Postnatal Depression

Postnatal depression falls between baby blues and puerperal psychosis. It mayaffect up to 1 in 7 new mothers although some experts in this field believe it affects more that this. Symptoms tend to start as baby blues and then get worse or they may take some time to develop. It may be more obvious when your baby is between 4 and 6 months old.

The earlier it is recognised, diagnosed and treated the faster you will recover.

Postnatal depression can last for longer than 3 months and even years if not treated.

Often a family member or friend will notice there is something wrong before you do.

What causes postnatal depression?

We do not know the exact cause of postnatal depression but research suggests that there are a number of factors that contribute to it.

These include:

Personal history
If you have a history of depression, this can be a risk factor for postnatal depression,

Birth Experience
You may find that your birth experience does not match your expectations. The feeling of being let down can contribute to depression. Some women who develop postnatal depression have a traumatic or difficult birth or a premature or ill baby.

Biological Factors
A small number of women who develop postnatal depression have a temporary thyroid gland problem, which is linked with mood changes. Some women may be particularly vulnerable to the drop in hormones after giving birth. There is no firm scientific evidence to support this but studies continue in this area.

Changes in Lifestyle
The birth of a baby brings changes to your life. New babies are hard work with the constant demands of feeding, bathing, crying and putting to sleep. This usually means you lose a lot of sleep. A new mother is suddenly responsible 24 hours a day. You lose the freedom you enjoyed before you had your baby. This sense of loss can contribute to depression. It may take time for you to find ways to adjust to the changes in your life.

Relationships
The birth of a baby can also have a profound impact on your relationship with your partner, family and friends. This can sometimes cause enormous strain.

Stressful life events
Recent life events such as bereavement or serious illness may mean that you are emotionally stressed before the birth of your baby. You may also be affected by unemployment or lack of money. Mothers who do not have a supportive partner or are isolated from their families may be more likely to suffer from depression after birth.

Images of motherhood
Images of motherhood through the media, suggests that mothers should be attractive, energetic and living in a perfect home with a supportive partner. Many women think motherhood is instinctive and not a skill you need to learn. If you find the weeks and months after childbirth difficult, you may feel you are the only one not coping. This can lead to overwhelming feelings of failure and isolation.

Signs and Symptoms of Postnatal Depression

Postnatal depression can have a broad range of symptoms which can vary in severity.

These include:

Irritability
You may feel irritable and angry sometimes for no reason.

Anxiety
You may feel inadequate or unable to cope. You may feel worried about things that you normally take for granted. You may not want to leave the house or meet friends. Some mothers are afraid of being left alone with the baby.

Panic Attacks
You may start to have panic attacks. The symptoms of panic attacks include sweating hands, pounding heart and feeling nauseated. They can happen at any time and are very distressing. You may start to avoid situations where you experience them, such as social occasions, shopping or public areas.

Sleep problems
You may find it hard to sleep even when your baby is fast asleep.

Tiredness
You may feel constantly exhausted and no energy. You may feel unable to cope with house work or looking after your baby or other tasks. You may lack interest in your own appearance, sex and in your surroundings.

Concentration
You may have trouble concentrating, easily distracted and feel confused at times.

Appetite
You may comfort eat or lack interest in food.

Tearfulness
You may cry often and not for reasons you can understand.

Obsessive Behaviour
Constantly tidying your home and trying to keep up impossible high standards is typical of this behaviour. You may have overwhelming fears for example about dying. Some mothers have recurring thoughts about harming their baby but very few mothers ever act on this.

Helping yourself

The most important thing to do is look for help. Talk to your partner, family, midwife or GP immediately.

Be open about your feelings and worries. This will help others understand what you need.

Believe that you will get better.

Postnatal depression is temporary.

Take every opportunity to rest.

Learn to have short naps especially when your baby sleeps. If you are breast feeding your partner or family member can give your baby expressed milk from a bottle to give you a rest.

Eat well
Choose healthy nutritious food that don’t need much cooking.

Ask for help
Especially help around the house such as housework and ironing. Set time aside for you and your partner or members of your family. This can help you relax.

Organise a daily treat
This could be a walk in the park, an exercise class, or go for a coffee and a chat with friends.

Find time for fun
Accept offers to baby sit to let you out for a meal or to the cinema.

Be intimate with your partner
A kiss and a cuddle can be very loving and comforting even if you don’t feel like sex.

Don’t

Don’t try to be superwoman
You may need to reduce other activities, and focus on you and your baby.

Don’t blame yourself or your partner
Parenthood is a huge transition for couples.

Don’t move house while you are pregnant or for a few months after the birth of your baby if you can avoid it.

Find out what support networks are in your area such as post natal support groups or mother and toddler groups.

Mothers in a similar situation can give emotional and practical support. Your midwife or GP may be able to give you details or groups in your area.

Counselling

Professional counselling can help. You may benefit from talking to someone understanding in an uncritical environment. Talk to your GP about this.

Some women with postnatal depression seek psychiatric treatment. This can be part of your recovery plan but you will also need the support and practical help from your partner, family and friends.

Medication

Drug treatment for postnatal depression usually involves antidepressant medication. If used correctly anti-depressant tablets are not addictive. However they can take up to 2 weeks to start working.

Certain anti-depressant tablets are suitable to use if you are breastfeeding so let your GP know if you are breastfeeding.

You may need to continue to take your medication for up to 6 months after the depression has lifted. It is important you talk to your doctor about how you are feeling before there is any change in the dose or frequency of your tablets. You need to give yourself time to recover.

Hospital

Sometimes your doctor may feel you need more intensive help or rest to recover.

Occasionally a short stay in hospital is necessary.

Family and Friends

Living with someone who is depressed can be very difficult and frustration.

Try to be patient and understanding.

Give support, encouragement and hope.

Your help is invaluable to them at this time.

If you need support or information ask your GP.

If you think your friend, sister or daughter has postnatal depression you can help by:

• Encourage her to talk to her GP, midwife, or counsellor
• Let her express her true feelings, listen with empathy, don’t criticise her
• Help her to arrange childcare
• Encourage her to join a support group
• Find out more about postnatal depression

For couples:

• Try to do things as a couple without the children
• Encourage your partner to be active for example getting out for a walk
• Try to make sure she gets enough food and plenty of rest
• Remind her frequently that postnatal depression is temporary and she will get better

Puerperal psychosis is the most extreme and very rare form of postnatal mood change.

It affects 1 in 500 new mums. Puerperal means the first 6 weeks after childbirth and psychosis is any form of mental illness in which you lose contact with reality. Symptoms begin soon after child birth usually with the mother becoming restless, mildly confused and unable to sleep even when her baby is sleeping. This form of depression usually requires hospital care.

The Baby Blues are so common they are considered normal for new mothers.

They usually begin 2-4 days after the birth of your baby.

You may have crying spells, increased feelings of vulnerability, irritability, loneliness and weariness. Although you may find it distressing, the baby blues will pass quickly, usually within a week or two. It is important you get as much rest as possible and lots of support from your partner, family and friends.