Postpartum depression symptoms and signs how to deal with it

A newborn brings a variety of emotions, from joy and excitement to anxiety and fear. After childbirth, hormonal changes occur in the female body. Postpartum depression is a temporary mood disorder that can be quite severe. You can also find in the medical literature a definition of this condition as postnatal depression.

Postpartum depression affects approximately 1 in 7 women. This can have a negative impact on the well-being of mother and baby, but 1 in 5 women remain silent about their symptoms and therefore do little to combat the problem.

Postpartum depression is a treatable psychological disorder. It can be managed effectively, which will significantly improve the condition. But first of all, it is important to seek help from a doctor.

It's not your fault you're depressed, and depression doesn't make you a bad parent.

What is postpartum depression?

Postpartum depression is a form of depressive disorder that affects women after the birth of a child. You can also come across the term “postnatal depression”. It negatively affects the condition of both the mother and the child. Despite the skepticism of many people about this kind of mental disorders, they are quite serious and require qualified treatment. Depression develops during the first months after childbirth.

According to statistics, up to 13% of all women in the postpartum period suffer from it. Most often, postpartum depression occurs in women who have previously suffered from depressive disorders. They account for up to 50% of all episodes. Research in this area indicates that up to 70% of all women suffer from mild depression after childbirth.

Complications

Without treatment, postpartum depression can negatively impact your relationship with your child.

For moms. Depression, if left untreated, can last for months or even years, sometimes becoming chronic. In addition, treatment does not guarantee that depression will not develop again; on the contrary, it increases the risk of the disorder developing in a more severe form, so support is needed in the first years after the condition improves.

For fathers. Postpartum depression has a ripple effect, causing resentment in everyone close to the new baby. When a new mother has depression, the father is at high risk of developing it.

For children. Children of mothers with untreated depression are more likely to suffer from psychological problems, such as difficulty sleeping and eating, crying and delays in speech development.

Causes of postpartum depression

Among the risk factors leading to the development of postpartum depression in a woman are the following:

Heredity. If a woman’s mother experienced a similar condition after she was born, then it is possible that the woman herself will react to severe stressful situations in a similar way;
Hormonal changes occurring in the body. During pregnancy, every woman's blood level of hormones such as estrogen and progesterone increases several dozen times. When a newborn is born, the concentration of these hormones begins to decrease sharply. During the first three days they return to normal levels. These jumps can negatively affect a woman’s psychological state. In addition, recent studies indicate that there is a relationship between depression occurring after childbirth and the level of the hormone prolactin. It drops sharply immediately after the birth of the child, and then, over the course of several weeks, rises;
The psychological state of a woman is also influenced by hormones produced by the adrenal glands, namely cortisol and aldosterone. Fluctuations in their blood levels are reflected in the occurrence of depressive disorder. Moreover, it was found: the brighter the symptoms of PMS in a particular woman, the stronger the depression will be after childbirth;
Stress. The worries that a woman experiences after the birth of a child, associated with the increased workload on her, cannot but affect her emotional state. In addition, sleep is disturbed, it becomes restless and short-lived, physical fatigue is present, which also leads to aggravation of the problem;
Predisposition to depressive disorders. In this case, we are talking about a woman’s tendency to such conditions. That is, if depression occurred before childbirth, then it is more likely to occur after it. At the same time, women who are prone to depression will suffer from it both after the second and third births;
Unfavorable social status and low level of well-being are aggravating factors. This may also include unemployment, lack of own housing or poor living conditions;
Premature birth or illness of a child can lead to a feeling of guilt, which often transforms into depression;
Psychological problems in marriage;
Premature discharge from the maternity hospital, when the woman has not yet fully adjusted to her new role and has not acquired the necessary knowledge and skills to care for the baby;
Stressful situations that occurred during pregnancy, for example, the death of relatives, change of place of residence, etc.;
The beginning of the lactation period and the pain and lack of sleep associated with this process. Depression can be caused by stagnation of milk, lactation crises, and inability to breastfeed;
Characteristics of a woman. Often a trait such as selfishness leads to the formation of a problem;
Changes in appearance. Increased body weight, the appearance of stretch marks, age spots, lack of time for proper self-care - all this can negatively affect a woman’s condition;
Violations of sexual relations with a partner. Fatigue, inability or reluctance to engage in intimacy, decreased libido, aversion to sex are factors predisposing to depression;
The presence of bad habits, in particular alcoholism and drug addiction, both in the woman herself and in her husband;
The presence of mental illness in the woman who gave birth;
Negative experience of a previous pregnancy.

