"ניט נאָר מיד": דערקענען און אָוווערקאַמינג פּאָסטפּאַרטום דעפּרעסיע

How to Know if It’s Happened to You: Symptoms of Postpartum Depression

I suspected postpartum depression about a week after giving birth. Later, I realized that I had about 80% of the symptoms that fit perfectly into the classic clinical picture of the disorder. Typical symptoms of postpartum depression are depressed mood, an obsessive feeling that you are a bad parent, sleep and appetite disturbances, and decreased attention. Many women with this diagnosis come up with contrasting thoughts about harming their child (contrast refers to obsessive thoughts that are sharply different from what a person consciously desires. — Approx. scientific ed.).

If depression is not aggravated by psychosis, a woman does not succumb to them, but mothers with a severe form of the disorder, accompanied by suicidal thoughts, may even kill their child. And not because of anger, but because of the desire to make life easier for him with a bad parent. “I was like a vegetable, I could lie on the bed all day,” says 20-year-old Margarita. — The worst thing was to understand that nothing can be rewound. A child is forever, and I thought that my life no longer belongs to me. Pregnancy came as a surprise to Margarita, the situation was complicated by a difficult relationship with her husband and a difficult financial situation.

“The pregnancy was easy, without toxicosis, threats of miscarriage, swelling and excess weight. <...> And when the child was two months old, I began to write to my friends that my life had become hell. I cried all the time,” says 24-year-old Marina. — Then I began to have attacks of aggression: I broke down on my mother. I wanted to be saved from my motherhood and shared with me hardships and difficulties. When the child was five months old, everything was hard for me: walking, going somewhere, going to the pool. Marina always dreamed of a child; the depression that happened to her was unexpected for her.

“My life, which I built brick by brick exactly the way I liked it, suddenly collapsed,” these are the words of 31-year-old Sofia. “Everything went wrong, nothing worked out for me. And I did not see any prospects. I just wanted to sleep and cry.»

Sophia was supported by relatives and friends, her husband helped with the child, but she still could not cope with depression without medical help. Often, postpartum mental health disorders go undiagnosed because their most common symptoms (such as fatigue and insomnia) seem to be part of motherhood or are associated with a gender stereotype of motherhood.

“What did you expect? Of course, mothers do not sleep at night!”, “Did you think it was a vacation?”, “Of course, children are difficult, I decided to become a mother — be patient!” All this can be heard from relatives, doctors, and sometimes from paid professionals like breastfeeding consultants.

Below I have listed the typical symptoms of postpartum depression. The list is based on ICD 10 data on depression, but I supplemented it with a description of my own feelings.

• Feelings of sadness/emptiness/shock. And it is not limited to the feeling that motherhood is difficult. Most often, these thoughts are accompanied by the belief that you can not cope with the new state of affairs.
• Tearfulness for no apparent reason.
• Fatigue and lack of energy that is not replenished even if you managed to sleep for a long time.
• The inability to enjoy what used to be a joy — a massage, a hot bath, a good movie, a quiet conversation by candlelight, or a long-awaited meeting with a friend (the list is endless).
• Difficulty concentrating, remembering, making decisions. Can’t concentrate, words don’t come to mind when you want to say something. You do not remember what you planned to do, there is a constant fog in your head.
• Guilt. You think you should be better at motherhood than you are. You think your child deserves more. You wonder if he understands the severity of your condition and feels that you do not experience the joy of being with him.

