Motherhood is for many women the most beautiful experience in life. However, it does not always turn out to be a source of boundless happiness. Sometimes after the birth of a child there is no joy at all, but disappointment, depression or… heartbreaking emptiness. Why does this happen? Can such a lowering of mood be postpartum depression? And if so, how to break out of its clutches and find satisfaction in being a mother?
What is postpartum depression?
The birth of a child opens a whole new chapter. It is a time when our previous lifestyle changes, and each day begins to set the rhythm of parental responsibilities. All these challenges can be overwhelming, even if we had previously eagerly anticipated the date of delivery and wanted to fulfill the dream of becoming a mother.
At some point, we may realize that nothing is as we imagined it. Instead of happiness, we are filled with sadness, and instead of positive thoughts, fears and doubts boil in our heads: Am I a bad mother? Will I be able to cope? Does it all make sense?
A persistent lowered mood, a sense of overwhelm and a belief that we won’t be able to cope with our daily responsibilities can signal a developing postpartum depression. It’s a mental disorder that affects up to one in five mothers – so it’s much more common than you might think. However, it is worth remembering that feeling worse after childbirth does not always indicate depression.
Baby blues – postpartum sadness
Many women experience more or less intense mood changes after giving birth. Well known among newly mothers is the term “baby blues”, which refers to a state of lowered mood that appears just a few days after giving birth. Baby blues is referred to as postpartum depression. It begins between the third and fifth day after delivery and is associated with sudden hormonal changes. Responsible for this are decreases in progesterone and estrogen, which increased up to tenfold during pregnancy, and now slowly return to their former levels.
Symptoms of the baby blues include:
- crying,
- loss of appetite,
- changeable moods,
- a feeling of constant sadness,
- being overwhelmed by a new situation,
- fatigue and difficulty concentrating attention.
Baby blues passes spontaneously after a few days – when hormone levels stabilize. Most often, already about two weeks after giving birth, the mother stops complaining about annoying mood swings.
Baby blues and postpartum depression – differences
Baby blues occurs in up to 80 percent of women after childbirth – it is a fairly common reaction of the body, which tries to adapt to the new situation. Its symptoms are unpleasant, but usually mild. They also quickly subside on their own, without the need for drug treatment.
Postpartum depression, on the other hand, develops in about 10-20% of mothers over a period of up to one year after the birth of the child. Its symptoms make it much more difficult to function on a daily basis and take care of the baby. Nor should you delay a visit to a specialist in the hope that everything will return to normal. Untreated postpartum depression can develop into chronic depressive conditions over time and affect not only a woman’s well-being for many years, but also take a toll on the child’s development.
Symptoms of the baby blues usually include mild feelings of melancholy, sadness, anxiety and emotional lability, which occur in many women within days or weeks after giving birth. These symptoms are usually mild and pass on their own within a few weeks. They occur as a reaction to hormonal changes, fatigue associated with caring for a newborn, uncertainty in the new role of parent, and other stressors associated with childbirth and childcare. Read also: stress in pregnancy
Unlike postpartum depression, which is a more serious emotional condition requiring medical intervention, the symptoms of the baby blues are usually mild and transient.
Symptoms of postpartum depression
Symptoms of postpartum depression are no different from symptoms of depression experienced at other periods of life. They are primarily:
- tearfulness,
- low self-esteem,
- lowered mood,
- anxiety and irritability,
- excessive feelings of guilt,
- lack of hope for the future,
- avoidance of contact with loved ones,
- difficulty concentrating attention,
- belief in being worthless,
- loss of previous interests,
- change in appetite (its loss or increase),
- sleep disturbances (especially insomnia), headaches,
- suicidal thoughts.
Symptoms characteristic only of postpartum depression are also listed. These are primarily:
– anxiety about the health and safety of the child,
– a sense of being overwhelmed by the new life situation and the role of the mother,
– intrusive thoughts about hurting oneself or the child,
– a belief that parental responsibilities are beyond our capabilities.
How long does postpartum depression last?
Postpartum depression, also known as postpartum maternal depression, is a type of depression that occurs in women after the birth of a child. It can last from several weeks to several months, and sometimes even longer. It is a condition that requires attention and treatment. Postpartum depression can lead to serious complications for both mother and child, so it is important to get support and medical help.
