Postpartum depression

Women frequently experience a low mood for a few days after giving birth. However, postpartum depression (also known as postnatal depression) is more severe than these normal “baby blues”. Depressive symptoms and feeling very mixed emotions in relation to the baby are typical of postpartum depression.

At a glance

  • Experiencing a low mood after giving birth is not uncommon.
  • However, the negative feelings are stronger and last for longer in the case of postpartum depression.
  • Postpartum depression can be very distressing for the mother.
  • Without treatment, there is a risk that the depression will become chronic.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Postpartum depression: woman looking stressed standing in the kitchen holding a baby in her arms and holding her head.

What is postpartum depression?

Pregnant women usually look forward to the happy days and weeks they will spend with their new child after the birth. However, they may instead feel down and experience mood fluctuations once the baby arrives.

If this low mood persists, this may indicate the beginning of depression. The depression that a woman may experience after the birth of her baby is known as postpartum depression (PPD) or postnatal depression (PND).

What is depression?

The video below explains the signs of depression. What triggers it and what treatment options are there?

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What are the symptoms of postpartum depression?

Postpartum depression displays the typical symptoms of depression, which is an illness that can occur at any stage of life. The main difference is that mothers with postpartum depression often develop strong feelings of guilt towards their baby. They blame themselves for failing to live up to their image of the ideal mother and worry because they find it difficult to care for the new baby.

Many mothers find it difficult to talk about their feelings with others in this situation. Feelings of shame and fear may cause them to feel increasingly isolated.

Indications of postpartum depression are deep sadness, sleep disturbance, lack of interest in one’s own child, self-doubt, feelings of emptiness and hopelessness, feelings of guilt.

Postpartum depression differs from the “normal” baby blues that almost half of all women who give birth experience after the baby arrives. The baby blues are a dip in mood that occurs after giving birth and normally lasts for a few days but occasionally persists for up to two weeks.

Mood swings, crying, and irritability are very common during this period. In most cases, a mother experiencing baby blues simply needs support and understanding to alleviate these feelings.

Eine Frau liegt auf einem Teppich und hält sich beide Hände vors Gesicht. Sie wirkt erschöpft. Neben ihr liegt ein Baby. Es scheint zu strampeln und zu weinen.

The negative feelings are much stronger in the case of postpartum depression. Typical symptoms of postpartum depression include:

  • low mood (deep sadness, crying, feelings of emptiness, hopelessness)
  • loss of interest in things that were previously a source of pleasure and, in particular, feelings of indifference towards the new baby
  • anxiety
  • sleep disorders
  • loss of appetite
  • difficulties concentrating
  • self-doubt
  • thoughts of self-harm or of harming the baby
  • feelings of guilt

These signs and feelings only indicate depression if they last for several days.

What causes postpartum depression?

It is not yet clear what exactly triggers postpartum depression. Some theories assume that hormonal changes in the female body after birth are responsible. However, this has not yet been proven.

Motherhood is frequently portrayed as something natural and fulfilling. And this is exactly how it is for many mothers. However, the role of the mother can also be difficult and challenging at times – both physically and emotionally.

Another aspect to consider is that women often don’t receive the help and support they need. It is therefore hardly surprising that some mothers feel overwhelmed shortly after giving birth and respond to problems by becoming depressed. Depression can occur at any time in life, not just after giving birth.

A number of risk factors are specific to postpartum depression. It is more likely to affect a woman if she:

  • has previously had a mental illness, such as anxiety disorders or depression
  • experiences stress and stressful life events during her pregnancy and after the birth
  • has relationship problems or lives alone, suffers domestic violence, or generally lacks social support

How common is postpartum depression?

Up to 15% of all women suffer from depression in the first three months after giving birth.

Up to 15 in every 100 women suffer from depression in the first three months after giving birth. Around half of these (8 in every 100) develop a mild to moderate form, while 7 out of every 100 women suffer from severe postpartum depression.

How does postpartum depression progress?

Without treatment, there is a risk that the depression will become chronic. In most cases, postpartum depression lasts between 4 and 6 months without treatment. Some symptoms may persist even after a year has passed.

Many mothers who suffer from postpartum depression have already experienced a depressive phase during the pregnancy.

Treatment should be sought for postpartum depression to prevent the depression from persisting for a long time.

How is postpartum depression diagnosed?

A consultation with a doctor is required in order for postpartum depression to be diagnosed. Doctors will recognize the symptoms that point towards depression.

A physical examination may be performed to exclude other diseases and problems that could cause similar symptoms.

How is postpartum depression treated?

With mild postpartum depression, more emotional support and practical help with daily life may be all that’s needed. The person providing this support (e.g., the father) should avoid being critical and judgmental. It can also help to meet and talk with other mothers. For example, it may be beneficial to chat with friends, acquaintances, or women in support groups who are having or have had similar experiences.

Medical or psychological support is important when treating moderate to severe depression. In these cases, treatment by a professional psychotherapist or a specially trained adviser is recommended. Studies show that this type of support makes things at least a little easier for many women.

More detailed information, e.g., about what options are available to help those with postpartum depression, is available at gesundheitsinformation.de.

How do other women and families cope with postnatal depression?

Women with postnatal depression very quickly begin to experience feelings of loneliness. These are reinforced if they are often alone at home with their babies.

Many women feel that they no longer have control over their own lives. They also worry that life will never return to “normal” and that they will never be able to experience joy again. Many women also report a loss of interest in sex, which can, in turn, lead to conflict with their partners.

Many women don’t share their feelings or fears with the people closest to them. This may be the right choice for some. However, others deny themselves the opportunity to get the help they need by doing so. With the right support, they could quickly begin to enjoy life and their baby again.

As this may also be a very difficult time for the partners of women with postnatal depression, they may sometimes also need support or to be included in the treatment.

There are also some women who are gradually able to shake off their feelings of depression by fighting their way through it one day at a time. These women gradually manage to regain control of their lives in this way.

Postpartum depression doesn’t last forever. However, it is important for those affected to receive the daily help and support they need. It can be difficult to ask for help, especially for those with postpartum depression who may be feeling ashamed.

Nevertheless, there are usually people, including professionals, in the woman’s immediate environment who are willing and able to help rather than to judge. This can help someone with postnatal depression to deal more effectively with their difficult situation.

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG).

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