All these reasons can lead to the development of postpartum depression. However, the question of the triggering factors in the formation of the problem still remains open in medical science.

Symptoms of postpartum depression

The following symptoms indicate that a woman is developing or has already developed postnatal depression:

The woman begins to experience a persistent feeling of depression. She is unable to cope with this depressing feeling, which is especially intensified in the evening or morning (sometimes it appears both in the morning and in the evening);
Often thoughts arise in my head about the lack of meaning in future life;
A guilt complex may begin to form, especially if the child has any health problems;
Irritability increases, which manifests itself in the form of aggression directed at all family members (most often, the husband and older children suffer from these manifestations);
Distraction of attention, the inability to concentrate on one activity is the most important symptom of most signs of postpartum depression;
Emotional sensitivity increases. It is expressed in excessive tearfulness, which appears for the most seemingly insignificant reasons. Against the backdrop of the fact that a woman experiences emotional exhaustion, there is a loss of strength;
The impossibility of proper rest, since the woman’s overwhelming feelings do not give her the opportunity to sleep peacefully. Therefore, insomnia is a characteristic symptom of postpartum depression;
Anhedonia, or the inability to enjoy any joyful moments in life. Accompanied by a reluctance to laugh at jokes, despondency, melancholy and apathy;
Excessive concern about the health of the newborn child. Mothers with postpartum depression are frequent visitors to pediatricians and children's doctors with a narrower specialty;
Fears for your own health. The woman begins to search and definitely finds signs of terrible diseases. Against this background, hypochondria begins to develop, which is accompanied by frequent complaints about one’s own health, the perception of any ordinary sensations as signs of pathology, the conviction of the presence of one or another disease;
Sometimes it happens that a woman completely stops worrying about the baby, moreover, she experiences a feeling of rejection and hostility towards him. Such a condition can lead to a woman convincing herself that the child is not her own, but a substitute in the maternity hospital;
There is a frequent change of mood, from a cheerful smiling woman, a young mother with depression can turn into a sobbing hysteric in a minute;
Often, women who become depressed experience memory loss;
Against the background of developing postpartum depression, functional disorders may occur, for example, disturbances in the gastrointestinal tract, the appearance of headaches. Physical manifestations of depression can also include discomfort in the joints, muscles, back, and frequent dizziness;
A woman may lose the desire to eat, and against this background, uncontrolled weight loss begins;
The gait and speech changes. Most often, they accelerate, although in rare cases there may be slowness and retardation.

When depression worsens, it can transform into psychosis, which often involves thoughts of harming yourself, or even your child.

How long does postpartum depression last?

Depressive disorder after childbirth is not considered a serious mental illness. However, the time period immediately after childbirth poses the greatest danger in terms of the onset of the development of persistent emotional disorders. If we talk about the duration of postpartum depression, it is important to distinguish between postpartum psychosis and maternal melancholy.

On days 3-5, a woman may fully begin to experience manifestations of maternal melancholy. It is expressed in inexplicable sadness and melancholy, increased tearfulness, lack of appetite, and insomnia. The timing of maternal melancholy is quite extensive; sometimes the feeling of despondency can last only a few hours, sometimes it can take several days. However, at the same time, the woman does not distance herself from the child, performs all the necessary actions to care for him, and treats the baby with care and attention.

Therefore, maternal melancholy is not usually classified as a psychological disorder, since it is only a temporary manifestation of hormonal disorders occurring in the female body. However, if additional risk factors are present, maternal melancholy may develop into postpartum depression after a few days.

Postnatal depression most often begins to form in the second or third week after the baby is born. It often manifests itself when the mother and baby are discharged from the maternity hospital. Although sometimes suppressed emotions begin to overwhelm a woman several months after the baby is born, when fatigue from constant worries about him reaches its climax. Postpartum depression can last one month or several years.

If, after a few weeks, signs of mental disorder continue to be observed, then it is advisable to assume that the woman has experienced prolonged postpartum depression. This condition is rare, but in a particularly severe form, depression can last for years, acquiring the character of a chronic disease.

