Information on Post Natal Depression

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 and you may feel distressed or guilty for feeling like this, as you expected to be happy about having a baby.

PND can happen to anyone and it is not your fault.

It’s never too late to seek help. Even if you have been depressed for a while, you can get better. The help you need depends on how severe your illness is. Mild PND can be helped by increased support from family and friends.

If you are more unwell, you will need help from your GP and health visitor. If your PND is severe, you may need care and treatment from a mental health service.

The timing varies as to when it can happen – with my first child it began immediately but with my second took til about 6 months after the tiredness and exhilaration began to set in. PND often starts within 1 or 2 months of giving birth. It can start several months after having a baby. About a third of women with PND have symptoms which started in pregnancy and continue after birth.

What does it feel like to have PND?

You may have some or all of the following symptoms:

Irritable

You may get irritable or angry with your partner, baby or other children.

Tired

All new mothers get pretty tired. Depression can make you feel utterly exhausted and lacking in energy.

Depressed

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.

Sleepless

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.

Appetite changes

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.

Anxious

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.

You may be so worried that you are afraid to be left alone with your baby. You may need re-assurance from your partner, health visitor or GP.

When you feel anxious, you may have some of the following:

• Racing pulse
• Thumping heart
• Breathless
• Sweating
• Fear that you may have a heart attack or collapse.
• You may avoid situations, such as crowded shops because you are afraid of having panic symptoms.

Avoid other people

You may not want to see friends and family. You might find it hard to go to postnatal support groups.

Hopeless

You may feel that things will never get better. You may think that life is not worth living. You may even wonder whether your family would be better off without you.

Thoughts of suicide

If you have thoughts about harming yourself, you should ask your doctor for help. If you have a strong urge to harm yourself, seek urgent help (see below).

Psychotic symptoms

A small number of women with very severe depression develop psychotic symptoms. They may hear voices and have unusual beliefs. If this happens, you should seek help urgently (see below).

How does PND affect how I feel about my baby?

• You may feel guilty that you don’t feel the way you expected to.
• You may or may not love your baby.
• You may not feel close to your baby.
• You might find it hard to work out what your baby is feeling, or what your baby needs.
• You may resent the baby or blame the baby for the way you feel.

Do women with PND harm their babies?

Depressed mothers often worry that they might do this, but it is very rare. Occasionally, through utter tiredness and desperation, you might feel like hitting or shaking your baby. Many mothers (and fathers) occasionally feel like this, not just those with PND. In spite of having these feelings at times, most mothers never act on them. If you do feel like this, tell someone.

Women often worry that if they tell someone how they feel, their baby may be taken away. Actually your GP, health visitor and midwife will want to help you get better. This will mean that you can enjoy and care for your baby at home.

Doesn’t everyone get depressed after having a baby?

Having a baby is a time of huge change! It’s a massive change!

It is normal to feel many different emotions and not everyone gets a depressive illness.

Over half of new mothers will experience the ‘baby blues’ – this usually starts 3 to 4 days after birth.

• You may have mood swings.
• You may burst into tears easily.
• You can feel irritable, low and anxious at times.
• You may also over-react to things

It usually stops by the time your baby is about 10 days old. Women with baby blues do not need treatment. If it continues for more than 2 weeks, tell your health visitor or GP. They can check whether you have PND and hopefully help you.

What causes PND?

Many possible causes for PND have been suggested. There is probably no single reason, but a number of different stresses may add up to cause it.

You are more likely to have PND if you:

• Have had mental health problems, including depression before
• Have had depression or anxiety during pregnancy
• Do not have support from family or friends
• Have had a recent stressful event – e.g. death of someone close to you, relationship ending, losing a job.

There may be a physical cause for your depression, such as an underactive thyroid. This can be easily treated.

PND can start for no obvious reason, without any of these causes. Also having these problems does not mean that you will definitely have PND.

Recognising postnatal depression

The first thing is to recognise you have had a depressive illness. Don’t dismiss it as the ‘baby blues’. Don’t assume it’s normal to feel like this when coping with a baby.

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.
• Some women worry that their baby will be taken away. In fact, you are doing what is best for your baby and for yourself by getting help for your PND. Doctors and health visitors want to get the care you need so you can look after your baby.

People are now more aware of depression in general. This means PND shouldn’t be missed so often.

Doctors, midwives and health visitors usually ask new mothers about their mental health. They may ask you to fill in a questionnaire or ask the following questions:

• During the last month, have you been bothered by feeling down, depressed or hopeless?
• During the last month, have you been bothered by having little interest in pleasure or in doing things?
• Is this something you feel you need or want help with?

If your answers suggest you might have PND, you should see your GP as your GP will need to ask more questions to confirm the diagnosis.

All the best.