What is postnatal depression?

Depressed mother

PND is a type of depression that affects as many as one in 10 women during the perinatal period (the first year following birth). Having a baby is undeniably life-changing, but postnatal depression can make some mothers feel overwhelmingly anxious and low. If you think you might be a sufferer, it's important to get the advice and treatment you need to begin to recover

What is postnatal depsression? | Postnatal depression symptoms | Possible risk factors | Treatment for PND

What is postnatal depression?

Postnatal depression, or PND, is an illness that affects many women after having a baby, usually within the first year of birth. It is a form of depression that varies in severity and can come on gradually, or appear all of a sudden. While there is no real consensus on what actually causes it, there are several factors that are thought to increase the risk of PND in new mothers. The main ones are stress; the strain of the huge life change new parents experience; having had antenatal depression, and a traumatic birth experience. Some research suggests that the rapid change in reproductive hormones in the perinatal period is the culprit, but these studies are far from conclusive.

Postnatal depression symptoms

There are many signs of postnatal depression and it can be hard to work out how you feel when so much is already in flux. How do you know if your sleep is disturbed by depression or simply by a baby waking you every two hours? Are you irritable or would you be irritable anyway while coping on too-little sleep with cracked nipples and piles while trying to establish breastfeeding?

If you’re noticing a few of the symptoms below, or any one of them is making you feel overwhelmed, it could be that you have PND, so speak to your midwife, health visitor or GP:

  • Sadness
  • Loss of interest in your baby
  • 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, failure or guilt
  • Utter despair
  • Tension
  • Irritability
  • Inability to make decisions
  • Foggy brain
  • Irrational fears
  • Obsessive thoughts
  • Loss of self-confidence
  • Loss of libido
  • Paranoia
  • Mood swings
  • Feelings of changed personality
  • Self-harm
  • Suicidal thoughts

Postnatal depression treatment

Be kind to yourself and almost certainly things will fall into place. I needed the first six weeks to adjust to being a parent. And remember, postnatal depression is a chemical imbalance and not a character defect.

The most important thing is not to suffer in silence – once you reach out, help will be available and treatment will make a difference.

Talk to your partner or other family members and supportive friends, especially those who might understand what you're going through. Make an appointment to see your doctor and tell them how you're feeling.

There is a range of treatments available, from antidepressants, cognitive behavioural therapy or counselling to changes in your diet and taking more exercise. Your doctor will be able to advise you on the best treatment for you. The important thing is to make that first contact, with your doctor, midwife or health visitor, so that you can start to get the support you need.

How do I know if I have the baby blues or PND?

If you’re experiencing the baby blues the important thing to remember is that you're not doing anything wrong and your feelings will usually lift after no more than a fortnight. It’s also hardly surprising that your moods are up and down, and that you feel irritable or even get tearful for no particular reason. Apart from anything else, you’re probably not getting as much sleep as you need. This is all really common and how you're feeling should pass.

Postnatal depression is another matter. It's an amplified and prolonged version of the feelings described above. You will not feel up and down so much as on a spiral that keeps you from making the most of what you're likely being told repeatedly is the special newborn period.

The symptoms and feelings associated with PND vary from one person to the next, so it can be difficult to diagnose. But it’s more common than many people realise, with experts believing PND affects approximately 20% of mothers in the UK. Among teenage mothers, the figure is higher – estimated at around 40%.

Postnatal depression can hit you quite suddenly or come on very gradually, meaning it can be difficult to spot. It can also occur at any time in the first year after birth.

If you think you might have PND, you don't need to suffer in silence. Speak to your doctor and tell them how you’re feeling. If you're not feeling up to talking to your doctor, try and talk to a close friend or relative first. It's vital that PND is diagnosed as soon as possible so that you can get the treatment you need as quickly as possible.

Am I at risk of postnatal depression?

When I had my first son I thought we'd made a mistake. I was ashamed of thinking that. With my second son I was terrified he was going to die. I'm well now and love my boys. My recovery was quicker because I asked for help and did what I was advised.

There are many possible risk factors for PND and it's usually a combination of these that contribute to a new mother experiencing the illness.

However, there will be women who have many possible risk factors and don't become depressed. Conversely, there will be those who have very few risk factors but do suffer.

It’s worth being aware of them just so that if you are in the higher-risk bracket you’re conscious of the possibility that you might be affected and can, therefore, seek treatment more quickly.

Key risk factors

  • Previous depression. If you've suffered from depression in the past then being pregnant, and anticipating the changes in your life that parenting will involve, could trigger another bout of depression. If you are already a parent and experienced a perinatal mental health problem after the birth of a child then you are at increased risk of suffering again.
  • Lack of support from others. Having a baby is always exhausting and can be lonely at times, so you benefit from having a support network. This might be a partner who does their fair share of looking after the baby, extended family who help when the going gets tough and friends you can talk to. Without these it’s easy for feelings of isolation to develop, which can contribute towards PND.
  • Unresolved childhood trauma. Evidence shows that women who suffered unhappy childhoods – including parental neglect, physical and sexual abuse – can be vulnerable to PND. The prospect of bringing a child into the world, and feeling anxious about your ability to care for them, can stir up distressing emotions.
  • Stressful home life. Sometimes it feels like the world conspires to make having a baby more difficult than it is already. If you're dealing with issues like money worries and poor housing, at the same time as getting used to life with a newborn, then you might be vulnerable to be PND.
  • Other major life events coinciding with your baby's birth. It's best to avoid upheaval in the months leading up to or just after birth. But there are plenty of events beyond your control that could increase the likelihood of you suffering from PND. The death of a loved one is the obvious example but a break-up, illness or redundancy could all be triggers.

Other risk factors

  • Losing the relationship with your mother before the age of 11, not necessarily through death, but a loss of the emotional relationship
  • Your mother or sister having experienced PND
  • Having had fertility treatment
  • Having high expectations of parenthood
  • Being a victim of domestic violence Sad young mum and baby
  • Relationship problems
  • Hormonal changes
  • Experiencing a role change in relationship/career
  • Having a traumatic birth
  • Being a mother of multiples
  • Previously having experienced a miscarriage, stillbirth or termination

What Mumsnetters say

“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.”

“How did I know I had PND? I felt miserable, didn't want to go out and didn't feel any joy. I did one of those health visitor's tests which give you are a mark out of 10 or 20 and scored low.”

“Having a baby is totally overwhelming and relentless. The early days can feel like the longest days in all of time and groundhog day every day. Your hormones are all over the place. You're tired out. It's how millions of women feel after having a baby. But tell your hubby, or someone close, how you feel. If you find your GP or health visitor helpful then speak to them.”

“Identifying what was wrong with me felt almost like a benediction.”

“I've suffered from depression on and off throughout my adult life. Having a child was, at first, quite a difficult time for me. But with the help of Home Start, plus the right anti-depressants, I felt better in time.”

“Once you've spoken to somebody about how you're feeling, you'll feel a whole load better. It helps to know that the way you're feeling is part of an illness and not just you being an uncoping mummy.”