A postpartum depression (medically referred to as peripartum or postpartum depression) is a depressive disorder that begins in the first few weeks or months following childbirth. "Postpartum" translates to "after birth" and refers to the immediate period after delivery—often called the postpartum period (typically around 6 to 8 weeks)—during which the mother's body recovers. Historically, the term postpartum is used primarily to describe the mother's state, whereas postnatal typically refers to the child after birth.

According to data, approximately 8% of mothers in Europe are affected by postpartum depression. Typical symptoms include persistent low mood, a loss of interest and joy, feelings of guilt, constant rumination, and severe exhaustion. Disrupted sleep and appetite, alongside immense difficulties managing daily routines, are also highly characteristic.

Crucial Note: Postpartum depression is never a reflection of personal character or a sign of personal failure. It is a recognized medical condition that can and should be treated. No mother should have to go through this alone.

Observe yourself, your wife, or your partner with kindness—not judgment. Look out for the following signs. If they persist over a longer period, exhaust you, or cause you anxiety, please reach out to your midwife, your gynecologist, or another trusted person.

• Mood: Sadness, hopelessness, frequent crying spells, inner restlessness, and irritability.
• Cognition & Thoughts: Constant rumination, intense feelings of guilt or failure, as well as difficulty concentrating.
• Body & Sleep: Persistent and severe exhaustion due to trouble falling or staying asleep—even when the baby is sleeping. Additionally, a loss of appetite or increased appetite may occur.
• Bonding Difficulties: Difficulty feeling close to the baby, alongside quickly feeling overwhelmed by tasks related to the baby. Important: This is not a reflection of your love for your child.

If you notice that you want to harm yourself or your baby, or if these thoughts simply will not leave your head, this is a medical emergency. Do not hesitate for a second—immediately dial 112 (or your local emergency number) or go directly to the nearest emergency room.

Occasionally, mothers may hear voices, feel highly confused, or experience a sense that the world around them is no longer real—this is known as a loss of reality. This is a sign of a condition called postpartum psychosis. Although it is very rare, it is also a true emergency that requires immediate medical help and hospital treatment to protect both mother and child.

The EPDS (Edinburgh Postnatal Depression Scale) is a short, 10-question questionnaire. It helps you and healthcare professionals assess your emotional well-being over the past week and gauge how heavily you are affected by depression.

What the EPDS can and cannot do:

• Guidance, Not a Diagnosis: It is not a diagnostic test and can never replace a consultation with a doctor, gynecologist, or psychotherapist. Rather, it serves as an initial guide.
• When You Should Act: A score of 13 or higher on the scale indicates an increased probability of postpartum depression. If you reach this score, you should promptly discuss it with your midwife, doctor, or a mental health professional.

Without professional support, postpartum depression can last for many months. This extended duration can significantly complicate relationships with loved ones, breastfeeding, and recovery from childbirth. However, the good news is that if you begin treatment, your mood typically starts to brighten within just a few weeks. Furthermore, a thorough and consistent therapy program can lower the risk of relapse. Remember: seeking help early is the single most important factor in keeping the period of distress as short as possible.

The following factors increase the risk of developing postpartum depression:

• Mental Health History: A history of previous depression and anxiety disorders, or a family history of depression.
• Severe Stressors: High levels of stress due to lack of sleep, being alone frequently, relationship conflicts, or financial worries.
• Physical Factors: A complicated delivery, severe pain, or difficulties with breastfeeding.
• Social Factors: Limited support from a partner, family, or friends, as well as experiences of violence or discrimination.

If you feel that you urgently need help, there are many resources available to support you. Your first step should be to speak with your midwife or your gynecologist, though primary care physicians are also excellent points of contact. Be sure to request a prompt appointment so that the type of support you need can be determined quickly.

To relieve pressure immediately, it is highly recommended to involve your family and friends and ask them to take over everyday chores. It is essential that you organize your sleep and try to get as much rest as possible. Accepting help right now is the most important step toward recharging your energy.

• Emergency: If you feel that you or your child are in danger, immediately dial 112 (in Europe) or your local emergency number (such as 911 in the US).
• 24/7 Support: The TelefonSeelsorge (in Germany) offers confidential help at any time at 0800 111 0 111, 0800 111 0 222, or via the EU-wide number 116 123. In the US, you can call or text 988 to reach the Suicide & Crisis Lifeline.
• Further Assistance: You can locate regional crisis services and specialized counseling centers near you through the Stiftung Deutsche Depressionshilfe (German Depression Aid Foundation).

Talk therapy is the gold standard for treating postpartum depression:

• Cognitive Behavioral Therapy (CBT): Helps identify distressing thoughts and behavioral patterns, guiding you to change them step-by-step.
• Interpersonal Therapy (IPT): Strengthens relationships and improves communication.
• Involving Loved Ones: Including your partner or family provides relief and stabilizes your daily routine.

Keep in mind that sleep acts like medicine for your recovery. Try to organize sleeping in shifts so that you have support during the night and can take naps during the day. Incorporate light physical activity into your routine, ideally by getting fresh air every day during a short walk. To keep your system stable, it is important to eat small, regular meals and stay well-hydrated. Additionally, stay in touch with people who make you feel good and try to talk to someone daily. It can also be very helpful to organize your thoughts by writing down whatever is weighing on your mind. You can then take these notes straight to your doctor's appointment.

deprexis is an approved Digital Health Application (DiGA) designed to support individuals dealing with depression. It provides valuable insights, daily inspiration, and practical exercises based on the principles of Cognitive Behavioral Therapy (CBT). Talk to your doctor or gynecologist about getting a prescription. The costs are typically fully covered by statutory health insurance.

It is important to recognize that not only mothers, but also fathers can experience depression after the birth of a child—this is referred to as paternal postpartum depression. In fathers, depression often does not manifest as typical sadness and crying, but rather presents differently:

• Increased Irritability and Anger: Instead of feeling sad, affected fathers often react with impatience, irritation, or anger toward their surroundings.
• Withdrawal or Escaping into Work: They may distance themselves from their family and social networks, or throw themselves excessively into work to avoid coping with their emotions.
• Physical and Mental Difficulties: They frequently suffer from sleep issues and difficulty concentrating.

Fathers face specific pressures that can increase their risk of developing depression:

• Relationship Conflicts: Arguments, strain, or tension in the partnership.
• Stress: Lack of sleep and financial worries.
• The Partner's Mental Health: If the mother herself is suffering from postpartum depression, the risk for the father increases significantly.

Just like mothers, affected fathers should seek professional help early on.