Understanding postnatal depression

Jul 08, 2019

At least one in 7 women in Ireland is thought to experience postnatal depression (PND) after they have a baby. But the true figure could be even higher, as many women don't ask for help or tell others how they're feeling.

PND isn't the same as the baby blues. Thought to be caused by sudden changes in hormone levels, the baby blues is when you feel emotional during the first week or 2 after giving birth. Having the baby blues is so common, it's considered normal (up to 85% of mothers are believed to be affected).

With the baby blues you may feel weepy, anxious, tense and generally a bit down from around the third day after giving birth. PND on the other hand is less common and usually starts during the first month after childbirth (though it can be triggered several months later). The symptoms - many of which are similar to those of ordinary depression - last longer than the baby blues. But there are ways to treat PND successfully (no treatment is usually recommended for the baby blues).

Symptoms associated with PND

  • Low mood or mood swings
  • Feelings of sadness or despair
  • Crying a lot
  • Feelings of worthlessness, hopelessness or guilt
  • Loss of interest in everything, an inability to feel pleasure or enjoyment
  • Feelings of anxiety, irritability or anger
  • Inability to sleep properly
  • Loss of appetite or increased appetite (comfort eating)
  • Low energy, feelings of exhaustion
  • Lack of confidence in looking after your baby
  • Lack of interest in sex or your partner
  • Alarming thoughts (e.g. harming your baby or suicide)
  • Poor concentration, feelings of confusion

These symptoms may start so gradually that some mothers may not realise they have PND. And not only women are affected. According to the NHS, research has found up to one in 25 new fathers also become depressed after their partner has a baby.

What causes PND?

Experts aren't really clear about what causes PND, but several things have been linked to it, including a history of mental health issues (including depression during pregnancy), having close relatives who had PND, recent high-stress events, health problems caused by pregnancy or childbirth, unplanned pregnancy, relationship or financial problems and a lack friends and family close by who can offer support.

But even if none of these things apply to you, you may still experience PND, as having a baby is a major life-changing event and can be tiring and stressful to say the least. There again sometimes there is no obvious cause.

What should you do if you think you're experiencing PND?

Experts suggest PND symptoms should improve within 3 to 6 months without any help or treatment. But if you do seek help you'll not only help yourself to recover more quickly, you could also improve your relationship with your partner and your family, as well as your baby. It's also important to remember that admitting you're feeling depressed isn't a sign of weakness and it can happen to anyone.

Your GP or health visitor can suggest ways to help you feel better. The type of treatment you may be offered will depend on a number of things, including what symptoms you have (and how severe they are), whether you've had depression or other mental health problems before and what type of treatment you'd prefer. These include the following:

Psychological treatments

Counselling has been shown to be an effective treatment for PND. Cognitive behavioural therapy (CBT) is often recommended, as well as other therapies such as interpersonal therapy and psychodynamic psychotherapy. Your GP or health visitor may also recommend a self-help course, such as one based on the same principles as CBT.

Antidepressants

If your symptoms are moderate or severe your GP may recommend taking antidepressants. There are several types of antidepressant medicines you could take, so if one isn't suitable your GP can prescribe another. Speak to your doctor about any concerns you may have about taking antidepressants while breastfeeding, as some antidepressants are more suitable than others for breastfeeding mothers.

Self help

Talking about your feelings with your partner, friends and family members may help, and you may find others will offer lots of practical help that could make a big difference. Try to rest as much as possible - don't worry about things like housework and get lots of sleep.

Eating a healthy diet can support your mind and body during challenging times too. And while you may not feel like doing much exercise, regular gentle activity could help boost your mood. It's also a good idea to get out and about with your baby and mix with other new mothers (your health visitor will suggest local groups you can join).

Article reproduced with the kind permission of CABA, the organisation providing lifelong support to ICAEW members, ACA students and their close family around the world.