About 1 in 10 mothers develop postnatal depression, so you are not alone! Support and understanding from family, friends and sometimes from a professional such as a health visitor can help you to recover and there are many treatments available.
What is postnatal depression?
Having a baby is a very emotional experience. You may feel tearful and your mood may feel low. There are three causes of low mood after childbirth:
- Baby blues. It is very common and almost considered normal to have these. Symptoms include being weepy, irritability, anxiety and feeling low. Baby blues usually start around the 3rd day but usually go by the 10th day after childbirth. They do not usually need any medical treatment.
- Postnatal depression (PND). This occurs in about 1 in 10 mothers. It usually develops within the first four weeks after childbirth. However, it can start several months following childbirth. Symptoms, including low mood, last for much longer than with baby blues. There are many treatments available for PND.
- Postnatal (puerperal) psychosis. This is an uncommon but severe form of mental illness. It may involve a low mood but there are a number of other features.
The baby’s father may also develop depression in the weeks after a baby is born.
Postnatal depression symptoms
The symptoms are mostly similar to what you would experience with depression. Symptoms are usually there on most days, for most of the time, for two weeks or more. They can include the following:
- Low mood. Tends to be worse first thing in the morning, but not always.
- Not really enjoying anything. Lack of interest in yourself and your baby.
- Lack of motivation to do anything.
- Often feeling tearful.
- Feeling irritable a lot of the time.
- Feelings of guilt, rejection, or not being good enough.
- Poor concentration (like forgetting or losing things) or being unable to make a decision about things.
- Feeling unable to cope with anything.
You may also have thoughts about harming your baby. It is not uncommon for women with PND to have these thoughts. If things are very bad you may have ideas of harming or killing yourself. This only happens in very rare cases. If you have such thoughts, you must ask for help.
In addition, you might also have less energy, disturbed sleep, poor appetite and a reduced sex drive. However, these are actually very common and considered normal for a while after childbirth and so on their own do not necessarily mean that you have postnatal depression.
Why should you do anything about postnatal depression?
If you do nothing about the PND (or do not even know that you’re depressed), it is likely that you will get better in 3-6 months anyway. However, there are many reasons to ask for help:
- To help yourself recover quickly. You don’t need to feel like this and it’s definitely not a sign of weakness to admit that you’re depressed.
- To help your partner or family. If you are depressed, it can cause problems in your relationships, your job and life in general.
- To help your child (or children). If you are depressed, your relationship with your baby might not be as good as it could be. You may not give as much attention to your baby as you would like to. As a result, your baby’s development may not be as quick as it should be. There is evidence to suggest that developmental problems that occur in the baby because of a mother’s depression may persist into adolescence.
Many women are able to hide their PND. They care for their baby perfectly well and appear fine to those around them. However, they suffer the condition as an internal misery. Please do not be afraid to seek help if you are feeling like this.
Treatment for postnatal depression
Support and advice
- Having understanding from your loved ones is an important part of recovery. It is often best to talk to close friends and family to explain how you feel rather than bottling up all of your feelings. It might also be beneficial to get some help from family and friends in caring for your baby. This can give you some much needed time off to rest and and maybe play some of your favourite games! Support and help from a health visitor can also help as you can tell them if you feel depressed and they might be able to lend an ear and talk things through with you.
- Antidepressant medication is a common treatment prescribed for PND, especially if the depression is moderate or severe. Symptoms such as low mood, poor sleep, poor concentration, irritability, etc, are often eased with an antidepressant. This may then allow you to function more normally, and increase your ability to cope better with your new baby.
- There are several types of antidepressants, including tricyclic antidepressants (for example, imipramine, lofepramine) and selective serotonin reuptake inhibitors (SSRIs) – for example, fluoxetine, citalopram. They all have pros and cons. For example, they differ in their possible side-effects. If the first one that you try does not suit then another may be found that is fine.
- Cognitive behavioural therapy (CBT). This is a combination of cognitive therapy and behavioural therapy. Briefly, cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as depression. The therapist helps you to understand your thought patterns. In particular, to identify any harmful, unhelpful and false ideas or thoughts which you have that can make you depressed. The aim is then to change your ways of thinking to avoid these ideas.
- Guided self-help. This is based on the same ideas as CBT. You would be given some reading or video or computer-based information. You would then go through this, reading, watching or listening to it at your own pace. You would be able to talk to a therapist regularly, either face-to-face, or on the phone, who would help you work through it.
- Interpersonal therapy. This type of psychological therapy can help you to identify any problems in your relationships with family, friends, partners and other people, and see how these may relate to your depression and other problems.
Another thing to bear in mind is that psychological treatments are sometimes not practical for women with PND, due to the time commitments required. There may also be a waiting list. However, women with PND should start treatment within a month of referral at most. This is the guidance from the National Institute for Health and Care Excellence (NICE).
Some research suggests that a combination of an antidepressant plus a psychological treatment such as CBT may be better than either treatment alone.
Some dos and don’ts about depression
- Don’t bottle things up or go it alone. Try to tell people who are close to you how you feel. It is not weak to cry or admit that you are struggling.
- Don’t despair. Most people with depression recover. It is important to remember this.
- Do try to distract yourself by doing other things. Try doing things that do not need much concentration but can be distracting such as watching TV. Radio or TV is useful late at night if sleeping is a problem.
- Do eat regularly, even if you do not feel like eating.
- Don’t drink too much alcohol. Drinking alcohol is tempting to some people with depression, as the immediate effect may seem to relieve the symptoms. However, drinking heavily is likely to make your situation worse in the long run.
- Don’t make any major decisions whilst you are depressed. If possible, delay any major decisions about relationships, jobs, or money until you are well again.
- Do tell your doctor if you feel that you are getting worse, particularly if suicidal thoughts are troubling you.