Postpartum depression and baby blues

The world of advertisements, series or glossy magazines often serves us a sugary or even utopian image of motherhood, where smiling and well-groomed women tenderly cuddle polite, rosy children in a sterile space of a pastel living room. No wonder that looking at the real image of parenthood, full of love and beauty, but also used tissues, dirty diapers and the echo of crying bouncing off the walls, you may feel at least uncomfortable ;) Fortunately, we are increasingly and more openly exposing such false images.

Today we are discussing postpartum depression, which develops in 1 in 7 people after giving birth. A much larger percentage experience the baby blues, or periodic postpartum blues. Talking about mental health after giving birth is also an insight into the condition of the entire family and all those involved in caring for the newborn. Partners can also suffer from postpartum depression – let's not forget that!

Condemned to the (baby) blues?

If baby blues were actually a musical genre, despite its cute-sounding name, it would not be a cheerful background for children's games...

Contrary to the saccharine messages that a person in labor feels “flooded with love,” the first days after the birth of a child (and sometimes even weeks) are not always a time of euphoria. A new parent often experiences low mood, withdrawal, apathy, and tearfulness. This condition is usually referred to as postpartum blues. It is estimated that as many as 80% of people after giving birth suffer from it.

Baby blues – causes and course

Parents (especially if it is their first child) often struggle with unrealistic expectations of themselves. They feel the constant gaze of others, seemingly judging their abilities to care for a child, their methods of raising a child, or their lifestyle. Being a "good mother_father" has become an unattainable goal, but above all - an elusive and difficult to define concept.

Many hormonal changes contribute to lower mood. During pregnancy (in the third trimester, and especially in the perinatal period), there are very high levels of hormones such as estrogen, progesterone, prolactin and cortisol. All this madness is to prepare the body for the challenge of giving birth. Within a few days after delivery, the amount of these hormones decreases. The decrease leads, among other things, to a decrease in the concentration and activity of serotonin, or happiness hormones, and as a result - it can lead to mood disorders and increases the risk of depression. These are things completely beyond your control, so be understanding with yourself - not only during pregnancy!

Support from loved ones and monitoring your health and well-being are extremely important – baby blues do not require psychiatric treatment, but if the lowered mental state lasts longer than 3 weeks, it is worth considering the possibility of postpartum depression. Here, you will not be able to do without medical intervention!

What is postpartum depression?

Postpartum depression is a disease characterized by a number of reactions (both physical and mental) after the birth of a child. Very often, its symptoms (mood swings, anxiety states, etc.) appear already during pregnancy. After delivery, they may become more severe and the young parent may have problems acclimatizing to new roles - biological and social. Postpartum depression belongs to the group of affective disorders of the perinatal period, which, if left untreated, can significantly reduce the quality of life and cause a number of difficulties in the proper social functioning of both the mother_father and (in the longer term) the child.

What causes postpartum depression?

It is very difficult to give a clear answer to this question. The causes may be different and often relate to personal experiences. One of the sources may be individual personality traits and the ability to cope in stressful situations. External factors are of great importance: social and economic - a young parent without means of living or support from loved ones, and also subjected to various types of pressure, is also at risk. Scientific research is ongoing on the impact of the course of childbirth on the risk of developing depression, but so far no group of researchers has been able to explain it unequivocally. However, it has been confirmed that genetic factors are important. We cannot forget about biological aspects either - the body of a pregnant person, as well as after childbirth, goes through many changes and depression may be related to the destabilization of the body.

Postpartum depression may also affect people with previously diagnosed mental disorders, and is often the first episode of mental illness.

Main causes of postpartum depression

• A sharp drop in the concentration of sex hormones after the birth of a child - they affect the functioning of the brain and the entire nervous system; even small fluctuations in the levels of hormones and neurotransmitters can significantly lower mood and the overall functioning of the body.
• Difficulties in adapting to a new role – constant fear for the child’s health and proper development, the stress associated with them, and sometimes pressure from “experienced” relatives (and their endless advice, methods and tricks, which instead of being supportive, sometimes depress and irritate new parents).
• Previous traumatic experiences – for example, if the child was conceived as a result of rape or the person has other deep-seated and unresolved childhood traumas.
• Other natural worries of all kinds – whether it’s financial problems that keep you awake at night, or housing issues and finding the right space to raise a child and build a family.
• Disturbances of biological rhythms – sleep deprivation and fatigue lead to changes in the immune system (including the production of pro-inflammatory cytokines, the release of which increases the risk of developing depression).

Symptoms of postpartum depression

Depression is when the symptoms of postpartum blues do not go away or even get worse. These include:

• poor health and mood swings,
• fatigue and weakness,
• insomnia (or excessive sleepiness),
• eating disorders (either lack of appetite or "eating" emotions),
• concentration disorders and difficulties in making decisions,
• anxiety states,
• suicidal thoughts.

