Postnatal depression

Woman holding baby in rocking chairIt's common to feel emotional in the weeks and months after having a baby - it's a massive responsibility and upheaval to your pre-baby life. Throw in sleep deprivation and it's no wonder many women feel tearful, irritable and a bit up and down. But there is a difference between these fairly universal reactions to a new baby and postnatal depression (PND).

So, although women who don't have postnatal depression may experience some of the same feelings (most of us worry about our baby's health and how well we're looking after them), a woman with PND will find that her emotions and anxieties are amplified and last longer.

The associated symptoms and feelings associated with PND vary from woman to woman, making it harder to identify. Post natal depression is more common than many people realise and it's important it's diagnosed as soon as possible so that women (and their families) don't suffer in silence but get the treatment they need.

Symptoms | Possible risk factors | Support and treatment 


Symptoms of postnatal depression

Sadness • Tearfulness • Despondency • Inability to enjoy or look forward to anything • Exhaustion • Sleep disturbance • Appetite disturbance • Feelings of isolation and detachment • Anxiety • Panic attacks • Racing mind • Feelings of worthlessness • Feelings of failure • Utter despair • Tension • Irritability • Inability to make decisions • Feelings of guilt • Foggy brain • Irrational fears  • Obsessive thoughts • Loss of self-confidence  • Loss of libido • Paranoia • Mood swings • Feelings of changed personality • Self-harm • Suicidal thoughts 

Possible risk factors for postnatal depression

There are many possible risk factors for PND and it's usually a combination of factors that contributes to a new mother experiencing the illness. However, there will be women who have many possible risk factors who don't become depressed and women who have very few but do. 

Postnatal depression is thought to affect approximately 20% of mothers in the UK, and around 10% of fathers experience paternal depression.
  • Previous depression
  • Loss of mother relationship before the age of 11, not necessarily through death, but loss of the emotional relationship
  • Mother or sister who has experienced PND
  • Fertility treatment
  • High expectations of parenthood
  • Abuse in childhood/young adulthood
  • Domestic violence
  • Social/economic problems
  • Relationship problems
  • Hormonal changes
  • Role change in relationship/career
  • Traumatic birth
  • Multiple births
  • Previous miscarriage, stillbirth termination
  • Bereavement
  • Issues from the past that haven't been resolved
     

Support and treatment for postnatal depression

It is important to remember that just as symptoms vary from person to person, so does the support and treatment for PND. It's also important that if you have PND you have an informed choice as to what support and treatment is available to you.

  • GP - can give you medication, and/or a referral to a health visitor, community mental health team, counsellor or support group.
  • Health visitor - can offer to visit you on a regular basis, and make a referral to a support group if there's one available.
  • Midwife - it's very useful if your midwife is aware if you have had PND previously.
  • Antidepressants - these can play a very useful role in the recovery; they will be carefully monitored by your GP and should be taken for a minimum of six months before they are gradually reduced.
  • Community mental health team - you may need to see a psychiatrist or a community psychiatric nurse. This is very usual, so don't be frightened or alarmed by a referral to the CMHT.
  • Counselling - it can be very helpful to talk to a counsellor because someone who doesn't know you can be impartial and objective about how you're feeling. It may be helpful to talk to someone who has experience of PND. Your GP or health visitor may be able to refer you, see www.postnataldepression.com for further information.
  • Rest - sleep deprivation will make your depression feel worse, so if possible try to rest when you can, and accept offers of help so that you can have time to yourself if you feel like it.
  • Exercise - you may not feel up to any exercise when you have PND, but a short walk each day, if you can manage it, will aid your recovery. As you begin to feel better, you may well feel like taking more exercise.
  • Supportive relationship - it can be very helpful for you to be able to talk through your feelings with someone you trust and will not judge you. This may be your partner, a friend, family member or a counsellor.
If you want to chat to other women, our Antenatal and Postnatal depression Talk forum is available 24/7. Get support, empathy and help from other people who know what you're going through.
  • PND support groups – ask your GP and health visitor if they know of a specific PND support group in your area. This will be helpful in introducing you to other mothers who will be feeling similar to yourself, which can help to reduce your sense of isolation. Support groups also help with normalising your feelings and give you a focus from week to week.
  • Regular eating - if possible, eat little and often to keep your blood sugar levels stable. When blood sugar levels drop, our mood and anxiety levels can be affected. There are certain foods which may help your mood and anxiety. Please see www.postnataldepression.com for further information.
  • Complementary therapies - some mothers find cranial osteopathy, reflexology, massage and homeopathy helpful as an alternative, but more often as a complementary therapy.
  • Practical help - try not to feel a failure by accepting practical help. Your health visitor may be able to put you in touch with a Home Start scheme in your area. This charity provides volunteers who visit regularly to give you support and practical help. See www.home-start.org.uk for further details.

If you're worried about harming your baby, then try not to: women with PND almost never actually do. Hold fast to the fact that postnatal depression does go, although when you're in the depths of it things can be very frightening and it can be difficult to believe that you will recover.

Recovery is gradual and takes time, but many women who have come out the other side of PND feel stronger, say they have more compassion for others and the confidence that having survived PND they can survive lots of things.

What Mumsnetters say about postnatal depression

  • People's ignorance of PND can be summed up when they say, 'But he's such a good baby!' Yes, I know, but I still want to hang myself. colditz
  • All of my PND symptoms were physical - so much so that I terrified myself into thinking I had some awful illness and it took months for the doctor to persuade me it was depression. tubismybub
  • Identifying what was wrong with me felt almost like a benediction. adrift
  • There's a school of thought that mild depression is a perfectly rational response to being a new parent if you are inadequately supported/prepared for being one. I had never even held a baby before having my own, so it was all a huge shock to me and I really think it contributed to my depression. Wickedwaterwitch
  • Take baby steps. Be kind to yourself, lower your standards a little. Don't worry about tomorrow, just getting through the next hour and the hour after that. You will get better. Filthymindedvixen
  • Friends, HELP, SUPPORT (even if you think you don't need it!), exercise, good food, no alcohol, plenty of water, vitamins - this is what I do and it usually gets me through. Enid
  • The healing process was this: I began to get a few good days in between the bad days. Then I had more good days than bad days. Then I would maybe get a bad day a week. Eventually, but I didn't realise until I was off antidepressants completely, I realised that I hadn't had a bad day for a month or so..and then by the time my son was two I had not had a bad day for three months. ghosty
  • A mixture of antidepressants if you need them, therapy and just knowing you won't be dropped like a hot potato whenever you are discharged from hospital really can help. Toothache 

The information on this page is provided by Liz Wise, specialist postnatal depression counsellor. Read our webchat with Liz for more information about PND. 

Last updated: 23-Sep-2013 at 4:54 PM