• Restlessness or excessive anxiety. It becomes a background experience, from which neither sedative drugs nor relaxing procedures completely relieve. Someone during this period is afraid of specific things: the death of loved ones, funerals, terrible accidents; others experience unreasonable horror.
• Gloominess, irritability, feelings of anger or rage. A child, a husband, relatives, friends, anyone can enrage. An unwashed pan can cause an angry tantrum.
• Reluctance to see family and friends. Unsociableness may not please you and your relatives, but nothing can be done about it.
• Difficulties with forming an emotional connection with the child. It seems to you that you are very far from the baby. Perhaps you think that he needs another mother. It is hard for you to tune in to the child, communication with him does not bring you any pleasure, but, on the contrary, worsens the condition and exacerbates the feeling of guilt. Sometimes you may think that you don’t love your child.
• Doubts about their ability to care for a child. You think that you are doing everything wrong, that he is crying because you are not touching him properly and cannot understand his needs.
• Constant drowsiness or, conversely, inability to sleep, even when the child is sleeping. Other sleep disturbances may occur: for example, you wake up at night and cannot fall asleep again, even if you are very tired. Be that as it may, your sleep is absolutely terrible — and it seems that this is not only because you have a child who screams at night.
• Appetite disturbance: you either experience constant hunger, or you cannot cram even a small amount of food into yourself.

• Complete lack of interest in sex.
• Headache and muscle pain.
• Feeling of hopelessness. It seems that this state will never pass. A terrible fear that these difficult experiences are with you forever.
• Thoughts of hurting yourself and/or the baby. Your condition becomes so unbearable that consciousness begins to look for a way out, sometimes the most radical one. Often the attitude to such thoughts is critical, but their very appearance is very hard to bear.
• Thoughts that it is better to die than to continue to experience all these feelings.

Remember: if you have suicidal thoughts, you urgently need help. Each parent may experience one or two symptoms from the list above, but these are usually followed by moments of well-being and optimism. Those who suffer from postpartum depression often find most of the symptoms, and sometimes all at once, and they do not go away for weeks.

If you notice four or more manifestations from the list in yourself and realize that you have been living with them for more than two weeks, this is an occasion to seek help from a doctor. Remember that the diagnosis of postpartum depression can only be made by a specialist, and by no means this book.

How to rate yourself: The Edinburgh Postpartum Depression Rating Scale

To screen for postpartum depression, Scottish psychologists J. L. Cox, J. M. Holden and R. Sagowski developed the so-called Edinburgh Postpartum Depression Scale in 1987.

This is a ten-item self-questionnaire. To test yourself, underline the answer that most closely matches how you have felt over the past seven days (important: NOT how you feel today).

1. I was able to laugh and see the funny side of life:

• As often as usual (0 points)
• Slightly less than usual (1 point)
• Definitely less than usual (2 points)
• Not at all (3 points)

2. I looked to the future with pleasure:

• To the same extent as usual (0 points)
• Less than usual (1 point)
• Definitely less than usual (2 points)
• Almost never (3 points)

3. I unreasonably blamed myself when things went wrong:

• Yes, in most cases (3 points)
• Yes, sometimes (2 points)
• Not very often (1 point)
• Almost never (0 points)

4. I was anxious and worried for no apparent reason:

• Almost never (0 points)
• Very rare (1 point)
• Yes, sometimes (2 points)
• Yes, very often (3 points)

5. I felt fear and panic for no apparent reason:

• Yes, quite often (3 points)
• Yes, sometimes (2 points)
• No, not often (1 point)
• Almost never (0 points)

6. I didn’t cope with many things:

• Yes, in most cases I did not cope at all (3 points)
• Yes, sometimes I didn’t do as well as I usually do (2 points)
• No, most of the time I did pretty well (1 point)
• No, I did as well as ever (0 points)

7. I was so unhappy that I couldn’t sleep well:

• Yes, in most cases (3 points)
• Yes, sometimes (2 points)
• Not very often (1 point)
• Not at all (0 points)

8. I felt sad and unhappy:

• Yes, most of the time (3 points)
• Yes, quite often (2 points)
• Not very often (1 point)
• Not at all (0 points)

9. I was so unhappy that I cried:

• Yes, most of the time (3 points)
• Yes, quite often (2 points)
• Only sometimes (1 point)
• No, never (0 points)

10. The thought came to my mind to hurt myself:

• Yes, quite often (3 points)
• Sometimes (2 points)
• Almost never (1 point)
• Never (0 points)

רעזולטאַט

0-8 points: low probability of depression.

8-12 points: most likely, you are dealing with baby blues.

13-14 points: potential for postpartum depression, preventive measures should be taken.

15 points or more: high probability of clinical depression.