When your baby is born prematurely, you will be plunged into a situation of uncertainty as their condition fluctuates. You may need to take in a huge amount of medical and technical detail in a very short space of time.
As well as feeling joy, love and happiness at the birth of your baby, this period can also be extremely stressful and overwhelming. It is not unusual to feel quite exhausted and unhappy or tearful for several months after having your baby.
Many parents find it difficult to focus on their own needs after having a new baby – especially if the baby is unwell. This is understandable, but using some of your energy to take care of yourself will help your baby in the long run because it means you'll be in a better position to take care of them.
Symptoms of depression
If you’re suffering from a complete lack of motivation and feel very low after your premature birth, you could be depressed.
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 them, 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.
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.
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.
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.
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.
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.