During pregnancy and after birthDepressions occur throughout the entire life span, even in phases of life that we associate with joy and happiness, such as the time of "good hope" during pregnancy or after the birth of a child.
Many mothers experience a brief period in the first few days after delivery when they "lose their temper easily," are moody and anxious, and cry for no reason. This so-called "baby blues"subsides after a short time without treatment. However, if the depressive symptoms persist over a longer period of time, a serious illness can develop with potentially serious consequences for both mother and child, and often for the whole family: the Postpartum Depression.
"Life", Claudia Vettermann (photo competition 2011)
Even during pregnancy, depression is one of the most common mental illnesses. Many women are very anxious during this time, are very worried about the development of the child while the mother is still alive. They doubt whether they can cope with the demands of motherhood expectations and demands can fulfill. Depression during pregnancy can directly affect the fetus and is associated with increased risk of premature birth and lower birth weight.
Besides the Suffering In addition to the consequences of the illness for the mother, pre- and postpartum depression can also impair the development of the child's cognitive or emotional abilities in the long term. That is why depression around the birth of a child requires professional treatment. Depression is also common in this phase of life well treatable.
– Baby Blues – Postpartum Depression – Frequency and Causes – Treatment – Education – Links and Literature
50-80% of all mothers show symptoms of the so-called "baby blues" in the course of the first week after delivery, a short-lasting depressive upset. The joy of having a baby is accompanied by mood swings, fatigue and exhaustion, sadness and frequent crying, as well as sleep and restlessness. In the vast majority of women, this low mood arises between the 3rd month of pregnancy. and 5. Day after birth, lasts only a few hours or days and then subsides without treatment. If the depressive symptoms last significantly longer, a serious postpartum depression may be present, Postpartum Depression.
Unlike the baby blues, postpartum depression is a condition that more severe, longer lasting and in need of treatment depressive Illness, occurring in the first year after childbirth.
The Symptoms are no different from depressive disorders that occur independently of the birth of a child, but postpartum depression has the following characteristics:
– pronounced emotional lability, – inability to develop positive feelings for one's own child, up to numbness, – excessive fear and worry about the child's well-being, – pronounced thoughts and doubts about one's own abilities as a mother, as well as fears of failure: "I am a bad mother," "I cannot care for my child," – obsessive thoughts (z.B. harm the child), – breastfeeding problems.
Frequency and causes
10-15 % of women develop postpartum depression after giving birth. An increased Risk of disease have women who have already suffered from depressive moods at various times in their lives and women who show severe depressive symptoms in the first week after childbirth.
Several factors interact in the development of postpartum depression – as in depressive disorders in general:
Physical causes can be, for example, pregnancy complications and biochemical changes. Psychological factors can cause u.a. a traumatic birth experience, strong changes in one's own life rhythm and identity, as well as changes in self- and body image. Social factors include, for example, rediscovering one's role as a mother or a (changed) relationship with one's partner and relatives. In particular, a lack of social support and an unstable, unsatisfactory or absent partnership are risk factors. Social factors are z.B. Mother image (always loving mother). The exclusion of the dark sides of the mother role in public.
Differentiate Postpartum depression is different from the rarely occurring postpartum psychosis, in which about 1 to 2 out of 1.000 women fall ill after the birth of their child.
Postpartum psychosis usually occurs in the first 4 weeks after birth. The affected mothers suffer from agonizing delusions and sensory illusions (hallucinations) and are severely restricted in their everyday functioning. Due to the immediate danger for the affected person. For the child is fast professional help – i.d.R inpatient treatment – especially important.d.R inpatient treatment – particularly important.
The treatment of depressive disorders after childbirth depends on the manifestation and severity: In the case of the Baby Blues it is sufficient to inform mothers and relatives about symptoms, frequency and causes and to point out that those affected need the support of relatives, but that the upset usually passes without professional therapy.
Postpartum depression can, on the other hand, if left untreated, have serious long-term consequences for the mother, the child and the whole family. Immediate professional help is therefore necessary. Postpartum depression is well treatableDepending on the symptoms, a combination of psychotherapy and medication may be appropriate.
– The Medicinal treatment leads most quickly to an improvement of the complaints. It helps to regain the energy to cope with everyday life. Together with the attending physician, possible medications and possible side effects for mother and child are discussed. Breastfeeding is compatible with drug treatment in this context. Aim of psychotherapeutic measures is coping with the symptoms of the disease by educating the family about the disease, adjusting to the new situation, and establishing a good mother-child relationship. It is important to involve the partner and other relatives in order to deal with possible family and partnership conflicts and to discuss opportunities for relief. Cognitive behavioral therapy and interpersonal psychotherapy are most frequently used. – In some cases, it is helpful to consult a midwife, community nurse, social worker, or various other care services (z.B. household help, childcare via the health insurance), many affected. – In Mothers' and self-help groups coping strategies for stressors and conflicts can be discussed and practiced. In addition, information about developmental steps of the child is conveyed, which gives the mother security. Advantage of group therapeutic interventions is the impetus to build social contacts. In some cases (e.g.B. in case of severe depression or postpartum psychosis) is for the good of both mother and child a (common) Hospitalization necessary. At some psychiatric hospitals, there are special mother-child wards where the child can be admitted together with the mother. Information on this is provided by the shadow and light e.V. and the Marce Society.
Although postpartum depression well treatable Many of the women affected do not seek help. There is a danger that mothers and relatives may perceive the physical symptoms of postpartum depression (headaches, dizziness, heart problems, loss of appetite, sleep disturbances, reduced sexual interest) as a normal exhaustion reaction to the birth and care of the child and not consider them to be in need of treatment. Some symptoms (especially imposing thoughts, the feeling of failing as a mother and the perceived lack of feeling towards the child) lead to Shame and Guilt In the mother. The woman concerned is afraid of "blaming herself" and of being a "bad mother" and does not dare to talk to anyone about it. In both cases, those affected do not seek help, the depression remains undiagnosed and untreated, so that the illness phase is prolonged.
Necessary Clarification about the disease, also to Relief feelings of guilt. It is of utmost importance for the course of the disease that both the mother and her family understand that this is a treatable disease.
Postpartum depression is not a personal failure or a sign that a woman is a bad mother or does not love her child enough. It is a disease that can be treated. In the interest of the mother and the child, professional help should be sought.