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Postnatal depression

New mums who experience postnatal depression often don’t know where to turn, but there are ways to help you through it

Published 01 Apr 2008

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Many women feel weepy and low for a few days after giving birth. But if tearfulness and anxiety goes on longer you may be one of the ten per cent of mums who suffers from postnatal depression (PND).

Your feelings after giving birth

About half of all new mums get the ‘baby blues’. Believed to be triggered by changing hormone levels, it usually starts three to five days after birth, often when your breasts produce the first surge of milk to feed your baby (when your milk ‘comes in’).

You might find that you’re very emotional and cry for no reason, feel tired and lethargic and find it hard to sleep too. It’s also common to feel overwhelmed and unable to cope, especially if it’s your first child. Remember that these feelings are normal and should pass in a few days and certainly by two weeks.

What are the symptoms of postnatal depression?

If the symptoms above get worse as the weeks go by, you may have postnatal depression. These are some common signs (thoug Mum cuddling teddy bear h not all mums may have all of these):

Feeling low most of the time
Crying a lot, for no apparent reason
Not being able to enjoy or look forward to anything
Feeling very anxious
Feeling detached from everyday life and others
Feeling rejected by your partner, family or baby
Always being tired
Having no interest in caring for your appearance
Feeling like you can’t cope
Finding it hard to relax and concentrate on TV or reading or even conversations
Insomnia
No interest in sex.

In very rare cases, new mums can develop a severe mental illness called puerperal psychosis. They may experience hallucinations and voices or be extremely depressed or manic. Women who develop puerperal psychosis need to be admitted to psychiatric hospital for immediate treatment as there's a risk that they'll harm themselves or their babies.

How is postnatal depression treated?

It’s very important to get help. Talk to your GP or health visitor who will get you to fill out a questionnaire called the Edinburgh PND Scale which will ask you to describe how you’re feeling. This will help to discover how severe your depression is.

Elizabeth Wise, a postnatal illness counsellor, says: “Treatments that encourage you to talk are usually the first step. This could be with a counsellor, a trained health visitor or you may be referred for cognitive behavioural therapy (a form of psychotherapy which focuses on how our thoughts affect our behaviour) which can help to beat your depression.”

If your depression is more serious, or you haven’t noticed an improvement after talking therapy, you may need anti-depressant drugs. Your doctor can advise on which are suitable to take when breastfeeding. These take two weeks to start working and are normally taken for around six months after you start to feel better. You need to come off them slowly as some people get withdrawal symptoms.

“You can recover from mild PND without drugs, but it can take longer. The best treatment combines drugs with talking therapy and joining a support group,” says Elizabeth. Moderate to severe depression can take around a year to fully recover.

Helping yourself

Elizabeth Wise recommends the following tips:

If possible, rest when your baby does and forget the housework.
Low blood sugar levels can affect mood and anxiety levels so eat little and often. Carbohydrates (bread, pasta) rather than sugary snacks are best.
Don’t push yourself to do things you feel unable to do. Treat yourself as if you have a physical illness.
Stop comparing yourself with other mums.
Take some exercise — even a short walk can lift your mood.
A massage or reflexology may help.
Remind yourself this won’t last forever.

How can family and friends help?

Listen to her concerns and don’t judge or criticise.
Praise her for even little things she’s done well.
Give her time off away from the baby.
Be aware she might pretend she’s feeling better because she thinks that's what's expected of her.
Make time to ask her how she’s feeling each day. Talking really helps.
Help her out with chores like housework and cooking meals.
Remember that PND is an illness that takes time to recover from, but she will be her old self again.

Will I get postnatal depression next time?

There is no way of knowing if you will be affected next time round, and the best advice is to expect it will happen so you can plan lots of support for after the birth. If you don’t get ill you’ve lost nothing and the extra help may have prevented the illness returning.

There is some evidence that extra psychological help, such as talking therapy in pregnancy, can reduce your risk of getting postnatal depression again. Your GP can refer you for this.