Postnatal depression

Postnatal/postpartum depression is not 'baby blues'. It is prolonged feelings of feeling low. It can vary from mild to severe and it can affect women in different ways.

Woman looking sad and thoughtful.

Over half of new mothers experience the ‘baby blues’, which is a short period of feeling low, anxious, and irritable. You may have mood swings, overreact to things and burst into tears easily. It usually starts in the week after the baby’s birth and usually stops by the time your baby is around ten days old. These are normal feelings as your hormones adjust to not being pregnant, and you don’t need any treatment.

"It was a difficult birth and although I loved her because she was my child, I felt there was something missing. There’s so much pressure and expectation on new mothers - and I wondered what was wrong with me.” Caroline, mum of one

The ‘baby blues’ aren’t postnatal depression. Postnatal depression is when you have those feelings of being unhappy and they last for weeks or months. Depression can vary from mild to severe and it can affect women in different ways. You may find it difficult to look after yourself and your baby if you have severe depression.

Symptoms of postnatal depression

The main symptoms of postnatal depression are:

  • a persistent feeling of sadness and low mood
  • loss of interest in life, no longer enjoying things that used to give pleasure
  • lack of energy and feeling tired all the time.

Other symptoms can include:

  • disturbed sleep, such as having trouble sleeping during the night and then being sleepy during the day
  • difficulties with concentration and making decisions
  • low self-confidence
  • poor appetite or an increase in appetite (‘comfort eating’)
  • feeling very agitated or, alternatively, very apathetic (you can’t be bothered)
  • feelings of guilt and self-blame
  • thinking about suicide and self-harming.

If you have depression you won’t necessarily experience all of these symptoms. Remember that some these things can also be a normal part of being a new mother, such as disturbed sleep or lack of energy. If your feelings started gradually you may find it hard to tell where the line is between ‘normal’ difficult feelings and being depressed – maybe the ‘baby blues’ just don’t seem to pass. Or it may be obvious something is wrong because you suddenly start to feel very low.

"I came home on day three or four and the moment I walked into the house I burst into tears. I got the same anxiety feeling, the feeling I wasn't going to be able to cope with this." 

Stephanie, mum of two. Read more...

Trust yourself – you are the best judge of whether your feelings are normal for you. If you don’t feel right, or if you have some of the signs of depression and they last for more than two weeks, talk to your health visitor or GP.

How common is it?

Very common. Around than one in every ten new mothers experience postnatal depression.

What should I do?

Tell your midwife, health visitor or doctor how you feel.  You may feel very distressed or guilty at feeling low at a time when everyone expects you to be happy, but postnatal depression is not your fault. The midwife, health visitor or doctor won’t criticise you or judge you for having these feelings – they know this happens to many new mothers, and they will discuss and organise treatments so you can get better.

It can be difficult to talk about your thoughts and feelings.  You may want to write down what you want to say first, or you may want to have someone with you. The important thing is to let someone know so that the right help can be found as soon as possible. 

What makes depression more likely?

  • You had depression or anxiety when you were pregnant
  • You’ve had depression before
  • Not having friends or family or support
  • Money problems or relationship worries
  • A difficult time during labour and birth
  • Health problems caused by the birth, such as incontinence or ongoing pain after episiotomy.

But you can get postnatal depression ‘out of the blue’, even if none of these risk factors apply to you.

What is the treatment for depression ?

The good news is that postnatal depression can be treated - it is a temporary illness that you can recover from. The treatment is likely to depend on how severe your depression is.

“It’s difficult trying to find out what’s wrong with you. Is it just being a new mum? Is it you’re anxious because you can’t settle the baby? Is it postnatal depression? There are so many things that overlap.” 

Emily, mum of one. Read more...

  • If you have mild depression, the doctor may recommend an exercise programme and/or guided self-help. You may be offered medication, especially if you have had depression before.
  • If you have mild to moderate depression and have had no previous depression, you may be offered guided self-help or a ‘talking treatment’ (psychological therapy). Your doctor will discuss the options with you, depending on what is appropriate for you and your symptoms.
  • If you have severe depression or moderate depression and had previous depression your doctor might recommend psychological therapy and antidepressants.

If you are planning to breastfeed your baby, talk to the doctor about this so that they can factor this into the treatment discussions. Some antidepressants are not recommended for breastfeeding and the doctor who is treating you will prescribe one that is suitable instead.

"I was on medication...and I was under close review because things were bad... But by about four months things started to lift. I've always described it like layers of cling-film coming off."Stephanie, mum of two

 

How can I help myself?

  • If you know you are at risk be aware of the symptoms of postnatal depression so you can speak to someone about it sooner if it happens
  • Talk to your partner, family or a friend about how you are feeling.
  • Try not to feel guilty or embarrassed. These feelings are not your fault.
  • Look after yourself. It’s hard to do anything for yourself when you’re depressed, but   if you can, try some of our top tips for looking after your emotional wellbeing.
  • Get some exercise every day – keeping active will release some feel-good endorphins.
  • Eat well even if you don’t have much appetite.
  • Avoid alcohol – it can harm your baby and can make you feel worse.

"It was really only a week after she was born and things started to go right downhill again. I just couldn't get up. I couldn't get out of bed. It wasn't even about bonding with her. I just didn't want to exist anymore." Abby, mum of one

More information and support

PANDAS : Helpline 0843 2898401. Provides telephone support, online information and local support groups for pregnancy depression and postnatal depression.

APNI (Association for Postnatal Illness) Helpline: 0207 386 0868. Provides telephone support and online information on postnatal depression.

MIND: Helpline 0300 123 3393. Mental health charity providing information, support, local groups and an online chatroom

Local support groups may also be available.  Check out what’s on offer at Netmums or ask your GP.

Click here to find out more about treatments for depression

Other resources

Read more

Sources

  1. NHS Choices [accessed 6/5/2015] Symptoms of postnatal depression,http://www.nhs.uk/conditions/postnataldepression/pages/symptoms.aspx
  2. NHS Choices [accessed 6/5/2015] Postnatal depression,http://www.nhs.uk/conditions/postnataldepression/pages/introduction.aspx
  3. NHS Choices [accessed 6/5/2015] Postnatal depression,http://www.nhs.uk/conditions/postnataldepression/pages/causes.aspx
  4. NHS Choices [accessed 6/5/2015] Postnatal depression,http://www.nhs.uk/conditions/postnataldepression/pages/treatment.aspx
  5. NICE (2014) Information for the public: Mental health in pregnancy and the year after giving birth.http://www.nice.org.uk/guidance/cg192/resources/information-for-the-public-mental-health-in-pregnancy-and-the-year-after-giving-birth-pdf
  6. NHS Choices [accessed 6/5/2015] Postnatal depression,http://www.nhs.uk/conditions/postnataldepression/pages/introduction.aspx
  7.  ibid
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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