Baby blues

After the relative calm of pregnancy, giving birth is a physically and emotionally draining experience. But the changes don't stop there. A woman's estrogen levels drop significantly, and she now has to care for a crying baby 24 hours a day. Given these circumstances it's no wonder that up to 75 percent of new mothers around the world feel down for a few days after giving birth.

But new research has found there's an additional neurological cause to the baby blues as well.

Feelings of impotence

Anne-Christin B., who prefered not to use her last name due to the stigma of postpartum depression, is a 33-year-old mother from Berlin. For the first day or two after her daughter was born four months ago, she felt happy, but that quickly changed.

"Then came the feeling that I couldn't do things. I was afraid. I couldn't do things for the child - for whatever reason," she remembered. "And then I started to withdraw, I couldn't go out or talk with friends on the telephone and this increased very quickly to the point where I couldn't be by myself anymore."

Anne-Christin isn't the only one. Millions of German women also experience the baby blues. In her case, she was one of 15 percent of women who develop postpartum depression. She went to her local doctor, but he didn't take her seriously, so she sought professional psychiatric help.

The source of the problem

Dr. Julia Sacher, from the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, said it's well-documented that a sharp drop in estrogen levels and a big change in environment contribute to the baby blues. That's why research in this area is incredibly important.

"What we do know is that those women who have severe symptoms of postpartum blues have a higher risk of experiencing a full-blown episode later on," Sacher said.

Sacher and her colleagues published the results of their study in the peer-reviewed journal, Archives of General Psychiatry, earlier this summer. They found that there is a neurological cause for the baby blues.

"We see an increase in monoamine oxidase A and this can lead to a loss of serotonin, and a loss of serotonin has been associated with low mood," Sacher explained.

Feeling sad after childbirth is socially unacceptable

Other medical professionals, like Dr. Stephanie Krueger, said that this new study may prompt obstetricians to keep an eye on a mother's moods both before and after childbirth.

Krueger is a professor of psychiatry at the Charite in Berlin, one of the largest university hospitals in Europe. She treated Anne-Christin for post-partum depression. Krueger - who wasn't part of the study - said most women who feel depressed after their child is born don't seek necessary help, because it's not socially acceptable to feel sad at this time.

"In our culture, women who have just given birth are supposed to be happy, and if they are not, then there's something wrong with them and they are actually treated as some kind of an outlaw," Krueger said, adding, "in many cases they are being told: why aren't you happy?"

Krueger believes there needs to be more education and support for new mothers.

"Families and GPs [general practitioner] should not take these things lightly and not say, 'Well yeah I understand you've just given birth - everything will be fine'," Krueger said.

"Physicians and families should take any symptoms of depression seriously and go to someone who knows what they are doing, meaning a psychiatrist, for example."

Berlin mother Anne-Christin B. said she wished her doctors and other medical professionals had talked to her about the baby blues during the pregnancy.

"It would have been better if, even in a midwifery course, there was perhaps 30 minutes or an hour discussion in preparation for pregnancy, where it was explained, where you explain the symptoms and also tell people where they can call for help," Anne-Christin said.

Dietary supplements could help

While the baby blues usually goes away by itself after a couple of days, Dr. Sacher from the Max Planck Institute said treating this temporary condition could be an important step in preventing postpartum depression. She thinks the baby blues could be treated with medication or dietary supplements, which could counter the increase in the enzyme monoamine oxidase A.

But not everyone agrees the baby blues can be prevented so easily. Lisa Fehrenbach has been a midwife for 35 years. She said feeling a bit down after childbirth is a natural thing because childbirth is a physically and emotionally life-changing experience. Many women go from working full-time to being at home with a crying baby - often by themselves.

"You had a completely independent life and you organized everything and you had everything under control and suddenly there's a little baby," said Fehrenbach, "It clings to your body 24 hours and you have to care for it 24 hours and you cannot do what you want, but you have to do what the baby wants."

Fehrenbach said even if women took dietary supplements to counter the enzyme increase, they still have to adjust to this new baby in their lives.

Beyond making pregnant women aware of the physiological and psychological changes in their bodies, both Sacher and Krueger agree this problem needs to be discussed openly in order to fight the stigma of postpartum blues and depression.

"Postpartum disorders are nothing the woman is responsible for. They can't help it," Krueger said. "It has biological reasons for the most part and it can be treated effectively and it should be treated effectively."

Sacher's next step will be to test for the elevated enzyme in postpartum depression.

Author: Cinnamon Nippard
Editor: Stuart Tiffen