In addition, there are issues related to getting to know each other and coexisting with a new household member. Often, problems with getting used to the child appear in the delivery room – this may be simply caused by the effort and shock associated with the birth itself. Sometimes, however, this turns into avoiding contact with the newborn – the young parent may be afraid that for some reason they will not be able to cope with caring for the baby, or even unintentionally hurt the baby, for example due to their lack of competence. Such thinking is often accompanied by a sense of guilt and helplessness. In order to minimize the risk of these fears coming true, the mother/father begins to distance themselves from the child. This in turn leads to a spiral of guilt. The person blames themselves for devoting too much attention to themselves and too little to the child, they begin to think of themselves as a “bad mother/father”, which results in a decrease in both self-esteem and a sense of agency. Depression translates into a lack of energy to perform everyday activities, as well as a lack of interest in things that previously brought joy.

What to do if you suspect postpartum depression?

It is extremely difficult to admit to having mental health problems. Many people are still afraid of being stigmatized as “crazy,” or, on the contrary, being equally painfully ignored and having their problems thrown into the bag of “bad days.” Both of these attitudes, negating the seriousness of mental health disorders, are extremely harmful. It is especially important to disregard them in relation to people after giving birth. From one day to the next, their lives change 180 degrees, new responsibilities appear, the pressure to be the best parent in the world is bustling around in the corners, and the child cries and communication with him resembles a game of ships, where we blindly try to hit the heart of the problems and needs.

Remember: depression is a serious illness that you cannot ignore – both for the safety of your child and your own. Any worrying symptoms should be openly discussed with your doctor or midwife.

What is important – try to make this problem real. Mental health problems affect many people in the postpartum period and require treatment. Reject thinking about yourself as a problem, a risk to yourself and your loved ones. Just as you need the support of your family and partner in mastering all the new responsibilities, you also deserve their understanding and tolerance in the event of a deterioration in mood, fears or any doubts.

Edinburgh Postnatal Depression Scale – what is it?

One of the tools that can help diagnose postnatal affective disorders is the Edinburgh Postnatal Depression Scale, a test consisting of ten short questions that helps determine the likelihood of this condition. It is not a full psychiatric examination, but the results can be entered into medical records to allow for faster support if needed.

The 2018 Regulation of the Minister of Health on the organizational standard of perinatal care states that the assessment of the risk and severity of depression symptoms should be performed between the 11th and 14th week of pregnancy and the 33rd and 37th week of pregnancy. We do not have data from private practices that would allow us to determine what percentage of parents undertake psychiatric treatment, but we know that only a few dozen patients use therapy under the National Health Fund per year. The reason may be the long waiting time for an appointment. In addition, many people simply hide how they feel - they do not want to worry or disappoint their loved ones, they worry that they will be perceived as "bad mothers_fathers", they believe that they should deal with their problems themselves, which incites a spiral of shame and guilt. It also happens that certain people are not aware that their condition is a disease that can be treated, and ignoring postnatal depression can lead to tragic consequences (for both the mother_father and the child).

Treatment of postpartum depression

Depression is a serious illness and, like all disorders of this type, requires professional treatment. It usually proceeds in two ways – with therapy and psychotropic drugs.

Psychotherapy

A psychiatrist, diagnosing postpartum depression, may suggest individual or group therapy. Psychotherapy allows you not only to confront your fears and problems with an outsider, but it is also a great step towards self-acceptance. Woman, mother, wife, daughter… Lots of these roles ;) So sometimes a suitable “double” is useful, who will help you understand their mechanics and establish an appropriate hierarchy between them. If you want to learn how to prepare for psychotherapy, you can read the article: first visit to a psychotherapist .

Psychotropic drugs

The decision on whether a person should take antidepressants is of course made by a medical specialist. This requires a thorough interview and tests that will allow you to choose a safe preparation and determine the optimal dosage.

How long does pharmacological therapy for people suffering from depression last? There is no clear answer here. Treatment of postpartum depression usually takes several months, but the recovery period can be accelerated by appropriate support for the patient in caring for the child, involving her in the entire process, as well as the previously mentioned psychotherapy.

Postpartum Depression in Men – Boys Don’t Cry?

For many, unfortunately, this is still a revealed truth. A man must plant trees, build houses, and solve all kinds of problems with a defensive, strong hand, being a support for the child-bearing stronghold of the home hearth.

Let me step outside myself, stand next to you, and demolish these stereotypes of masculinity.

Yes – guys cry too. And that’s good. The first step in maintaining a stable mental state is to openly express emotions. It turns out that postpartum depression can be struggled not only by the person who has given birth – their partner can also feel overwhelmed by the new, unknown reality.

What causes postpartum depression in men?

We already know that postpartum depression is caused by psychological, social, and biological factors. The determinants of affective disorders cannot be generalized by gender, because each of us has different experiences, ordeals, and sometimes traumas. In addition, after the birth of a child and the appearance of a new family member, all other household members find themselves in a reality turned upside down. We are talking about a change in hierarchy here - attention must focus on the new arrival who needs care, so feelings of loneliness or rejection are natural in this situation.

