What is postnatal depression?
Postnatal Depression is a depressive illness which affects between 10 to 15 in every 100 women having a baby. The symptoms are similar to those in depression at other times. These include low mood and other symptoms lasting at least two weeks. Depending on the severity, you may struggle to look after yourself and your baby. You may find simple tasks difficult to manage.
Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault.
What does it feel like to have PND?
You may have some or all of the following symptoms:
You feel low, unhappy and tearful for much or all of the time. You may feel worse at certain times of the day, like mornings or evenings.
You may get irritable or angry with your partner, baby or other children.
All new mothers get pretty tired. Depression can make you feel utterly exhausted and lacking in energy.
Even though you are tired, you can't fall asleep. You may lie awake worrying about things. You wake during the night even when your baby is asleep. You may wake very early, before your baby wakes up.
You may lose your appetite and forget to eat. Some women eat for comfort and then feel bad about gaining weight.
Unable to enjoy anything
You find that you can't enjoy or be interested in anything. You may not enjoy being with your baby.
Loss of interest in sex
There are several reasons why you lose interest in sex after having a baby. It may be painful or you may be too tired. PND can take away any desire. Your partner may not understand this and feel rejected.
Negative and guilty thoughts
Depression changes your thinking:
- You may have very negative thoughts
- You might think that you are not a good mother or that your baby doesn't love you
- You may feel guilty for feeling like this or that this is your fault
- You may lose your confidence
- You might think you can't cope with things.
Most new mothers worry about their babies' health. If you have PND, the anxiety can be overwhelming. You may worry that:
- Your baby is very ill
- Your baby is not putting on enough weight
- Your baby is crying too much and you can't settle him / her
- Your baby is too quiet and might have stopped breathing
- You might harm your baby
- You have a physical illness
- Your PND will never get better.
Can postnatal depression be prevented?
Don't try to be 'superwoman'. Try to do less and make sure that you don't get over-tired.
Do make friends with other women who are pregnant or have just had a baby. It may be more difficult to make new friends if you get PND.
Do find someone you can talk to. Do go to antenatal classes. If you have a partner, take them with you. If not take a friend or relative.
Don't stop antidepressant medication during pregnancy without advice. Around 7 in 10 women who stop antidepressants in pregnancy relapse if they stop the medication. You need to discuss the risks and benefits of continuing treatment in pregnancy and breastfeeding.
Do keep in touch with your GP and your health visitor if you have had depression before. Any signs of depression in pregnancy or PND can be recognised early.
Do make sure that you have treatment for depression in pregnancy. This may be a talking therapy or medication.
Do accept offers of help from friends and family.
Recognising postnatal depression
There are lots of reasons why women delay seeking help. You may:
- Not realise what is wrong
- Worry about what other people think
- Feel ashamed to admit that you are not enjoying being a mother.
Which treatments are available?
- Talking treatments
Talking about your feelings can be helpful, however depressed you are. Sometimes, it's hard to express your feeling to someone close to you. Talking to a trained counsellor or therapist can be easier. It can be a relief to tell someone how you feel. It can also help you to understand and make sense of your difficulties.
There are also more specialised psychological treatments. Cognitive Behavioural Therapy can help you to see how some of your ways of thinking and behaving may be making you depressed. You can learn to change these thoughts which has a positive effect on other symptoms. Other psychotherapies can help you to understand the depression in terms of your relationships or what has happened to you in the past.
If you have a more severe depression, or it has not improved with support or a talking therapy, an antidepressant will probably help.
There are several types of antidepressants. They all work equally well, but have different side-effects. They are not addictive. They can all be used in PND, but some are safer than others if you are breastfeeding.
Antidepressants take at least 2 weeks to start working. You will need to take them for around 6 months after your start to feel better.