.
- Make sure you get enough sleep. It also helps to rest yourself when the baby is asleep.
- Make sure you get enough exercise. Walks in the fresh air are as uncomplicated as they are helpful and simply do you good. Postnatal gymnastics is the perfect sport for your physical health and emotional strength.
- Don't be afraid to accept support from family and friends.
- Treat yourself to "relaxation oases". This could be a warm bath, a yoga class or a little me-time break with your favourite book, for example.
- Be lenient with yourself. Just because you're ill doesn't make you a bad mum. You don't have to prove anything to anyone.
- Say goodbye to the idea that you and your everyday life have to be perfect. If necessary, give up social media consumption so that you don't let the supposedly "great life" of others drag you down any further.
- Be patient with yourself. Treating depression takes time.
- Be proud of yourself. You have bravely taken the first step to find help for yourself and your baby.
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