Postpartum depression vs. postpartum psychosis
Sometimes psychotic symptoms can also develop after pregnancy. Then we talk about postpartum psychosis – a serious disorder that can have serious consequences. Its course is characterized by the presence of mood swings, difficulty concentrating, sleep and appetite disorders, as well as hallucinations, delusions and thoughts of taking the life of the child.
However,postpartum psychosis is diagnosed infrequently – it affects only 0.1% of postpartum moms. Its risk is highest in women with bipolar affective disorder.
What contributes to feeling worse after childbirth?
Learning about the various disorders that can make it difficult to function after childbirth, the question may come to mind, “Why do some moms experience such symptoms and others do not?” However, it is impossible to give one simple answer. There are a lot of factors that influence how we feel after pregnancy – whether it’s related to personality, family situation or the support we receive.
Risk factors for postpartum depression:
- young mother, young mother’s age,
- low self-esteem,
- poor health of the child,
- difficult, stressful childbirth,
- difficulties with breastfeeding,
- lack of support from the partner,
- experiencing violence during pregnancy,
- reduced sense of self-efficacy,
- low sense of acceptance and security in the relationship,
- unrealistic expectations of motherhood,
- experience of highly stressful events during pregnancy,
- a history of depressive and anxiety disorders.
Faces of postpartum depression – what can depression look like?
Postpartum depression has many faces. It does not always look the same and is not always easy to see from the outside. It often likes to hide, take on masks and pretend to loved ones that everything is as fine as possible. While in fact it is getting worse every day.
When we experience postpartum depression, we can:
- feel constantly irritated and fear that something bad will happen to us,
- feel like running away from everything and being somewhere far away,
- experience insomnia (even when the baby is sleeping soundly),
- face a rush of thoughts that is impossible to control,
- doubt whether one is fit to be a mother,
- be overwhelmed by caring for an infant.
We can cry, get angry, argue with loved ones. But we can also suppress our emotions and remain silent. However, no matter how we react, there is suffering behind it – that’s why it’s not worth downplaying feeling bad and seeking professional help.
Effects of postpartum depression
Postpartum depression takes away the joy of caring for a child and greatly impedes daily functioning. Many women who have experienced this disorder lament that they were unable to make the most of their first months together with their toddler. Symptoms of depression robbed them of energy and willpower, and taking care of the infant did not bring satisfaction and fulfillment.
What else does postpartum depression result in?
– abandonment of plans for further family expansion,
– difficulties in establishing and developing a relationship with the child,
– a decline in self-esteem and a poorer self-image,
– avoidance of interpersonal contacts and isolation from loved ones,
– marital problems that are sometimes so serious that they lead to divorce,
– a tense atmosphere with household members and the emergence of conflicts with distant family members,
Postpartum depression – “no one understands how I feel”
Rose has had enough. She feels terrible. Preferably, she would lie in bed all day, not rising from it even for a moment. Everything seems empty and meaningless. And yet it was supposed to be so beautiful…
The woman sees that everyone around her does not understand how she can be so sad. After all, it’s so simple for them – she gave birth to a healthy daughter, she should be happy. But Rose just can’t.
Women with postpartum depression are often left alone with their difficulties. All the attention of loved ones is directed to the baby and its needs, while the newly minted mother suffers quietly right alongside. She feels completely misunderstood, left out and unimportant. And yet it is right now that she should be surrounded by care, unconditional acceptance and kindness.
Postpartum depression – diagnosis. Edinburgh Postpartum Depression Scale
Several different tools are designed to diagnose postpartum depression. The most commonly used is the EPDS (Edinburgh Postpartum Depression Scale). You can also reach for the PDSS(Postpartum Depression Screening Scale) and BPDS(Bromley Postnatal Depression Scale). Sometimes tools developed without regard to the specifics of the postpartum period are also used – for example, the Beck Depression Questionnaire.
Each tool allows for a quick but accurate assessment of mental status. In addition, the information obtained during the interview with the patient is taken into account. This gives the specialist a better understanding of the nagging symptoms a woman is facing – and this in turn influences the tailoring of appropriate treatment.
What protects against the onset of postpartum depression?
