Last updated September 2011. Planned review date: September 2013
Am I depressed?
If you’re suffering from a complete lack of motivation and feel very low after your premature birth, you could be depressed.
Symptoms of depression
The following feelings are symptoms of depression.
- feeling tired and lacking interest, motivation or pleasure – in the case of postnatal depression, this can sometimes include not feeling close to your baby or enjoying being with her, which may be accompanied by a sense of guilt and incompetence
- feeling low, sad, guilty, tearful, helpless or hopeless
- low self-esteem, self-hatred and needing reassurance
- feeling irritable and intolerant with those around you, including your baby or partner
- finding it virtually impossible to carry out even simple tasks
- insomnia or sleeping too much
- poor appetite or overeating, sometimes with weight loss or gain
- trouble concentrating and making decisions
- being restless, fidgety or overwhelmingly anxious
- negative or guilty feelings, or feeling that you’d be better off dead, or wanting to harm yourself
- in very rare cases, hallucinations or delusions, such as hearing voices.
I have some of those symptoms, am I depressed… or just struggling to cope?
It’s important to remember that having some of the above symptoms does not necessarily mean that you have depression. Many can be caused by the lack of sleep, and stress. A key difference is that even during periods of grief most people feel some moments of joy, whereas if you are depressed your mood is likely to be constantly flat. If you are constantly feeling the symptoms above you should seek help.
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Diagnosing postnatal depression
Postnatal depression is defined as depression that starts within four weeks of the baby’s birth.
During the early weeks, your healthcare team will ask routine questions to check how you are coping emotionally.
Some new mothers are nervous about asking for help, especially if they have had mental health problems such as depression in the past. However, if you feel you can’t cope, and this feeling lasts for two weeks or more, do seek help. In extreme cases, untreated depression could impact on your baby’s well-being and development.
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Be aware of your mental health history
If you already had a mental health problem before becoming pregnant, you are more likely to develop problems again during pregnancy, or during the first year of your baby’s life, than at other times in your life. Try not to let this worry you, but keep an eye out for the signs, so that if anything happens you can seek help quickly, as any severe problem could put you or your baby at risk.
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Treatment for depression
Research shows that simple lifestyle changes such as taking up exercise can often help reduce the symptoms of depression and anxiety. However, if you feel that you may need treatment for depression or anxiety, the options fall into two main categories:
- psychological treatments (such as counselling or cognitive behavioural therapy (CBT))
- medication such as anti-depressants.
Doctors will often recommend that you combine psychological and medical treatments, aiming to reduce the medication after the psychological therapy is finished. If you are prescribed any medication and are breastfeeding, make sure you mention this to the doctor.
Counselling therapies
Many people find it easier to talk to a professional than to a friend or family member. Counsellors are trained to listen non-judgementally and to help you find a way through your difficulties, while cognitive behavioural therapists are trained in techniques to help you change the ways you think or behave that might be contributing to the way you are feeling.
How to find a therapist
Ask your GP for a referral or go to the website of the British Association for Counselling and Psychotherapy. Some baby units also provide befriending or counselling services to offer support or practical advice, which you may find useful.
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What to do if you feel like you can't cope
If you feel like harming yourself or you feel unable to look after yourself or your baby, call your GP or their out-of-hours service urgently, or go to A&E. They can refer you to a mental health service.
In this section
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The following organisations can give you more information about the topics covered in this section.
Sources
Carek PJ (2011) Exercise for the treatment of depression and anxiety, 'International Journal of Psychiatry in Medicine', Vol 41, No 1, p15-28
Fraser DM, Cooper MA (2009) Myles Textbook for Midwives (15th edition), London, Churchill
Henderson D, Macdonald S (2004) Mayes Midwifery (13th edition), London, Balliere Tindall
MIND (2001), Oates (2001), Robinson (2002) cited in Henderson D, Macdonald S (2004) Mayes Midwifery (13th edition), London, Balliere Tindall
NHS Choices (accessed Sept 2011) Tools, Depression self-assessment test, http://www.nhs.uk/Tools/Pages/depression.aspx
NHS Direct Wales (accessed Sept 2011) Encyclopaedia, Post-natal depression, http://www.nhsdirect.wales.nhs.uk/encyclopaedia/p/article/postnataldepression/
NICE (2007) Antenatal and postnatal mental health, CG45, National Institute for Health and Clinical Excellence
RC PSYCH (2011) Postnatal depression, The Royal College of Psychiatrists, London
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On this page
Symptoms of depression
Diagnosing postnatal depression
Be aware of your mental health history
Treatment for depression
What to do if you feel like you can't cope
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‘I realised that the way I was feeling wasn’t normal – everything was really sensitive and raw. I was either ecstatic or really low, and it was getting progressively worse. Apparently I’d become quite a bitch to my husband. I started going to the counsellor at the surgery, and afterwards I felt lighter – someone there listening to me, not as a wife and a mother, but just me.’
DIANE
TIP
You don’t need to be feeling suicidal to contact the Samaritans. If you feel you’re not coping and need someone to talk to, trained Samaritan volunteers are available 24 hours a day offering nonjudgemental support.
‘Having a full-term baby seemed to engender grieving for what I’d been through with my premature daughter. I was so intent on doing it perfectly this time round – trying to erase the past – that I got completely exhausted and ended up in hospital with pneumonia for five days. It was only then that I realised I was very depressed. It was so extreme in the neonatal unit, and then you become a mum and have to look after your newborn baby. Your emotional side hasn’t been looked after.’
DEBBIE