Postpartum depression: understanding it to take action

Le baby blues est une réaction émotionnelle transitoire survenant dans les jours suivant la naissance. C’est très fréquent et cela touche environ 60 à 80% des jeunes mamans (1). Il se manifeste notamment par des sautes d'humeur, des pleurs, une fatigue intense, etc. Il disparaît généralement en moins de 15 jours sans traitement spécifique. S’il ne disparaît pas, il peut en effet conduire à une dépression post partum. 

En revanche, la dépression post partum (DPP) est un trouble plus profond qui peut apparaître dans les semaines suivant l'accouchement et durer plusieurs mois si elle n'est pas traitée. La DPP affecte environ 15% des mères (2). Toutefois, les symptômes de ce trouble peuvent apparaître même chez la femme enceinte, après une fausse couche, ou encore pendant le sevrage. 

Sans traitement, la DPP peut durer des mois, voire des années. Une étude a montré qu’un tiers des femmes non traitées avaient encore des symptômes jusqu’à 3 ans après la naissance. La plupart des mamans qui se font accompagner vont beaucoup mieux ! 

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. 

Demandez de l’aide si vos symptômes :

• Ne s’améliorent pas après 2 à 4 semaines
• Deviennent plus intenses
• Empêchent de prendre soin de votre bébé ou de vous-même
• Incluent des pensées de mort ou de violence

Quoi qu’il en soit, si vous en ressentez le besoin, n’hésitez surtout pas à demander de l’aide. Plus vous vous ferez accompagner et aider tôt, et plus vous aurez de chance de vous en sortir rapidement et sans traitement médicamenteux lourd. 

Chaque parcours est unique, et les solutions doivent être personnalisées. Parmi les options (10) :

• La thérapie, avec un(e) psychologue ou psychiatre formé(e) aux troubles postnataux.
• Les groupes de parole, pour partager avec d’autres mamans ce qui peut faire une vraie différence.
• Les “auto-soins”, avec du repos, une alimentation équilibrée, du temps pour soi… C’est essentiel ! De nombreuses études montrent un lien entre alimentation post partum et troubles dépressifs (oméga 3, zinc, vitamines B et vitamine D notamment). La prise d’un complément alimentaire post partum peut aider à combler ses besoins et réduire le stress de cette période.
• Les médicaments, qui peuvent parfois être nécessaires, notamment en cas de symptômes sévères

Peut-on prendre des antidépresseurs en allaitant ?

La réponse courte est oui : certains antidépresseurs sont compatibles avec l’allaitement (11). Il est toutefois essentiel d’en parler avec votre professionnel de santé, qui consultera le site du CRAT. 

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.