What is it about ?
The first month after childbirth, women are extremely susceptible to mental disorders. For example, the risk of depression is three times higher than in women who have not given birth. A number of risk factors increase this likelihood: depression before pregnancy, postpartum depression after a previous childbirth, first childbirth, marital problems, single mom, cesarean section, family history of mood disorders and, most importantly, personal history of bipolar disorders (manic-depressive illness).
The underlying cause of postpartum mental disorders is difficult to interpret. It is most likely a combination of physical factors (such as hormonal changes, thyroid dysfunction), psychological factors, and social factors. Genetic factors may also play a role in postpartum psychosis.
What is their frequency?
80% of new mothers have a depressed mood 3 to 5 days after giving birth, which is called the “baby blues”. This is a normal phenomenon. In contrast, 10-20% of new mothers have signs of postpartum depression. If the new mother has already experienced depression before pregnancy, this risk increases up to 25%. If she has experienced postpartum depression after a previous childbirth, the risk of relapse even climbs to 40%. Fortunately, cases of postpartum psychosis are rarer; they occur after 1 to 2 in 1,000 deliveries.
How to recognize them?
Depressed mood after childbirth (“baby blues”)
You cry easily, you are irritable, you have mood swings, headaches, trouble sleeping, and loss of appetite. You don’t necessarily have postpartum depression. The baby blues, however, can be a precursor to postpartum depression. Either way, it increases the risk of depression.
Postpartum depression
Postpartum depression usually appears within the first 3 months after childbirth, although it can occur up to 6 months later. The main symptoms are disturbed sleep, inability to feel a sense of pleasure, difficulty concentrating, feeling unable to cope with the new family situation, excessive preoccupation and fear about the baby. This phenomenon can compromise the development of a normal relationship between mother and child. In addition, children of mothers with postpartum depression are also at greater risk of developing psychiatric problems later in life. Sudden infant death syndrome is also more common among these children. Sometimes a dysfunction of the thyroid can lead to postpartum depression. In this case, the new mother also has symptoms of hyperthyroidism (abnormally high production of hormones by the thyroid gland) or hypothyroidism (insufficient production of hormones by the thyroid gland), such as loss or intake of weight, excessive sweating or dry skin, rapid or slow heart rate.
Postpartum psychosis
It is the most serious of the psychiatric disorders occurring after childbirth. Most often, symptoms appear within 14 days of the new mother returning home. It is often family members who notice strange behavior in mom. The first signs are an inability to stay still, sleeplessness, restlessness and mood swings, which progress to confusion and manic psychosis. The mother is hyperactive, loses the sense of reality and, as a result, exhibits all kinds of unpredictable behaviors. Sometimes his view of the world is extremely negative, which can lead to suicidal tendencies.
How is the diagnosis made?
Usually, family members notice the change in mom’s behavior. The doctor will systematically take a blood test, in particular to check the functioning of the thyroid. He can ask the mother to fill out a questionnaire to screen for postpartum depression. If psychosis is suspected, the doctor always refers the mother to the hospital for psychiatric treatment. An increased risk of recurrence in subsequent pregnancies must be taken into account. The opinion of a psychiatrist is therefore sought during pregnancy.
What can you do ?
It is essential to intervene without delay. If you notice any symptoms, talk to them as soon as possible. Discuss it with your loved ones and with your doctor. Make sure that care is going as well as possible for both mother and child.
What can your doctor do?
A depressed mood goes away on its own. It does not require medication. Support from family, doctor and caregivers (postnatal care) is sufficient.
In the case of postpartum depression, treatment consists of psychotherapy, possibly supplemented by an antidepressant. The choice of antidepressant depends on whether the mother is breastfeeding or not. This is because some drugs pass into breast milk. The advice of a psychiatrist is sometimes necessary.
In postpartum psychosis, hospitalization is necessary because the risk of suicide is increased. The new mother is prescribed both psychotherapy and antipsychotics. Research is currently underway on the beneficial effects of female hormones (estrogen). In some cases, electroshock treatment may also be applied. During a subsequent pregnancy, the psychiatrist will have to determine the relevance of administering antidepressants as a preventive treatment, given the high risk of recurrence.
Want to know more?
- Born parents – Yapaka
- Postpartum Depression – Being Born and Growing
- Take a drug if you want a child, pregnancy or breastfeeding? – FAMHP – Federal Agency for Medicines and Health Products
Are you looking for more specialized help?
- Mental Health Services – The Social Guide
- Approved family planning centers in Wallonia and Brussels – LoveAttitude
- Find a psychologist – Commission des psychologues
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