Postpartum depression: understanding it to take action

The baby blues is a transient emotional reaction occurring in the days following birth. It is very common and affects around 60 to 80% of new mothers (1). It manifests in particular through mood swings, tearfulness, intense fatigue, and so on. It generally resolves within 15 days without specific treatment. If it does not resolve, it can lead to postnatal depression. 

Postnatal depression (PND), on the other hand, is a more profound disorder that can appear in the weeks following birth and last several months if left untreated. PND affects around 15% of mothers (2). However, symptoms of this disorder can also appear in pregnant women, following a miscarriage, or during weaning. 

Without treatment, PND can last for months, or even years. One study showed that a third of untreated women still had symptoms up to 3 years after the birth. Most mothers who receive support make a significant recovery! 

The signs of PPD can be similar to baby blues, but are more intense and longer-lasting. Signs of PPD include persistent sadness, loss of interest in daily activities, sleep disturbances, extreme fatigue, feelings of guilt or worthlessness, and sometimes suicidal thoughts. Every woman is different and may experience one, several, or all of the symptoms. These signs can affect a mother's ability to care for her child and herself (3).

Difficulty bonding with your baby

Some mothers feel a strong bond with their child from birth, while for others, this bond builds gradually. But if you are struggling to form an emotional attachment with your child, this may be a sign of postpartum depression.

Research shows that around 12% of mothers experience a delayed bond in the first two days following birth, a figure that drops to 7% after 15 days. However, among those suffering from severe postpartum depression, 57% report an impaired emotional bond with their child (4).

Social isolation, withdrawal from family or friends

This detachment linked to PPD can also extend to those around you: social isolation or withdrawal from loved ones is another common symptom of postpartum depression.

Sleep disturbances 

Lack of sleep is a common complaint among new parents. Insufficient rest can lead to fatigue, irritability, and difficulty concentrating. These are factors that can worsen or contribute to the onset of PPD (5).

In turn, postpartum depression can disrupt the sleep cycle. If you find it hard to fall asleep, or conversely if you are sleeping excessively, this may be a sign not to overlook (6).

Experiencing intense negative emotions 

In addition to sadness, postpartum depression can be accompanied by negative emotions such as anxiety, anger, low self-esteem, or a loss of interest in things that previously brought you joy. Many women also feel guilty for not experiencing constant maternal happiness.

It is however essential to remember that postpartum depression does not call into question your worth as a mother. It is a condition linked to a combination of factors: hormonal, genetic, psychological, and social.

Other most common symptoms of postpartum depression 

The following points are characteristic of this syndrome:  

• Persistent sadness or intense mood swings
• Extreme fatigue, lack of energy
• Frequent crying, without obvious reason
• Loss of interest in everyday activities
• Guilt, shame, the feeling of being a "bad mother"
• Severe anxiety, panic attacks
• Intrusive thoughts, dark thoughts, suicidal ideation

If you are experiencing these symptoms, do seek specialist advice. If in doubt, do not hesitate to contact your doctor. If you are experiencing even more intense or severe symptoms, seek help immediately. 

There is no single cause for this syndrome. However, several psychological, social and biological factors often play a role (7):

• Hormones. After giving birth, levels of oestrogen and progesterone drop sharply. This disruption can affect emotional balance. Thyroid hormones may also become dysregulated.
• Lack of sleep. Indeed, chronic fatigue makes everything worse, including mental health.
• Nutrition. Certain deficiencies are linked to postnatal depression. For example, it is known that a lack of the omega-3 fatty acid DHA is associated with an increased risk.  
• Pressure. The weight of responsibility that comes with a new baby can be overwhelming.
• Loss of familiar landmarks. Many women feel they have "lost themselves" in their role as a mother and no longer recognise who they are.

Remember: developing postnatal depression is never a personal failing, nor something you could have "avoided".

Any woman can be affected. However, certain factors can further increase the risk of this syndrome:

• History of depression or anxiety (during or before pregnancy).
• Family history of depressive disorders.
• Difficult or traumatic birth. For example, data show a 20% increase in risk in the case of an emergency caesarean section (8). 
• Lack of support from a co-parent or those close to you.
• Relationship difficulties or domestic violence.
• Financial or personal stress.
• Young motherhood (under 20 years of age).
• Premature baby, or one who has been hospitalised or has particular medical needs.
• Breastfeeding difficulties.
• Unplanned pregnancy.

If left untreated, postnatal depression can affect every area of life (9):

• The relationship with the co-parent
• Professional life
• The mother-child bond (particularly in the first few months)
• Overall mental health
• Social isolation

In severe cases, suicidal thoughts or thoughts of harming one's baby may occur. Please seek help without delay. 

Seek help if your symptoms:

• Do not improve after 2 to 4 weeks
• Become more intense
• Prevent you from caring for your baby or yourself
• Include thoughts of death or violence

Whatever the case, if you feel you need help, please do not hesitate to ask for it. The sooner you seek support and assistance, the better your chances of recovering quickly and without heavy medication. 

Every journey is unique, and solutions must be personalised. Among the options (10):

• Therapy, with a psychologist or psychiatrist trained in postnatal disorders.
• Support groups, to share experiences with other mothers — something that can make a real difference.
• "Self-care", with rest, a balanced diet, time for yourself... This is essential! Many studies show a link between postpartum diet and depressive disorders (omega-3, zinc, B vitamins, and vitamin D in particular). Taking a postpartum food supplement can help to meet your nutritional needs and reduce the stress of this period.
• Medication, which may sometimes be necessary, particularly in cases of severe symptoms

Can antidepressants be taken while breastfeeding?

The short answer is yes: certain antidepressants are compatible with breastfeeding (11). However, it is essential to discuss this with your healthcare professional, who will consult the CRAT website. 

Postpartum depression is a serious condition that requires particular attention. It is crucial to recognise the signs of this depressive syndrome. Understanding the risk factors and seeking appropriate support are essential. Talking about your feelings, consulting a professional, and surrounding yourself with trusted people (co-parent, family, friends, etc.) are important steps towards recovery.

You are not alone. With the right tools and caring support, you can feel better.