"Postnatal (postpartum) depression affects more than one in ten women, usually within a year of giving birth. While mood swings and some degree of stress and worry are normal in the weeks surrounding a birth (sometimes called "baby blues"), postnatal depression is characterised by persistence of these feelings that intensify over time," says Dr Mark Winwood, Clinical Director of Psychological Health at AXA PPP Healthcare.
Postnatal depression can develop gradually, so it can be hard to recognise until it becomes a serious problem. However, it's important to remember that you're not alone. There are coping strategies that many people find helpful, including:
- Talking about it with family, friends, your partner or with a professional
- Going to support groups with others who are going through the same thing
- Exercising, getting enough rest and eating healthily
- Allowing people to help you with your daily life, for instance by doing your shopping
- Meditating and other relaxation exercises
- Staying away from alcohol, caffeine and tobacco
Recognising postnatal depression
Recognising postnatal depression is the first step to treating it. As soon as you suspect you might be experiencing significant low mood, you should speak to your GP or health visitor. Some women may feel embarrassed about postnatal depression, and some might even worry that they could lose access to their child because of it. Remember that it's a common condition, and healthcare professionals are there to help.
The symptoms of postnatal depression vary from person to person, but they usually include overwhelming feelings of sadness, apathy, stress or guilt. These feelings can be even more intense and confusing because of the expectations that having a new baby is supposed to be a joyous time in life. If these feelings persist for more than two weeks after the birth, you should talk to somebody about it.
Other common symptoms to be aware of are:
- Crying, especially for no clear reason
- Irritability and withdrawing from people
- Losing interest in things you used to enjoy
- Difficulty sleeping at night, or feeling tired even when you've slept
- Changes in appetite
- Trouble concentrating and making decisions
- Feeling isolated and like "nobody understands"
- Negative thoughts – feeling helpless or worthless
- You might‘compare and despair’ – looking at others and thinking they are coping better than you / giving yourself a hard time
It can be particularly distressing if the negative thoughts you are harbouring are about your baby. Some people with postnatal depression worry that they aren't bonding with their baby, or have frequent, overwhelming fears about their baby's health and wellbeing. Some people even have thoughts about hurting their baby. This is normal for postnatal depression, and it's extremely rare for anybody to act on these feelings. ‘Remember, thoughts aren’t facts,’ says Dr Winwood. ‘If these thoughts are hurting you, seek help.’ Don't be discouraged from talking about it.
Causes of postnatal depression
Postnatal depression can happen to anybody – even if you've had children before and have not experienced mood problems. Though usually experienced by mothers, it can affect fathers too. While the causes of postnatal depression aren't very well-understood, a number of factors are thought to contribute to these feelings, such as:
- A history of depression, either personal or in the family. There is some debate about the role of nature vs. nurture with depression.Any previous episodes of depression or postnatal depression should be reported to midwifery staff as soon as possible to ensure you receive necessary help, such as referral to Mother and Infant Mental Health Service or extra midwife visits.
- Relationship problems
- Physical or psychological trauma (such as a difficult birth or pregnancy)
- Unplanned or unwanted pregnancy – research indicates women with unwanted pregnancies are four times more likely to experience postnatal depression
- Financial problems
- Low self-esteem, feeling helpless or worthless
- A reaction to change of life / added responsibilities
- Lack of support – either real or perceived
Treating postnatal depression
It may take time for symptoms to subside, but many of the strategies used by people living with other types of depression apply. It's important to avoid becoming isolated. It may feel like you're going it alone. and nobody can help, but contact with others is one of the best ways to cope.
Talking about it can be a big help. If you have a partner, it's important for them to understand what you're going through. Friends, family, your GP, health visitor or midwife can help and support you.. You can also find postnatal support groups run by hospitals and charities in your area. It can be reassuring to talk to people with similar experiences.
The effects of depression can make it difficult to exercise, eat well and get enough sleep – as can looking after a baby - but these three things can make a big difference to how you feel day-to-day. Try to make time for activities you enjoy, and don't be afraid to ask for help with everyday tasks if you're feeling overwhelmed.
As well as the coping strategies above, your GP might also recommend psychological treatments, such as cognitive behavioural therapy (CBT) and counselling. In some cases, they might prescribe antidepressants that you can use while breastfeeding.
Dr Mark Winwood has answered people's queries about postnatal depression during a live chat, which contains lots of good information including help for new mothers feeling guilty about the way they feel and whether or not postnatal depression is hereditary. If you have questions that aren't answered in this article, you might find the information you need there.Do you have a question for our nurses? Our Ask the Expert service is available 24/7.
Additionally, there are a number of organisations that can help with postnatal depression – some of them offer helplines and information packs. Find out more about them on their websites.
Help and support
- Mumsnet – The UK's biggest network for parents
- Mothers for Mothers – An online support group for people who have experienced postnatal depression.
- The Association for Postnatal Illness – A charity that supports and raises awareness of people with postnatal depression.
- Mind – A mental health charity that provides support for people with all kinds of mental health problems, including postnatal depression.
- The NHS – Factsheet on Post-Natal Depression
- The Royal College of Psychiatrists
- National Childbirth Trust (NCT)
- "A meta-analysis of the relationship between postpartum depression and infant temperament"
- "Risk factors for postpartum depression: a retrospective investigation at 4-weeks postnatal and a review of the literature"
- Live chat with Dr Mark Winwood