Certain categories of women are prone to prolonged postpartum depression. Among them are those who have a neurotic character, are hysterical, withdrawn, experience pathological fears (phobias) or uncontrollable desires (mania). In addition, women who in childhood did not receive enough emotional participation and response from their own mother are predisposed to the development of prolonged depression. In some particularly severe cases, even a qualified psychologist cannot predict how long a woman’s postpartum depression will last.

Rarely, in about one in a thousand women, postpartum psychosis begins to form against the background of emerging depression. In this case, it will not be possible to do without medical help, and the woman will need the help of a specialist in order to return to a normal psychological state and fully experience the joy of motherhood.

How to deal with postpartum depression?

You can take some steps to combat postpartum depression on your own, without seeking help from a psychologist.

Here are the most important aspects:

Attractiveness. You need to try to remain attractive, for which you need to find time to care for your own appearance and body. For a normal emotional state, it is important for a woman to see her non-repulsive reflection in the mirror. Naturally, the postpartum period and caring for the baby takes a lot of time. However, you should try to set aside at least 15 minutes every day to carry out hygiene and cosmetic procedures. To make it easier to care for your own appearance, you can visit a salon and get a fashionable haircut that does not require a long time to style. You should pay attention not only to walking clothes, but also to home clothes. It should be practical, comfortable, and at the same time beautiful;
It is necessary to learn to hear the child. In this case, we are talking about an adequate response to his crying about hunger or the need for hygiene procedures. There is no need to panic about the slightest cry, because most often it is the result of the baby’s natural development, and not a sign of any pathology. At this age, children only need food, timely care and the proximity of their mother;
Communication with the baby. It is necessary to communicate as much as possible with the newborn child. Even if he is only a few days old, this is not a reason to spend all his time in silence. You need to talk to him, coo and coo. With these simple actions you will be able to bring your own nervous system into balance. In addition, communication has benefits not only for the mother, but also for the baby. Hearing her calm voice, he will develop better intellectually, verbally and emotionally;
Help. You should not refuse any help that allows you to relieve a woman. This could be an offer to take a walk with a sleeping baby or a service in terms of housekeeping. Any help to the young mother will be useful, as it will allow her to rest a little;
Relationships with a partner. The man nearby should not be an outside observer, but a full participant in the process of caring for the child. It is difficult for him, just like a woman, to get used to the new role of a parent; he may not understand how to care for a child. Therefore, specific requests for help are needed, with a precise indication of the required set of actions, and not abstract complaints and claims;
Communication and leisure. You shouldn’t limit your social circle to your family and isolate yourself in the house. In order to diversify your leisure time, you can try to establish contact with the same young mothers walking on the street with their children. Joint discussion of problems and small achievements of the child will allow you to find new friends with whom you will always have something to talk about. In addition, the Internet is useful in this regard. You can communicate on forums, share your own experiences and problems;
Baths. Relaxing baths can help in the fight against postpartum depression. You can, for example, take a bath with rose petals, which, just by its appearance and aroma, will relieve fatigue and depression.

Additional recommendations

If a woman does not consider it necessary to seek psychological help, but feels that something not quite right is happening to her emotionally, she should, first of all, try to adhere to a healthy lifestyle. Active physical exercise in the morning, walking with your baby in the fresh air, normalizing your diet, healthy low-calorie food, giving up bad habits - all this is the key to a successful recovery from depression after childbirth.
Also, you should not try to become an ideal mother in everything and build a model of an impeccable family. As a rule, the inability to realize everything planned leads to depressive disorders. To improve your peace of mind, you can consult with a close friend or relative who has gone through childbirth and faced similar difficulties.
It is important not to be embarrassed to admit to a loved one your experiences, feelings, and emotions. Don’t be embarrassed to tell your man about your feelings of anxiety. Perhaps your husband is no less worried about the birth of a child than you are, and by talking with him, you will be able to solve not only your own problem. Male postpartum depression is not as rare as it might seem at first glance.
If none of the tips helps get rid of depressive disorder, and the condition continues to worsen, then you need to seek medical help. The woman may need qualified treatment using medications.

On the subject: How to get out of depression on your own?

What should a husband do during his wife’s postpartum depression?