Of course, a pregnant person is additionally "burdened" with all the physical aspects related to their condition and chemical processes occurring in their body, which can cause various disorders or mood swings. It turns out, however, that despite the fact that postpartum depression in men is usually considered to be the result of strong emotional experiences, hormonal fluctuations can also be observed in the partner accompanying the person in childbirth. After childbirth, testosterone levels in men drop, while prolactin levels increase. This causes a decrease in libido and greater emotional instability.

How can you help someone struggling with postpartum depression?

First of all, if someone close to you suffers from postpartum depression, accept this problem and name it appropriately to its scale.

It may sound trivial, but on the other hand it is one of the most difficult tasks. You may feel helpless, anxious, scared. Your partner's illness always causes stress and requires huge amounts of strength to reawaken a sense of security and trust in the other person during treatment and therapy.

Try to be understanding and patient. Unstable mood, communication problems, or other behavioral changes in a person struggling with depression are natural. Many parents struggling with depression believe that they will never be good mothers/fathers, and these negative thoughts can radiate to all members of the household, especially the partner, who is jointly responsible for raising and caring for the child.

You have every right to ask: "what do you need?", "how can I help you?" Encourage conversation, naming the problem. You may hit a wall many times, but the key in this case is the aforementioned patience. This is a process that takes time. You wonder: how long? There is no answer to this question, but with the support of the family and, above all, the intervention of a specialist, postpartum depression can be shorter.

Offer more help with childcare. If you have the strength, take on some of the responsibilities, allowing the other person to rest and breathe more. However, take care of yourself and don't neglect your health either. In the case of postpartum depression, the person after giving birth, the child, and other family members should be provided with appropriate care and support.

Postpartum depression without taboos

In cultures where the image of a multitasking mother completely devoted to her child is ingrained, baby blues and postpartum depression are still taboo subjects, which is why many people cannot get the support and treatment they need. The way to change and improve this state is to change social awareness and provide direct help. If we have young parents in our environment, let's not limit ourselves to general questions about their well-being - let's show them sincere interest and offer to relieve them of their duties. Let's not allow others to hold them accountable for how they find their way in their new role. When we start treating depression like other illnesses, it will be easier to cope with it.

Remember: you have the right to feel sad, tired, angry. Being a parent is, above all, being a human being. In order to take care of your child, you also have to take care of yourself. It works both ways – after all, a family is one organism beating with a common rhythm :)

MA Becker, GF Mayor, EJS Kunkel, Psychotropic drugs and breastfeeding , "Psychiatria po Dyplomie" 2009, vol. 6, no. 5, pp. 63-72, https://podyplomie.pl/publish/system/articles/pdfarticles/000/010/354/original/63-72.pdf?1472808073 [accessed 12/04/2021].
P. Brudkiewicz, Postpartum depression and psychosis , https://www.mp.pl/pacjent/psychiatria/choroby/91686,depresja-i-psychoza-poporodowa [accessed 12/04/2021].
Postpartum depression , https://wyleczdepresje.pl/depresja-poporodowa/ [accessed 12/04/2021].
Postpartum depression – a disease you cannot ignore ,
https://www.cefarm24.pl/czytelnia/zdrowie/mother-and-child-zdrowie/postpartum-depression/
https://www.cefarm24.pl/czytelnia/zdrowie/matka-i-dziecko-zdrowie/depresja-poporodowa/ [accessed 12/04/2021].
Postpartum depression – symptoms and treatment , https://www.psychoterapia.org/depresja-poporodowa-objawy-i-leczenie [accessed 12/04/2021].
Postnatal Depression , https://www.rcpsych.ac.uk/mental-health/translations/polish/depresja-poporodowa-postnatal-depression [accessed 11/04/2021].
K. Grzęda-Łozicka, What happens to a man when he becomes a father? Decrease in testosterone and libido , https://parenting.pl/u-mezczyzn-po-porodzie-nastepuje-spadek-testosteronu-i-libido-to-potwierdzaja-wyniki-badan [accessed 12/04/2021].
R. Jaeschke, Can women with postpartum depression safely use antidepressants? , https://www.centrumdobrejterapii.pl/materialy/czy-kobiety-z-depresja-poporodowa-moga-bezpiecznie-stosowac-leki-przeciwdepresyjne/ [accessed 12/04/2021].
How to help a person with depression , http://przystanek-mama.spsk4.lublin.pl/informacje-dla-bliskich/ [accessed 12/04/2021].
K. Krocz, Baby blues , rev. K. Drozd, https://parenting.pl/baby-blues [accessed 11/04/2021].
T. Nęcki, Postpartum depression in men – how to recognize male postpartum depression? , https://www.mjakmama24.pl/mama/kacik-taty/depresja-poporodowa-u-mezczyzn-aa-HdYT-ijvj-yhuo.html [accessed 12/04/2021].
About postpartum depression , https://twarzedepresji.pl/o-depresji-poporodowej/ [accessed 12/04/2021].
Z. Opolska, For a man, admitting to depression is a "double disgrace" , https://www.medonet.pl/psyche,poporodowa-depresja-u-mezczyzn,artykul,1730762.html [accessed 12/04/2021].