What is postnatal depression?
Postnatal Depression is a depressive illness which affects 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 (127).
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 which 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:
Depressed: 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.
Irritable: You may get irritable or angry with your partner, baby or other children.
Tired: All new mothers get pretty tired. Depression can make you feel utterly exhausted and lacking in energy.
Sleepless: 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.
Appetite changes: 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: 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 (101).
Anxious: 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, you might harm your baby, you have a physical illness, your PND will never get better (101). You may be so worried that you are afraid to be left alone with your baby. You may need re-assurance from your partner, health visitor or GP (127). When you feel anxious, you may have some of the following: racing pulse, thumping heart, breathless, sweating, 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.
Hopeless: 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 (127).
Which treatments are available?
The treatment you need depends on how unwell you are. You should be told about all the likely benefits and risks of treatment so you can make the best choice for you (127).
Talking about your feelings can be helpful, however depressed you are. Sometimes, it's hard to express your feeling to someone close to you.
Talking to a trained counsellor or therapist can be easier. It can be a relief to tell someone how you feel. It can also help you to understand and make sense of your difficulties (127).
There are also more specialised psychological treatments.
Cognitive Behavioural Therapy can help you to see how some of your ways of thinking and behaving may be making you depressed. You can learn to change these thoughts which have a positive effect on other symptoms.
Other psychotherapies can help you to understand the depression in terms of your relationships or what has happened to you in the past (127).
A problem with talking therapies is that they are still hard to get in some areas. National guidelines state that women with PND should be seen within a month. In reality, there are often long waiting lists. This means you may not get any treatment for quite a while (127). Counselling and Psychotherapy may be provided via Skype and FaceTime in the comfort of your home, office or any place of your choice.