A husband who notices signs of postpartum depression in a woman is obliged to help her cope with this destructive condition. To do this, he needs to take on at least a small part of the household responsibilities, even if previously they were performed only by a woman. In addition, the wife needs to help not only with housekeeping, but also with meeting the needs of the child.

There is evidence that those women who do not feel cared for by their husbands are most often susceptible to depressive disorders. If he does not take an active part in family affairs and does not offer his help to the young mother, then she is more likely to suffer from postpartum depression.

It is important to provide not only physical but also psychological assistance. For a woman, it is necessary to see support in her husband’s face, his desire to listen, sympathize, give practical advice, and not criticize and condemn.

A man must understand that postpartum depression is not a whim, but a disease from which a woman suffers. She is not able to simply take and forget about her own experiences, just as a patient with diabetes cannot lower her blood sugar level by sheer force of will.

For a woman after childbirth, it is simply necessary to feel loved and needed. The willingness of a loved one to come to the rescue and relieve her a little from household chores is the best a man can offer to lift a woman out of depression.

Advice from experienced women

It will be useful for a woman to learn that she is not the only one who experiences psychological problems after childbirth. Many of the fairer sex have had the same problems and share tips on how they managed to cope with postpartum depression.

Alena, 28 years old. “Nothing and no one can help you get out of this state except yourself. It’s good to have people nearby who don’t judge you and understand you. Depression will go away on its own after some time. You will feel the love of life again. The main thing is not to have doubts about the feeling of love for the child, and so it will be.”

Ulyana, 25 years old. “I didn’t feel the signs of postpartum depression immediately, but about three weeks after the birth of my daughter. How all these advisers infuriated me then, and I generally took hostility to my husband’s proposal to seek help from a specialist. But it’s good that she came to her senses in time, and her beloved still insisted on his own. Three sessions with a psychologist - and everything fell into place.”

Sveta, 31 years old. “When I was pregnant, I thought that the moment the baby was born would be the happiest in my entire life. But then Kiryusha was born, and I felt a strong feeling of loneliness. It was as if I had been deprived of all the usual joys of life. If earlier at work I simply basked in attention, was the most attractive, could boast of proportional forms, now I am thin and scary. Meetings with friends, parties, travel - all this is in the past. Now only a child! But my husband found a way out - he rented a house in the countryside, and my nanny and I moved there for the whole summer. It was there that I was able to reflect on my behavior and look at changes in life differently. And I felt better, I realized that I madly love my baby and appreciate my husband. You shouldn’t think that I went crazy, it was really very difficult for me then, but now it’s all gone.”

Nina, 25 years old. “I was so looking forward to pregnancy and wanted a child that I didn’t even think about any depression. But then it just hit me. Unreasonable sobs, constant tears in my eyes, I thought that was it – I had gone crazy. My husband left and my mother tried to support her to no avail. It seemed that life had stopped. But one day I was walking in the yard and met the same mother, and she turned out to be a psychologist. She and I chatted for hours while the kids were sleeping. Thanks to Lena, I returned to normal life, and my husband, by the way, also returned. Everything has improved for us."

Natasha, 28 years old. “You shouldn’t think that fatigue and depression are the same thing. When you're depressed, things are much more serious. I wanted a baby, I gave birth, they helped me, my husband took care of me, I had everything at home. But for some reason I hated myself and, as terrible as it was, my daughter. Time dragged on, I did everything like a robot, because I had to. For the first time I felt tenderness for my daughter at five months. And now she’s almost three and I’m crazy about my baby. It’s scary to even think about going back to that time.”

Dasha, 21 years old. “When Sonya gave birth, the child was literally taken away from me. My mother and mother-in-law did everything for me, except breastfeeding. So I lay stupidly in bed and watched TV. But everything changed when my mother-in-law left for a month to visit, and my mother was hospitalized, I literally had to become more active. I worked like I was running on batteries, but I again felt a taste for life, became active, cheerful and cheerful. Something like that".

Zhenya, 26 years old. “I was so sorry that I gave birth, I even wanted to give up Misha. But she was treated and stayed in the hospital. Now Misha is 2, everything can be survived, everything has passed.”

Yulia, 24 years old. “I was so sick, the melancholy was just gnawing at me, I was either angry, then bored, then crying. But when my girl smiled at me, at me, I realized that I was happy. And so, only a month ago I gave birth to my second princess, but now there is simply no place for melancholy in my life.”

