Postpartum depression: What if you are feeling depressed after giving birth

The birth of a baby can start a variety of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression. Postpartum depression is a global issue, affecting tens if not hundreds of millions of women+  annually across all countries. While exact postpartum depression rates are unknown, there are some generally agreed-upon figures about the number of women who experience postpartum depression annually. Approximately 1 in 10 women will experience postpartum depression after giving birth, with some studies reporting 1 in 7 women. 

What is Postpartum Depression

Postpartum depression is also called pregnancy depression or rather, postpartum depression. It's quite common. People often feel anxious after giving birth, a feeling of ‘emptiness’, and often have to deal with a lot of feelings of guilt. After all, in most cases, you've brought a healthy baby into the world, so you should be happy. Feelings of confusion and loneliness arise when it doesn't feel that way at all. It's good to know that postpartum depression can also start during pregnancy and also occurs after a miscarriage or abortion.

Postpartum depression is different from postpartum anxiety disorder. With an anxiety disorder, you don't have to experience depressive feelings. People with depression, on the other hand, often suffer from anxiety. It is important to get the diagnosis right because the treatment is often different. 

Symptoms of postpartum depression

The symptoms of postpartum depression are the same as with 'normal' depression, but can also cause negative feelings towards your baby:

• Gloom, feeling down                                    

• Being lethargic

• Anxious after childbirth

• Feeling worthless                     

• Eat a lot or very little             

• Poor sleep                                     

• Restless or inhibited behavior        

• Being tired

• Difficulty concentrating

• Not being able to make decisions

• Thoughts of Death

• Having trouble bonding with your child

• Finding it difficult to be left alone with your child

• 'Not liking' your child

How long does postpartum depression last?

People can become depressed during (the latest phase of) pregnancy,  just after giving birth, but also weeks or months after. Sometimes stopping breastfeeding is a trigger or going back to work. Usually, this depression goes away after a few months (usually between three to six months), but this can also take longer. There have been cases where this takes years.

What is the difference between 'baby blues' and postpartum depression?

Due to the huge drop in hormones after childbirth, about 80% of people who have given birth experience feelings of anxiety, irritation, anger, or worry two or three days after giving birth.

These feelings are quite normal. You're sleep-deprived, your hormones are all over the place, and the list of responsibilities is only increasing. It's not surprising that you can be really upset by this. These feelings are also known as the 'baby blues'. Within a few days to two weeks, these feelings will disappear on their own.

Postpartum depression is different. This can take months or longer and the feelings of anxiety, sadness, anger, and sadness are more intense with postpartum depression than with the 'baby blues' where you feel depressed for a few days or a few weeks after giving birth. Feelings of feeling worthless, sadness, anger, and gloom take over in a postnatal depression that makes it impossible to shower, eat, and take care of yourself, for example. People often isolate themselves and withdraw more and more.

Who is more at risk for postpartum depression?

People who are chronically ill or have psychological challenges (such as ADHD, prenatal anxiety, and previous depression), use alcohol or drugs, or have a mild intellectual disability are more likely to suffer from postnatal depression. A hereditary factor can also play a role: Children whose mothers have ever had postpartum depression are three times more likely to get one themselves. Research also shows that women between the ages of 18 and 24 are more likely to suffer from depression. And then there are so-called perinatal factors: think of an unwanted or unplanned pregnancy, stress, anxiety or complications during pregnancy and childbirth, or premature birth or illness of the baby. Finally, social factors such as education, work, and major life events also play a role.

Of course, it is not the case that if you have one of the risk factors, you automatically get depressive feelings after giving birth. Just as well, if you don't have risk factors, you can't get postpartum depression. Anyone can become depressed after giving birth, but there are things you can do yourself to reduce the risk of depression.

How to prevent postpartum depression

Prevention is certainly not always possible, but there are tips that can help. It is important to live a healthy life and get enough exercise (outside!).  It is also good to meet nice people and continue to do fun things when the baby is just born because otherwise, your world will become very small. It helps if you have people around you who support you and if you are not too harsh on yourselves. And talk about your feelings. This can be with your partner, friend, or professional. There's nothing to be ashamed of!

when to the GP

If your depressive feelings are affecting your daily life and, for example, you have trouble getting out of bed and taking good care of yourself and this takes longer than a few weeks, it is wise to get help. Even if these depressive feelings only get worse with time and you feel like you're slipping away!

Treatment and tips for postpartum depression

Many people who are depressed after childbirth or anxious after childbirth feel lonely and ashamed. Because they don't talk about it, a diagnosis often takes longer. It is estimated that nearly 50% of mothers with postpartum depression are not diagnosed by a health professional. While professional help is important. Depression can cause suicidal thoughts or feelings of harming the child. Depression affects the mother-child relationship and the way of bonding between mother and child.

In addition to sufficient rest, exercise, and good nutrition, antidepressants are often prescribed, sometimes in combination with a sleeping pill. The disadvantage is that breastfeeding is no longer allowed. The drugs are usually combined with therapy. Sometimes hormone patches are prescribed (estrogen patches). Supplements such as tryptophan, iron, fish oil, magnesium, vitamins B6 and B12 can have a supportive effect. In severe cases, psychiatric treatment or admission is necessary.

Zuranolone: The Postpartum Depression Pill

Since August 2023, a 'postpartum depression pill' named Zuranolone has been available in the USA. Zuranolone is said to be very effective for people with postpartum depression. Zuranolone, a pill, would be taken once a day for two weeks.  Unfortunately, at that time it will only be allowed in the United States.

Postpartum psychosis

One in 1000 women will experience a so-called postpartum psychosis. You will then get the symptoms associated with postnatal depression, but there are also other symptoms such as delusions, loss of contact with reality, fluctuating consciousness, confusion, and/or thoughts of suicide or wanting to do something to the baby. Then contact the GP's emergency line for immediate help.

Do you need (urgent) help? Please contact your GP or the national emergency line if you need immediate urgent assistance.