Postnatal depression

What is postnatal depression?

If a woman experiences more persistent symptoms, it could be the result of postnatal depression (PND). It can develop in the first four to six weeks after childbirth but in some cases it might not develop for several months after the birth. PND can have a variety of physical and emotional symptoms, but it can be treated.

At least one new mother in 10 goes through PND. It can come on gradually or all of a sudden. Many women feel unable to talk about it because they think they will be perceived as “bad mothers”.

Pregnancy and the first few months after birth can be difficult for parents. Some may experience a great deal of stress and frustration with a lot of mixed emotions. For new mothers it is common to feel tearful, have mood swings and become more irritable than normal – these are referred to as the baby blues and usually do not last a long time.

Symptoms

Postnatal depression can affect women in different ways. Key symptoms include:

  • a persistent feeling of sadness and low mood
  • lack of energy or interest
  • perpetual fatigue
  • disturbed sleep
  • difficulties with concentration and making decisions
  • low self-confidence
  • poor appetite or an increase in appetite ("comfort eating")
  • Panic attacks and overwhelming anxiety
  • Obsessive fears about the baby’s health or wellbeing

More severe symptoms include:

  • strong feelings of guilt or self blame
  • feeling very agitated and alternatively very apathetic 
  • contemplating suicide and self-harm
  • becoming physically and mentally unable to look after a child

Professionals are able to help but it is important that family members and close friends recognise the warning signs.

These can include:

  • the woman frequently crying for no obvious reason
  • they have difficulties bonding with their baby
  • they seem to be neglecting themselves. For example, not washing or changing clothes, losing sense of time
  • they lose all sense of humour and cannot see the funny side of anything

An extremely serious mental health condition that can develop after birth is postnatal psychosis. It is rare but can affect about one in 1,000 women. Symptoms are described as being similar to bipolar – people feeling depressed one moment and very happy the next. They believe things that are obviously not true (delusional) and they can see or hear things that are not really there (hallucinations).  

Treatment

PND usually gets better in time, but it can take up to a year. Forms of treatment can vary from simply talking to some one you love, to ongoing clinical support.

One of the most helpful things is to talk to other mothers and fathers – it can be very reassuring to find that all new parents share the same anxieties and frustrations.

The most important first step in managing postnatal depression is recognising the problem and taking action to deal with it. The support and understanding of your partner, family and friends plays a big part in your recovery.

Support and advice from social workers or counsellors can be helpful. Self-help groups can also provide good advice about how to cope with the effects of postnatal depression, and you may find it reassuring to meet other women who feel the same as you.

Ask your health visitor or GP about the services in your area.

  • Exercise - has been proven to help depression, and is one of the main treatments if you have mild depression
  • Psychological therapies - usually recommended as the first line of treatment for mild-to-moderate postnatal depression for women with no previous history of mental health conditions. These include guided self-help, which is based on the principle that your GP can "help you to help yourself", Cognitive Behavioural Therapy (CBT) and other treatments
  • Talking therapies - Where you are encouraged to talk through problems either one-to-one
  • Antidepressants – work by balancing mood-altering chemicals in your brain. They can help ease symptoms such as low mood, irritability, lack of concentration and sleeplessness, allowing you to function normally and helping you cope better with your new baby.


Treating severe postnatal depression

Referral

You may be referred to a mental health team if your postnatal depression is severe, or does not respond to treatment. These teams are usually made up of a range of specialists, including psychologists, psychiatrists, specialist nurses and occupational therapists.

Medication

Women who develop psychosis symptoms may be treated with mood-stabling medications such as lithium or an anti-epileptic drug, an antipsychotic (this helps combat the symptoms of psychosis) or a tranquiliser, such as a benzodiazepine, to help relax you

Hospital treatment

If it is felt your postnatal depression is so severe you are at risk of harming yourself or your baby, you may be admitted to hospital or referred to a mental health clinic.

The Mother and Baby Unit (MBU) at SLaM is based at Bethlem Royal Hospital. It specialises in the treatment of antenatal and postnatal illnesses. The service is for women who develop a mental illness or have a relapse of serious mental illness during pregnancy, and women who have developed postnatal depression, post partum psychosis or have had a relapse of serious mental illness following the birth of their baby.

Staff at the unit support the mother in developing a relationship with her infant in order to reduce the impact of the mother’s illness on the child. The MBU offers a holistic treatment programme and encourages the involvement of fathers or partners in the process.

Search for perinatal services using our clinical service finder.

Read Susan's story about getting treatment for bipolar depression at our Mother and Baby Unit here

 

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