Postnatal depression: causes, symptoms and treatment

As many as one in five women experience mental health issues after birth, with depression being one of the most common problems.

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This page was clinically reviewed by Dr Donna Grant (MBBS, MCRPsych, BSc Hons), Consultant Psychiatrist at Priory Hospital Chelmsford, in November 2021.

What is postnatal depression?

Depression in the postnatal period (the first year after a baby is born), is known as postnatal depression. It’s also sometimes referred to as postpartum depression.

It’s common to experience a wide range of emotions during the first year after the birth of a baby. Becoming a parent is one of the most significant life transitions that you'll experience; it can be the most rewarding thing you’ve ever done and yet also one of the most challenging. Sometimes you may feel happy and excited. At other times you may feel worried, anxious, overwhelmed or negative - all of which can be signs of postpartum depression. Postpartum depression doesn’t just affect new mums either; it’s possible for partners and men to experience it too.

Unfortunately, on some occasions, women, their families, and even health professionals don’t recognise that new mums have postnatal depression, which means that lots of women wait much longer than needed before having treatment. Some potential reasons for this include:

  • You may wrongly assume that your symptoms are a normal part of adjusting to having a new baby, so you might not speak to anyone about how you’re feeling
  • You may worry unnecessarily that if you admit you’re struggling, health professionals may think you can’t care for your baby
  • You may feel guilty about not being happy and excited following the birth of a baby, so may be ashamed to admit you’re going through a tough time

Anyone can be affected by mental health issues in the postnatal period, so you shouldn’t be afraid to ask for help if you think you might be unwell.

Postnatal depression symptoms

Depression in the postpartum period shares many similarities with other types of depression. The main difference is that your anxious and negative thoughts, which are common in depression, are often focused on your new baby.

Also, some of the symptoms of postpartum depression overlap with some common post-birth symptoms.

Postnatal Depression Symptoms

Symptoms of postpartum depression include:

  • Low mood, irritability, and tearfulness
  • Loss of interest and enjoyment – not enjoying things that you usually enjoy and not enjoying spending time with your new baby
  • Anxious thoughts – it’s common to worry about many things when you have a new baby. In postpartum depression, these anxious thoughts are more frequent and severe. Common worries may be a feeling that you’ve done something wrong when looking after your baby, or whether something or someone will harm your baby. You may also be afraid to be on your own with your baby. Your anxious thoughts may also cause physical symptoms of anxiety
  • Negative thoughts – such as thinking you’re a bad mother or your baby won’t love you. You may also doubt your ability to cope with looking after your baby
  • Guilty thoughts – feeling guilty for feeling depressed and thinking this is your fault, even though it isn’t
  • Hopelessness – a feeling that things will never get better or that life isn't worth living
  • Suicidal thoughts and self-harm – you may think about ways to harm yourself. These thoughts are common in depression and not everyone acts on them. If you have an urge to harm yourself, seek crisis support immediately
  • Fatigue and low energy – this is common when you have a baby but can be worse when you have postpartum depression
  • Poor sleep – it’s common to have poor sleep with a new baby, but in postpartum depression, you may not be able to sleep even when your baby is asleep
  • Poor appetite – many women find that their appetite increases when they’re breastfeeding and caring for a baby. However, in postpartum depression, you may find that you have little to no appetite
  • Avoiding people – not wanting to see or speak to family or friends, or attend any postpartum groups
  • Self-neglect – if you have severe postpartum depression, this can have an impact on your ability to look after yourself. You may not take care of your personal hygiene and you may find it hard to get out of bed and manage what are usually easy daily activities

Postnatal depression vs the ‘baby blues’

Following the birth of a baby, 50 to 80% of women also go through what's known as the ‘baby blues’. This usually starts within 3 to 4 days of giving birth and tends to resolve within 2 weeks.

Symptoms include:

  • Mood swings, irritability, low and anxious mood
  • Becoming tearful easily
  • Overreacting to things
  • Feeling overwhelmed

The baby blues are thought to be mainly down to hormonal changes that are happening in the body. However, unlike postpartum depression, the baby blues usually resolves on its own without any treatment and doesn’t tend to affect your daily functioning.

