Postnatal Depression
What is Postnatal Depression?
Postnatal depression (PND) affects around 10% of mothers, and is much more serious than the ‘baby blues’ which usually lasts between 1 to 3 days.
It can develop slowly and may not be noticeable until several weeks after the baby’s birth, or may continue on from baby blues.
Sadly, many mothers experience severe depression without recognising it as a treatable illness. This can mean the mother suffers needless distress which may also affect her family and friends. If a mother can recognise her condition, then she can seek medical help at an earlier stage of the illness.
What are the symptoms?
Most symptoms of postnatal depression start during the first year after your baby is born, usually within three months of the birth and are similar to symptoms of depression at other times in life. Symptoms of PND include:
• sad mood
• tearfulness
• feeling unable to cope
• anxiety / panic
• tension
• tiredness though difficulty sleeping
• unable to concentrate
• loss of interest in sex
• loss of appetite or opposite ‘comfort eating’
• lack of energy
In more severe cases, you may even have distressing thoughts about harming your baby, or even suicide. It is very rare for women with PND to harm their babies, but may feel so desperate you could worry that you are going to. Some mothers who don’t even have PND sometimes have these feelings.
Unfortunately whichever symptoms you may have, it is common to dismiss these feelings or hide them, due to worrying you will be thought of as a bad mother.
How will PND affect my life?
As you focus all your energy on looking after your baby, you will probably find that your relationship with your partner changes. You may be less interested in sex which could cause a strain on your relationship.
If you have stopped work, your social life plus your income will have lowered and this may add to your depression.
What are the causes?
There may be several factors which can cause PND. The drop in hormones after childbirth was thought to cause PND however, research has found no significant difference in hormone levels of women with PND and those without, plus treatment of hormones has not been effective.
The causes are more likely to be due to the combination of overwhelming life changes which a new baby brings. Some babies cry more than others and this can be extremely difficult to cope with; it is a demanding responsibility to look after a baby who is totally dependent on you!
You are more likely to get PND if:
• you have suffered depression or PND before or had the ‘baby blues’
• any members of your family have suffered from depression or PND
• you have a difficult relationship with your partner who you cannot discuss your feelings with
• you don’t get much help from family or friends
• you have experienced other stressful events recently, eg bereavement
• you or your partner have money worries
What types of treatment are available?
Postnatal illness is curable. With the right help, treatment and support you will recover fully.
Counselling and psychotherapy
Your GP can arrange counselling – some local practices have their own counsellor. Another type of psychotherapy commonly used is cognitive behavioural therapy.
How does cognitive behavioural therapy work?
Cognitive behavioural therapy tackles your negative thoughts. Cognitive behavioural therapy helps people think in a more balanced way and challenges a person's assumptions about their lives. It aims to identify and change aspects of behaviour that may cause or prolong symptoms of depression.
By helping you change the way you think about life, you'll be able to accept failures more easily and take credit for your achievements. Cognitive behavioural therapy aims to give you skills for life, reducing the likelihood of you becoming depressed again.
Click here for more information on cognitive behavioural therapy.
Antidepressants – what will I be given?
There are many different antidepressants. Your GP may prescribe you an SSRI (selective serotonin re-uptake inhibitor) such as fluoxetine (“Prozac”), or another type in the tricyclic-related family of medicines such as amitriptyline. Your course should last for several months and should be continued some time after your symptoms clear up so as to prevent PND coming back.
It is possible to continue breastfeeding when taking certain antidepressants. Your GP may advise taking your medication after breastfeeding and not to feed for a couple of hours afterwards. Or you could take a single dose of tablets before your baby has a long sleep.
How long will antidepressants take to work?
Antidepressants take time to have an effect, often a number of weeks, because they're helping nerve cells recover and resume their usual role in regulating mood.
Are antidepressants dangerous?
Antidepressants are not dangerous when you take them as prescribed. They are not addictive and can relieve your depression effectively. We will tell you about the possible side effects, but it is unlikely that you will have any.
What can I do to help myself?
Self-help can make a difference. Joining a self-help group is a great way to discover you are not alone and are not the only one to suffer from self-blame, rage and despair. Try to eat regularly and have a good diet, including fresh fruit and vegetables. Exercise will help relieve stress and tension, whether aerobic exercise such as jogging or more relaxing exercise such as yoga.
Please remember the following:
• Postnatal depression is an illness, not a sign of a bad mother
• treatment is effective and there are many treatment options available
• there is a suitable treatment for every person
• the aim of treatment is to get 100% well and stay well
Family support
Family should understand that the illness is temporary and that with their help and support you will recover fully. This may take some time before you are completely better. Try to get help around the house and ask them to babysit whilst you take a break.
Self help
Recommended reading:
This Isn’t What I Expected : Overcoming Postpartum Depression. By Karen Kleinman and Valerie Raskin
Surviving Post-natal Depression. By Cara Aiken
You can also check out the Marce Society online which offers much information about Postnatal mental illness. (www.marcesociety.com)
Finding help
Many women feel ashamed or worried about their symptoms, so do not seek help immediately. Contacting your GP is often the easiest way to get help and further treatment. He or she may offer you counselling or refer you to a specialist for further assessment. This may lead to outpatient treatment or, if more serious, day or inpatient treatment.
If you're worried about talking to your GP, consider writing down your concerns and questions. You can:
• take a friend or family member with you
• see another doctor in the practice; or
• join a new GP practice
The type of professional support offered will depend on the services that are available in your area and the arrangements that your primary care trust (PCT) have with other health authorities or private providers. Treatment for depression is also available privately through Priory.
If you feel that you or a close relative are affected by depression and would like help or more information, you can ask your GP or contact any of the following organisations:
The Association for Postnatal Illness 0207 386 0868 www.apni.org
Perinatal Illness UK (No helpline at present) www.pni-uk.com/messages
Parentline (24 hour helpline) 08088002222 http://www.parentlineplus.org.uk/
If you are interested in receiving treatment from us, your GP will be able to refer you.
If you or your relative has private medical insurance your insurer will probably insist that your GP refers you to us.
Why should I choose Priory?
Our service
Priory has specialist professionals who offer a service for new mothers suffering from severe mental health problems and who require professional support and guidance. We aim to foster development of the relationship between the mother and child and to promote understanding of the illness through parenting skills education and therapy. Where possible we involve family members in the treatment programme.
Our multi-disciplinary team provide the highest standards of care, understanding and service for everyone and our service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.
We admit patients 24 hours a day, seven days a week.
Find your nearest Priory hospital offering this service.