Depression

 

Depression

Motherhood and parental responsibilities can be extremely stressful, especially when material and social conditions are unfavorable. In turn, maternal mental illness can be a significant burden for children. Statistics show depression in 10% of all mothers; the proportion is even higher for economically disadvantaged mothers.

 

Postpartum mood crises (from Latin parts birth, childbirth) describe psychological states or disorders that occur in a material connection with the puerperium (Latin post = after; parts = childbirth, separation).  The spectrum of affective states occurring in the puerperium ranges from a slight sadness to depression to severe psychotic illnesses. Women are mostly affected, but more recent research has also reported postpartum depression in men.

 

So far, there are roughly three types of postpartum disorders, which often merge into one another:

 

·       the postpartum mood low (colloquially baby blues or crying days ),

·       the postpartum depression (PPD), also postnatal depression (born from lat. natus ), and the

·       Postpartum Psychosis (PPP).

Postpartum mood depression

The low postpartum mood, also known as "baby blues," is the mildest form of the disease. This is lighter, short-term disgruntlement in the first few weeks after the birth, which usually subsides within hours to days.

 

In addition to the subdepressive mood, the baby blues is characterized by pronounced mood lability, sadness, frequent crying, general irritability, excessive worries (mostly about the child), exhaustion, anxiety, irritability, appetite disorders, sleeplessness, and restlessness, and difficulty concentrating. As a rule, baby blues are not considered to be disease-related and will go away by themselves.

 

This mild postpartum mood is prevalent. In the DSM-IV, baby blues is specified as a temporary phenomenon that affects 70% of all women who have recently given birth, is not classified as disease-related, and must be distinguished from the postpartum affective episode. The figures vary between 25% and 80% in different studies; this range of variation is primarily related to methodological differences in the various tasks. What is certain is that in the first week after giving birth, dysphoric discomfort occurs four times more often than in a control group of women without giving birth.

 

Many experts describe the baby blues as a healthy reaction to the complex changes caused by childbirth and motherhood. But some behavioral researchers argue that the baby blues do not occur in many so-called " primitive peoples " and that it is a consequence of the interventions of modern industrial society around birth since it makes it impossible to get to know mother and child without being disturbed.

 

The information on which factors favor baby blues is very inconsistent. The risk seems to be higher if there is a history of depressive illness and little social support. The mode of birth does not seem to play a role. The frequency in women who gave birth by cesarean section does not differ from that of women who gave birth spontaneously, and the place of birth does not seem to play a role either. Only women who had to abort a planned out-of-hospital delivery had a significantly increased baby blues rate, which can be explained by the fact that the woman giving birth could not put her excellent ideas into practice leads to disappointment and feelings of failure.

 

The leading cause of the baby blues seems to be the hormonal change after the birth - the significantly increased estrogen during pregnancy - and progesterone levels drop with the birth of the placenta, and prolactin increases.  It is assumed that estrogen influences various brain functions and has a mood-stabilizing, antipsychotic effect; this effect has now disappeared and may lead to a drop in mood. This also explains similar phenomena connected with the menstrual cycle ( premenstrual syndrome ) and menopause.