If you find that you’re still experiencing the above symptoms for more than 2 weeks, it might be that you’re struggling with postnatal depression as opposed to the baby blues. If this is the case, it’s really important that you get help.

What causes postnatal depression?

There isn’t a single cause for postpartum depression. There are lots of different biological, psychological, and social factors that can become a cause of depression in the postpartum period.

potential causes of postpartum depression

Some of the factors that are linked to postpartum depression include:

  • Previous or current mental health issues, including depression
  • Experiencing depression or anxiety during pregnancy
  • Previous or current stressful events in your life
  • Lack of support from friends or family, especially in the postpartum period
  • Certain personality traits such as being a perfectionist or having low self-esteem
  • A traumatic birth experience
  • Complications in your pregnancy or in a previous pregnancy
  • Your own experience of childhood and relationships with your parents

How to cope with depression in the postnatal period

If you're struggling with low mood and symptoms of depression in the months after having a child, it's worth bearing in mind these few key strategies, thought processes, and principles that might help you to cope.

  • Try to be realistic - childbirth is a significant life event and the majority of women have a strong desire to be the best mother they can possibly be. However, it's crucial to identify the difference between aspiring to be perfect and expecting to be perfect. Motherhood can seem a daunting role to adjust to and it's helpful to try and cultivate a balanced image of motherhood that includes both negative and positive aspects
  • Don’t be a superhero - most people aren't very good at accepting help, but in reality, you're likely to need some help when you've got a new baby. If you should become clinically depressed postnatally, everything will seem so much harder. Try not to feel embarrassed about asking for help. Consider people you feel you can rely on. Don’t assume that those closest to you, which may include your partner, your own mother or your best friend, will know instinctively what your needs are unless you express them
  • Don’t neglect your own needs - most new mothers feel they are in second place to their babies. Remember that your physical and emotional health will affect your ability to care for your infant. Make sure you try to identify, prioritise and address your own needs. Basic functions such as maximising sleep, eating as healthily as possible and trying to get some exercise can be enormously beneficial
  • Seek help - don't feel ashamed or embarrassed about asking for help. Try to discuss your feelings with your health visitor or GP, who'll be able to assess you and offer the most suitable management options
Martina discusses her experiences with postnatal depression

Postnatal depression treatment

At Priory, we can provide specialist treatment for postnatal depression through our nationwide network of hospitals and wellbeing centres. We can also provide help for antenatal depression (depression during pregnancy).

Your mental health during pregnancy and after the birth of a baby is just as important as your physical health at these times. The right treatment will help you stay as well as possible and enjoy family life.

Depending on how severe your postnatal depression symptoms are, we can offer a number of different treatment programmes:

We can also offer lots of different therapy formats to help you with your postpartum depression. These include:

  • 1:1 therapy
  • Group therapy
  • Family therapy

The main type of therapy that we use in postpartum depression treatment is a technique known as cognitive behavioural therapy (CBT). This helps you to change your negative thinking patterns, which are common in postnatal depression. During pregnancy or after birth, depression can mean that you lack confidence or judge yourself negatively as a parent. CBT aims to give you the techniques to challenge these thoughts and improve your mood. It can help you to feel more confident in being a parent and to enjoy your pregnancy, baby, and other children more.

Antidepressants for postnatal depression

Antidepressants can be used on their own or alongside CBT to treat antenatal and postnatal depression. If you have more severe depression, or if your depression hasn't improved with talking therapy, this may mean you need antidepressant medication.

There are lots of different types of antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are most commonly used to treat depression in pregnancy and after birth. These help to restore the balance of chemicals in your brain that are known to regulate mood and emotions. You may have been taking antidepressants before you were pregnant, or you may need to start taking them during pregnancy or after birth.

Whatever the case, you should discuss the safety of antidepressants in pregnancy and breastfeeding with your doctor. Your doctor will help you to weigh up the benefits of this type of treatment in your individual case. If you're already taking antidepressant medication when you get pregnant, it’s important that you don’t stop taking this without getting professional advice first.

Depression following the birth of a baby can have a devastating impact on what can be a joyous time in your life. It’s important to remember that postpartum depression is entirely treatable, and with specialist help, you can recover and enjoy family life.

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