23. April 2020
… The new and overjoyed mother takes care of her newborn. The baby is content, cries only little and develops splendidly. Mother and father find themselves together in their new roles and float on cloud nine. Of course, both are over-slept and still quite overwhelmed by the new situation, but it all slowly settles on each other …
So it should be or – in some minds – it must be after the birth of a child. Many overlook in their dream ideas that the reality can look quite different. Because a birth is a drastic experience in the life of a woman. The new life with an infant upsets life, hormones and feelings. In addition to the common but short-lived “baby blues,” postpartum depression can develop, and it is imperative that it be treated professionally.
The baby blues is a common phenomenon. Approximately 50-80% of mothers experience brief depression-like symptoms shortly after birth (O’Hara & Swain, 1996). There are emotional outbursts, helplessness, and states of exhaustion. The joy about the newborn child is temporarily clouded. However, these symptoms subside after a few days without the need for treatment
Postpartum depression in the first year after delivery
Postpartum depression, unlike the baby blues, can develop throughout the first year after delivery. If depressed mood persists for more than two weeks within this period, postpartum depression must be considered. The better mothers and fathers are educated about the risk and symptoms of this disorder, the sooner professional help can be sought.
Education by doctors, nurses and midwives
Since early recognition of postpartum depression has a positive effect on the course of treatment, counseling and support of parents on this topic is of great importance. Postpartum depression should be addressed in the hospital by physicians and nurses and after birth by the midwife providing care. Postpartum depression is still not recognized because there is still a lack of information on this topic (Hartmann, 2011).
Incidence of postpartum depression
Postpartum depression is a taboo topic and major knowledge gaps exist among expectant parents. Yet postpartum depression is not uncommon. They occur in about 10-20% of mothers. Fathers can also suffer from postpartum depression. However, the risk is lower and is about 4% (Hartmann, 2011).
Important: Sometimes you hear the word postnatal instead of postpartum. From a medical perspective, postpartum is the correct term. Postpartum means “after delivery” and refers to the mother. The term postnatal, on the other hand, is used when talking about the newborn. In German, the term Wochenbettdepression is also common instead of postpartum depression.
In principle, the symptoms of postpartum depression are similar to those of depression at other stages of life. However, there are special features that arise due to the new role of motherhood. Often, affected mothers have trouble developing good feelings for their child. As a result, they feel cold and uncaring and doubt their abilities as mothers. Affected mothers are often convinced that they are not a good mother for their child. This leads to a high level of suffering due to strong feelings of guilt and worthlessness.
Compulsive thoughts as a symptom of postpartum depression
In the reverse effect, postpartum depression often results in extreme concern for the child’s well-being. This can result in obsessive, recurring fears. These obsessive thoughts often revolve around the mother’s ability to hurt or endanger the child through her behavior (for more information on obsessive thoughts, click here).
Disturbances in the interaction between mother and child
Problems with feeding or breastfeeding the infant often arise in connection with postpartum depression. The reasons for this are that depression alters the interaction between mother and child. Research shows that mothers suffering from postpartum depression are less sensitive to their child’s signals. The child also changes his or her interaction behavior as a result (Field, 2010).
Important: In addition to postpartum depression, postpartum psychosis can also occur in rare cases, in which sensory deprivation is the main symptom. Again, professional help is needed immediately!
The life-event approach to psychology states that depression often occurs after drastic experiences (Wittchen & Heuer, 2006). Most often, one thinks only of negative events, such as the loss of loved ones, a job change, or unemployment, but positive experiences can also drastically change one’s life! This is also true for a birth: As a prominent life event in a woman’s life, it increases the risk of mental illness. If other unfavorable factors are added, postpartum depression can develop:
These risk factors do not necessarily have to be present. Postpartum depression can develop even in mothers who are psychologically stable and socially well embedded. The exact causes are not clear. It can only ever be guessed what factors have led to the postpartum depression.
Like “normal” depression, postpartum depression is readily treatable. In addition to traditional treatment approaches, there are therapy components that specifically address the new role as a mother:
Often, outpatient care is sufficient and symptoms gradually subside. Sometimes, however, mothers need more intensive help and must be treated as an inpatient. Here there are now many clinic concepts, how mother and child can be treated together.
Last but not least, it is important to urge mothers and their families to do the following: Get help when you are not feeling well. Address feelings and problems. Don’t be influenced by role stereotypes and too high expectations of the new mother or father role. The sooner treatment for postpartum depression begins, the sooner time with the child can be enjoyed to the fullest again.