Postnatal depression, much more than the ‘baby blues’
Having a baby and becoming a parent is life-changing. While it is often a positive experience for many parents, it can also be a challenging time. Some parents find it hard to cope and may develop depression, especially if they have experienced depression before.
Depression during and after pregnancy is quite common, affecting up to 1 in 7 mothers. When it coincides with the arrival of a new baby, it can be particularly hard to deal with. We explain what postnatal depression is, how to spot the tell-tale signs, and where to get more help and information.
It’s normal to feel quite emotional during your pregnancy and in the days after your baby is born. You may feel a bit teary or down, especially if it's your first baby. This is often referred to as the 'baby blues' and it affects around 80 percent of new mothers.Usually, most women find their mood improves after a few days.
However, for some women these emotions become overwhelming, affecting their ability to go about their everyday lives. If these feelings don’t lift after 2 weeks, this may indicate the medical condition of postnatal depression. Postnatal depression is different from the 'baby blues', and can develop at any time up to a year after having a baby.
Symptoms can begin at any time within the first year. They can vary in severity but are generally similar to those of depression and may include:
- Persistent low mood
- Low self-esteem and loss of confidence
- Feeling guilty and/or inadequate
- Not enjoying time with your baby
- Not enjoying things you used to enjoy
- Difficulty sleeping unrelated to your baby’s sleep needs
- Feeling like you can’t cope with caring for your baby
- Worrying excessively
- Thoughts of hopelessness and maybe even self-harm
- Loss of appetite or excessive eating
These symptoms can also be experienced by men. People sometimes worry they will harm their baby but those with postnatal depression rarely do so.
The exact cause of postnatal depression isn't known – it may be several factors working together including:
- Physical changes: hormone changes after birth may affect your mood. The demands of becoming a new mother may be overwhelming; broken sleep and tiredness can also play a part
- Emotional changes: adjusting to the extra responsibility of looking after a totally dependent baby can be daunting. Some babies cry more than others, which can make them more difficult to look after. Your relationship with your partner may change as you focus on your child, and you may be less interested in sex for some time after childbirth. The birth experience itself can sometimes be disappointing or traumatic.
- Social changes: caring for a baby often leaves little time for work or socialising. Lack of support, difficult relationships within the family and financial worries can also be factors.
- Genetics: depression can run in families but the genetic factors are not clearly understood. If your mother or sister experienced postnatal depression, it doesn’t necessarily mean you will. And if it doesn't run in your family, that doesn't mean you aren't at risk. Knowing the signs and symptoms of postnatal depression can help you recognise them if they occur.
- Underlying mental health conditions: some women who are at risk of depression, or have experienced it, may be more likely to experience postnatal depression. This may explain why symptoms are sometimes detected in some women during pregnancy (antenatal depression).
Any pregnant woman is at risk of postnatal depression. It can happen after a miscarriage, stillbirth, a caesarean section or normal delivery. However, you may be more likely to develop it if:
- You've had depression or postnatal depression before
- Family members have depression or postnatal depression
- You don’t feel you can discuss your feelings with your partner
- You don't get much support from family or friends
- You've had other stressful events in your life (for example bereavement)
- You're in your teens or over 40
- The pregnancy was unwanted or unplanned
What should I do if I think I have postnatal depression?
Many women feel ashamed about their symptoms. They may blame themselves, their partner or their baby for the way they feel. Some mums dismiss their feelings through fear of being labelled a bad mother. Others may be reluctant to admit to themselves or to their friends and family that they are not coping.
However, it is important to remember that depression is a health problem like any other, and the good news is that it can be treated. If you delay seeking help, or leave it untreated, postnatal depression can get worse and have a greater impact on your life. Recognising the signs and getting help and support as early as possible can help reduce the impact of depression and achieve better health for mum and baby.
If you think you may have postnatal depression, or if your partner or other family members express their concerns, a good first step can be to talk to your midwife, maternal and child health nurse, or GP.
You may be referred for further counselling or other psychological treatments such as cognitive behavioural therapy (CBT) from a qualified mental health professional if necessary. CBT aims to reduce unhelpful thoughts and behaviours, and help you to develop ways of coping.
Your doctor may also talk to you about antidepressant medicines. These may help some people with their symptoms of depression and help prevent postnatal depression from recurring. There are antidepressants you can take while breastfeeding. It's important to follow your midwife or doctor's advice about the timing of feeds while taking these medicines, and to keep taking them even after your symptoms go away if your doctor advises you to do so.
Attending parenting classes or groups, preferably with your partner, may help you to feel less isolated and more in control. Practical measures, such as getting help with childcare so that you can have time off, can also be of benefit. Sharing experiences with other mothers affected by postnatal depression may also help.
Ask your GP, midwife or community health nurse about support groups in your area.
Better Health Victorian Government. Postnatal depression [Online] 2015 [Last updated Dec 2013; accessed Jan 2015] Available from: www.betterhealth.vic.gov.au
beyondblue. Depression [Online] 2015 [Accessed Jan 2015] Available from: www.beyondblue.org.au
Post and Antenatal Depression Association (PANDA). Postnatal depression factsheet [Online] 2010 [Accessed Jan 2015] Available from: www.panda.org.au
Raising Children Network. Postnatal depression [Online] 2014 [Last updated Jul 2014, accessed Jan 2015] Available from: raisingchildren.net.au
© Bupa Australia Pty Ltd January 2015. This information is intended as a guide only and should not be relied on as a substitute for professional medical advice. Bupa Australia Pty Ltd is not liable for loss or damage you suffer arising out of the use of or reliance on the information, except that which cannot be excluded by law. Consult your physician or other medical professional if you have questions.
Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.