What is Postnatal Depression (PND)?
Postnatal Depression is a depressive illness that 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. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, 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 a GP and health visitor. If your PND is severe, you may need care and treatment from a mental health service.
When does PND happen?
The timing varies. PND often starts within one or two months of giving birth. It can start several months after having a baby. About a third of women with PND have symptoms that 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:
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.
You may get irritable or angry with your partner, baby, or other children.
All new mothers get pretty tired. Depression can make you feel utterly exhausted and lacking in energy.
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.
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.
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;
- nowhere is clean or safe enough for your baby;
- 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 reassurance from your partner, health visitor, or GP.
When you feel anxious, you may have some of the following:
- racing pulse;
- thumping heart;
- 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. You may agree to go out and then make excuses at short notice.
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 and self-harm
If you have thoughts about harming yourself, you should ask a doctor for help. If you have a strong urge to harm yourself, seek urgent help.
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.
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 have2:
- previous mental health problems, including depression;;
- depression or anxiety during pregnancy;
- poor support from partner, family, or friends – or marital difficulties;
- a recent stressful event – e.g. death of someone close to you, a relationship ending, losing a job;
- experienced domestic violence or previous abuse;
- arrived in a developed country as a refugee or to seek asylum.
There may be a physical cause for your depression, such as an underactive thyroid or low levels of vitamin B12. These 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.
Recognizing postnatal depression
The first thing is to recognize 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 realize 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 babies 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?
It is important to answer these questions honestly so that you can be offered help if you need it. If your answers suggest you might have PND, you should see a GP. A GP will need to ask more questions to confirm the diagnosis.
Why is treatment important?
Most women will get better without any treatment within 3 to 6 months. 1 in 4 mothers with PND are still depressed when their child is one year old.
However, this can mean a lot of suffering. PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner.
You may not look after your baby, or yourself, as well as you would when you are well. PND can affect your child’s development and behavior even after the depression has ended. So the shorter it lasts, the better.
To get urgent help for free, contact us now.