There are also factors that reduce the likelihood of experiencing postpartum depression. These include:
- high resilience to stress,
- high self-esteem,
- receiving support from loved ones,
- strong involvement of the partner in the postpartum period,
- participation in activities organized by birthing schools,
- the sense of strong bond a woman feels toward her child during pregnancy and after birth.
It is also good to remember healthy habits during pregnancy. Taking care of regular physical activity, quality sleep and proper eating habits have a huge impact on mood and are counted among the important protective factors against the onset of postpartum mood disorders.
Treatment of postpartum depression
Postpartum depression does not always involve pharmacotherapy. However, this may be the most favorable solution if the symptoms experienced are severe and one is anxious to achieve rapid improvement.
The vision of taking new medications is not received with enthusiasm by young mothers. There is a natural concern about whether it will harm breastfeeding. Fortunately, studies and clinical observations show that most new-generation antidepressants are safe and penetrate into breast milk only in trace amounts. Therefore, there is no need to stop breastfeeding and fear adverse effects.
How to help during postpartum depression?
Postpartum depression can be a very difficult experience, but there are many ways to help moms cope with it.
- Understanding and empathy. It is important for you to be empathetic and understanding of her feelings. Don’t downplay or minimize what she is going through. Make sure she feels heard and understood.
- Emotional support. Be present and available to her. Take time to talk to her, listen to her without judging. Many people with postpartum depression feel isolated and alone, so your support can be crucial.
- Help with daily chores. Often people with postpartum depression have difficulty with daily chores, such as feeding, changing diapers and preparing meals. Help mom with these tasks to ease the burden and give her some time to relax.
- Encourage health care. Encourage mom to consult a doctor or therapist. Professional help can be crucial in treating postpartum depression.
- Take care of yourself. Remember that you also need to take care of your mental and physical health so that you can effectively help your mom. Find time to rest and take care of your needs.
- Arrange for outside support. If possible, involve other family members or friends to help with child care or household chores. The more support, the easier it will be for the mother to cope with postpartum depression.
- Encourage light physical activity. Regular physical activity can help improve mood and reduce symptoms of depression. Encourage moms to take walks outdoors or engage in mild exercise.
- Emphasize the positive aspects of motherhood. Help mom see the positives of motherhood and remind her that she has support and love all around her.
Postpartum depression – cognitive-behavioral psychotherapy
Cognitive-behavioral therapy is an effective support for treating depression. For mild depressive symptoms, it can be the only form of treatment. It allows to achieve long-term effects and reduces the risk of relapse.
Cognitive-behavioral psychotherapy helps with postpartum depression because:
– encourages reflection on one’s functioning and helps get to the hidden sources of our problems,
– supports us in identifying unfavorable beliefs and changing them into ones that will be much more supportive for us,
– prompts us to learn new ways of dealing with difficult emotions, daily challenges and stressful situations,
– attaches great importance to psychoeducation and imparting useful knowledge about psychological mechanisms affecting thoughts and behavior.
And most importantly, by engaging in psychotherapy, we can feel better again. We will break through inhibiting beliefs and regain joy in life. This will have a positive effect – and not only on us, but also on the forming bond between us and the baby.
Bibliography:
Dombrowska-Pali, A., Gebuza, G., & Kazmierczak, M. (2023). Multifactorial determinants of the risk of postpartum depression symptoms. In Promotion, health education and prevention in medical science: T. 9. Promotion, health education, and prevention in medical sciences, pp. 108-112. Medical University of Bialystok.
Kossakowska, K. (2019). Postpartum depression of the mother and its consequences for the child and family. Scientific Quarterly Fides Et Ratio, 39(3), 134-151. https://doi.org/10.34766/fetr.v3i39.127
Maliszewska, K., Świątkowska-Freund, M., Bidzan, M, Preis, K. (2020). Risk of postpartum depression and personality traits and social support: a Polish observational screening study of mothers 4 weeks and 3 months after delivery, Psychiatry Poland, 51(5), pp. 892- 896.
Suchowiak, S., Wszołek, K., Suwalska, J., Łojko, D., Suwalska, A. (2020). Screening for perinatal period depression: a review of screening tools and barriers, Neuropsychiatry and Neuropsychology 20(15), pp. 60-69.