Postpartum Depression

Postpartum depression: description

Postpartum depression (PPD) is a mental illness affecting many mothers after delivery. In total, three major mental crises and illnesses are distinguished after birth:

1. Postpartum mood low, also called baby blues or “howling days”
2. Postpartum depression
3. Postpartum psychosis

In the true sense of the word, the term postpartum depression refers only to postpartum depression. However, it is colloquially used for the other two forms of postnatal disorders. Apart from postpartum depression and postpartum depression, physicians also use the terms postnatal depression and postpartum depression (Partus (lat.): Childbirth).

Childbed depression: Creeping onset, often underestimated

Postpartum depression can develop throughout the first year after birth and can last for several weeks to years. It is characterized by moodiness, hopelessness and social shielding. The onset of the postpartum depression is usually insidious, and the disease is often recognized late by those affected and relatives.

In the population, the postpartum depression is often not taken seriously enough. Mothers and relatives should therefore pay more attention to signs of postpartum depression. Because some people are suicidal. In the worst case, it can lead to an extended suicide, that is, the mother kills first her child (Infanticide) and then himself.

Frequency of postpartum depression

An estimated 10 to 15 percent of all mothers are affected by postpartum depression. Also, some fathers develop postnatal depression, either as a result of maternal postpartum depression or independently.

Postpartum anxiety is considered a separate category because an anxiety disorder does not necessarily lead to depression. However, an untreated anxiety disorder after birth may develop into a postpartum depression.

Postpartum psychosis

Postpartum psychosis (postpartum psychosis) is the most severe form of psychological postpartum crisis. It develops in about one to two out of every 1,000 births. Postpartum psychosis usually occurs in the first six weeks after delivery, usually very suddenly within the first two weeks. The symptoms are similar to a postpartum depression, but more severe and also accompanied by psychotic symptoms such as loss of reality, disorders of thinking, behavior and affect. Also hallucinations and delusions can occur. Affected women are suicidal. In addition, it can also come to killing (infanticide). Women with postpartum psychosis should therefore be hospitalized immediately.

Baby blues

The baby blues is a phase of increased mental sensitivity after birth. He usually passes away after a few days. More in the article Baby Blues.

Postpartum depression: symptoms

The symptoms of the postpartum depression are varied and not all signs must show each affected person. Often, symptoms are rare and not attributed to postnatal depression. Therefore, attention should be paid to initially inconspicuous signs such as headache, dizziness, trouble concentrating and sleeping or excessive irritability. In addition, postpartum depression can trigger symptoms such as:

• Lack of energy, listlessness
• Sadness, joylessness
• inner feeling of emptiness
• Feeling of worthlessness
• guilt
• ambivalent feelings towards the child
• hopelessness
• sexual aversion
• heart problems
• numbness
• Tremble
• Fears and panic attacks

In addition, mothers with postpartum depression often show a general lack of interest. This can be related to the child and his needs or to the whole family. Affected persons often neglect themselves during this time and are impassive towards their child. Many mothers with postpartum depression provide their child correctly, but like a doll and without personal reference.

Killing thoughts can also occur in severe cases of postpartum depression. These can refer not only to the own person (Suizidgefahr), but also to the child (Infanticide = Infanticide).

Postpartum depression: causes and risk factors

The causes of the postpartum depression are not yet fully understood.

As an important factor is always the hormonal changes in the woman’s body after birth. After birth, the levels of the female hormones estrogen and progesterone decrease. These act in the body in different places, including in the brain. They have a stabilizing effect on the mood and counteract depression and psychosis. After the birth of the nut cake, the levels of these hormones in the body decrease as the concentration of the hormone prolactin increases. This is often regarded as the trigger of symptoms of puerperal depression such as mood scares and attacks of sadness and hopelessness.

However, there are also arguments that speak against the hormone change as the cause of the postpartum depression. For example, studies have found no difference between the hormonal status of mentally ill mothers and healthy mothers after birth. Also, researchers found no correlation between hormonal changes and the time of onset and duration of puerperal depression. In addition, some postpartum depression begins during pregnancy.

The hormonal change after birth as the cause of the postpartum depression is therefore controversial. But there are other factors known to favor the onset of mental disorder:

These include, for example, the family circumstances and the social situation, A difficult financial situation and lack of support from the partner favors postnatal depression. Symptoms and extent often depend on how much the woman lacks support.

Also mental illnesswho have been with the woman before pregnancy or appear in the family appear to increase the risk of postpartum depression. Duration and symptoms are then often influenced by the extent of the mental illness. These disorders include depression, obsessive-compulsive disorder, anxiety disorders, panic disorder and phobias.

Not to be neglected are the physical and mental exhaustion (e.g., in case of lack of sleep). Also Conversions of the metabolism (Change in thyroid hormones), screaming children and factors in the Biography of the woman (like traumatic experiences in childhood) can contribute to the development of puerperal depression.

Postpartum depression: examinations and diagnosis

For the diagnosis of a postpartum depression, there is currently no generally accepted approach. In many cases the diagnosis is subjective. It is suspected by relatives or the person concerned; In conversations with the doctor or gynecologist this usually results in a clearer picture.

The most helpful diagnostic tool to date has been the so-called Edinburgh Postnatal Depression Scale (EPDS). This is a questionnaire that will be filled out by patients with their doctor in case of suspected postpartum depression. The strength of the postpartum depression can be determined in this way.

Postpartum depression: treatment

Individual treatment for postpartum depression depends on its severity. In a light form often enough practical Assistance in baby care and in the householdto alleviate the symptoms. This support can come from family members, friends, and / or the midwife. Sometimes there is one too Home help or a nanny meaningful. As a result, all family members are relieved and can work on the cohesion of the family and the future planning.

In more severe cases of postpartum depression is one psychotherapeutic treatment necessary. Self-help is usually no longer enough here. Depending on the doctor’s own preferences and recommendations, affected women may choose between different forms of therapy such as conversation or body therapy. The partner and other family members should be included in the therapy. They can learn the right way to deal with the disease and develop more understanding for the patient. This will help them better.

If necessary, women with postpartum depression receive an additional one medical therapy (Antidepressants).

In particularly severe cases of postpartum depression, one is inpatient treatment necessary. In some cities, there are so-called mother-and-child clinics where mothers can be cared for inpatient care with their children.

Preventive measures in risk groups

Women who are prone to anxiety or depression during pregnancy are usually offered increased support during birth preparation. In the first period after the birth, the nursing staff of the clinic or the partner cares more about the baby, so that the mother can rest and has time to adapt to the new life situation.

Postpartum depression: disease course and prognosis

During the postpartum depression sufferers and relatives often lose the hope that the disease ever heals. The prognosis of the puerperal depression is good. As a rule, the affected women recover completely.

A good family environment and the help of the partner and the family make it extremely easy for all mothers the first time after birth and help to relieve the symptoms of a child Postpartum Depression to keep under control.