Many women experience mood swings after giving birth. These can range from happiness when they cradle their newborn in their arms to a sudden fear of loss. Psychologist Dr Valentina Rauch-Anderegg explains the difference between the baby blues and postpartum depression, and gives tips for dealing with this sort of low mood.

The difference between feeling down and postpartum depression

A few days after giving birth, most women experience a low (the «baby blues»– lit. «crying days» – or what used to be called «milk fever»), which disappears again within hours or days. It affects 40-80 % of mothers and does not require treatment. In contrast, postpartum depression is a depressive disorder that has a clear temporal connection with giving birth (according to classification systems, a period of up to one month after giving birth) that lasts for at least two weeks. The risk of depression increases already during pregnancy (especially in the third trimester). The depression can also set in more than four weeks after giving birth.

Symptoms of postpartum depression

The main symptoms of postpartum depression are as follows:

  • Feeling depressed most days
  • Lost of interest and reduced enjoyment of most activities

Additional symptoms which may appear during postpartum depression include:

  • Weight loss or weight gain (> 5%)
  • Sleeplessness or sleeping more
  • Physical restlessness or slowing down
  • Loss of energy or fatigue most days
  • Feeling useless or undue feelings of guilt
  • Concentration difficulties and reduced ability to think
  • Recurrent suicidal thoughts

Postpartum depression is defined as when one (or both) of the main symptoms and at least four of the additional symptoms are present for a period of at least two weeks.

Besides the symptoms listed above, the following are also possible: ambivalent feelings, no feelings at all or a negative attitude towards the baby, as well as constant fear and concern for the baby. These sensations can also lead to the parents having strong feelings of guilt. It is currently assumed that about 10-15 % of all women (some studies even speak of 30 %) and about 10 % of all men develop postpartum depression. The diagnosis is more difficult with new parents, because they often suffer from lack of sleep, loss of energy and concentration difficulties. This is probably also the reason why the studies mention such diverse figures. 

Risk factors

Scientists have not yet been able to conclusively establish why people suffer from postpartum depression. Nevertheless, studies can reveal risk factors which contribute to postpartum depression. They include:

  • Earlier episodes of depression
  • Sensitivity to hormonal changes (such as premenstrual syndrome)
  • Low satisfaction with your relationship and little support from your partner
  • Unplanned pregnancy
  • Stress during pregnancy
  • Financial difficulties
  • Dissatisfaction with your living situation

Tips for dealing with postpartum depression

The following tips can help you in your day-to-day life:

Emotions

Talk openly about your emotions

During a depressive phase in particular, many people withdraw and shut themselves off. This makes it difficult for those around them to offer support. As a result, they often feel helpless and turn away from the affected person. So try to share your feelings. If you do so, this can help those listening to understand you better and make it easier for them to give you the appropriate support or to look for support together.

Small steps

Take small steps

When you are depressed, dealing with the ups and downs of day-to-day life can feel like an insurmountable hurdle. You only see mountains of laundry, a baby that wants to be looked after, the gaping hole in the fridge, and so on. All this can put enormous pressure on people who are affected. Do not try to do too much too soon, as you need to feel a sense of achievement to strengthen your self-belief. Set goals that you think you can achieve, such as getting up before 9 am, washing your hair, eating something hot, or drinking a cup of coffee.

Positive experiences

Write down positive experiences

When you are depressed, a lot of things seem bleak and your thoughts go round in circles. You often focus on negative thoughts (e.g. «This will never get better», «I’ll never be able to do it», «I’m a bad mum / a bad dad»). This makes you feel even worse.

Every day, write down three positive experiences that you had that day (even if the positive moment only lasted for a few seconds). This will help you to focus on the positive again and at the same time, you will be creating a list of things/activities that do you good. You can always look at the list when you want to do something to make yourself feel better.

Specialist support

Postpartum depression has complex consequences: People who are affected by it go to their family doctor more often, are more anxious, have a lower quality of life and feel more stressed than people who are unaffected. Affected people also find it difficult to interpret signals from their baby correctly and to respond to the baby appropriately. In general, people who are affected are less engaged with their children, which in turn also has measurable negative consequences. These children are ill more often (e.g. have more episodes of diarrhoea and colic), have problems sleeping more often and their emotional and cognitive development is affected (which may cause subsequent problems at school or in relationships).

The relationship with the partner is also affected, as postpartum depression often leads to less support in the relationship, reduced intimacy and sexuality and increased conflict. This in turn can make postpartum depression last longer.

Do not feel ashamed of feeling depressed after giving birth. It is important that you do not keep everything to yourself and withdraw, but instead talk about it and seek help. Psychologists (or psychiatrists) are responsible for treating postpartum depression. Treatment is planned and carried out together. It has been shown to be very effective and lasting when people around you are involved. It is not easy to seek help, but is very worthwhile.

Portrait von Valentina Rauch-Anderegg

Dr Valentina Rauch-Anderegg is a clinical psychologist and a federally approved psychotherapist. She gained her PhD as part of the «Couples becoming parents» study at the University of Zurich and undertook her postdoc at the renowned Harvard Medical School. In her own practice she is able to apply her knowledge directly and advise and support individuals and couples on the subjects of pregnancy and parenthood.

Do you think you are suffering from postpartum depression? If so, please contact a specialist such as your gynaecologist, your midwife, a psychologist or the association Postnatal Depression Switzerland (only available in German and French).