Treatment

Treatment and recovery time depends on the severity of depression and the individual characteristics and needs of the mother. If the reason lies in the underdevelopment of the thyroid gland, the mother may be referred to an endocrinologist, but more often a psychiatrist, or even a psychologist, works with depression if the disease is caused by non-physical factors.

Your doctor may recommend meeting regularly with a psychologist or starting to take antidepressants. Often both types of treatment are recommended due to the effectiveness of related treatment strategies. Lifestyle changes may also help relieve some symptoms. If you are breastfeeding, any medicine you take passes into your breast milk. However, most antidepressants can be used while breastfeeding with little risk of side effects for the baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants.

Through therapy, you can find ways to deal with unexplained feelings, set realistic goals, and respond positively to situations. Family therapy also sometimes helps. The following strategies may help cope with increased postnatal stress:

Follow the regime: Go to bed at 10 pm;
Find time to exercise;
Surround yourself with supportive people;
Regularly eat nutritious meals high in calcium and ascorbic acid;
Free yourself from company with your child to take a break for emotional relief.

With appropriate treatment, symptoms of postpartum depression usually improve. In some cases, postnatal depression can become chronic. It is important to continue treatment after symptoms improve. Stopping treatment too early may lead to relapse.

Self-medication

In addition to professional treatment, there are some things you can do for yourself that are based on your treatment plan and can help speed up your recovery.

Adopt a healthy lifestyle (be physically active, walk with your child, engage in gentle forms of exercise, try to get adequate rest, eat healthy foods and avoid alcohol);
Set realistic expectations (don't force yourself to get your apartment in perfect order, lower your expectations, do what you can and don't overexert yourself);
Find time for yourself (take some time for yourself and get out of the house, but ask your husband to take care of the child or arrange for a nanny, do something you have always enjoyed, such as a hobby or listening to music);
Avoid isolation (communicate with your husband, family and friends, do not be afraid to open up about your feelings);
Don’t hide your need for help (open up to your loved ones, let them know that you need help. If relatives offer to babysit your child, agree if you are sure that they will not harm him. During this time, you can take a nap, take up a hobby or have some leisure time...);
Learn parenting skills: properly managing crying, disobedience and other emotional problems with a child, so as not to get irritated and, thereby, not to disturb his mental health.

Remember that taking care of your child includes taking care of yourself.

How is postpartum depression treated?

Depression can and should be treated.

There are several therapeutic options, including:

Cognitive therapy. It allows you to stop the development of a destructive psychological process. According to ongoing research, signs of depressive disorder after childbirth decrease after the first session, and after six, a marked improvement is observed. Only a specialist should use breathing and relaxation techniques;
Psychological consultation. It helps when the patient needs emotional support, objective advice to help find a way out of the current situation. It is worth preparing for several visits, since one consultation is not enough;
Use of antidepressants. The medication course should be accompanied by a visit to a psychologist. It is worth knowing that not all antidepressants can be taken while breastfeeding. Doctors recommend using selective serotonin reuptake inhibitors or tricyclic antidepressants (with the exception of doxepin).

Treatment tactics will depend on the severity of the condition. The woman may need to visit an endocrinologist and get tested for hormones. Sometimes the trigger for the formation of persistent depression can be anemia, which is often observed in women who have given birth.

Therefore, if during pregnancy there was a low level of hemoglobin, then it is advisable to donate blood for a general analysis and rule out anemia.

Don't forget about the principles of proper nutrition. Research indicates a direct connection between the amount of sugar a woman consumes and the incidence of postpartum depression. The same statement is true for chocolate. Therefore, sweet foods will need to be kept to a minimum.

On the subject: List of medications for depression

Diagnostics

Qualified doctors monitor the pregnancy of expectant mothers and, by the way, are interested in their physical and mental well-being after it. Don't be embarrassed, postpartum depression is common, so don't be afraid to talk about things that are making it difficult for you to adapt so that your doctor can create a treatment plan.

As part of the diagnosis, the doctor can:

Screen for depression using a questionnaire (a test for identifying depression will be at the end of the article);
Request a blood test to determine if an underactive thyroid is contributing to signs and symptoms;
Order other tests if signs indicate another disease.