Advice and resources : Postnatal depression advice

Overview

Postnatal depression is a type of depression that many parents experience after having a baby. It is common and affects more than 1 in 10 women within a year of giving birth - and can also affect fathers and partners. 

It is a lowering of mood that’s different to feeling flat, sad or miserable. It’s also more persistent, lasting more than a couple of weeks.

Having a baby is a huge life event that can impact on relationships, leave you feeling exhausted with disturbed nights and changes in your role (becoming a mum or dad) can be hard. But postnatal depression is treatable and probably more common than you think.

What you may see or feel

Many women feel a bit down, tearful or anxious in the first couple of weeks after giving birth. This is called the "baby blues" and is considered normal. They don't last for longer than two weeks after giving birth. 

If your symptoms last longer or start later, you could have postnatal depression. This can start any time in the first year after giving birth. It can develop gradually so can be hard to spot, but signs that you or someone you know may be depressed include:

• A persistent feeling of sadness and low mood
• You don’t get enjoyment out of things you would normally enjoy
• Inability to concentrate and make decisions
• Trouble sleeping 
• Lack of energy and feeling tired all the time
• Your appetite isn’t good and your enjoyment of food isn’t normal for you; or you’re losing weight
• Anxiety about everyday things might increase or, if you are someone with Obsessive Compulsive Disorder (OCD), the concerns and behaviours increase
• You go off sex and intimacy, and are irritable with people around you
• Difficulty bonding with your baby

It can be hard to care for yourself and a struggle to care for your baby, especially when getting up is hard work.

Sometimes when depression is more severe it can lead to thoughts of not wanting to be here or of wanting to harm yourself. This is a cause for concern.

There is no known cause for postnatal depression, but it has been associated with a history of mental health problems, a lack of support around you, stressful life events or a poor relationship with your partner. If you are pregnant and have a history of depression or mental health problems, or a family history of mental health problems after childbirth, tell your GP  so that they can offer appropriate monitoring and treatment if necessary.

What you can do

There are a number of things you could try to lift your low mood:

• Ask for help if you need it
• Let partners, friends and family help you, but if you’re finding them too intrusive it’s okay to ask for time to be alone
• Keeping in contact with friends is important, even if it is just a short phone call
• Do something each day, no matter how small, so you can look back and say you managed to do it
• Try and make time to do things you enjoy, and rest whenever you can
• Exercise and eating a healthy diet are good for low mood
• Try talking to friends and family about your feelings, if you find it too hard to talk about write it down and ask them to read it – it can be hard for those around you to understand how you feel and why it’s hard to do things
• Spend time cuddling, talking and reading to your baby. It’s time together that’s important
• On a bad day, when getting out of bed is difficult, remember that’s an achievement in itself and that’s before you start doing things to care for your baby.

Getting help when you need it will help you provide the best start for your baby. Talk to your health care professional such as your GP or Health Visitor; you won’t be telling them anything they haven’t heard before and they’ll know where to get help for you – remember 1 in 10 women experience postnatal depression If you’re prescribed medication such as anti-depressants make sure you take them regularly and don’t just stop taking them when you start to feel better

Post traumatic stress disorder (PTSD)

PTSD is a psychological disorder which can develop following a traumatic event, including traumatic birth experiences and/or perinatal loss.

It's perfectly natural to suffer distress following a traumatic event. Common experiences include bad dreams or nightmares about the event or persistent thoughts about what happened. People may also feel more emotional following a traumatic event including agitation, irritability and tearfulness.

Some people may want to avoid thinking about or talking about the event and others may try to use distraction, substances and/or engage in excessive activities (eg cleaning/work/exercise) as a way of coping.

Over time these feelings are likely to reduce, as people are able to emotionally process the traumatic event. However, for some, these experiences intensify and they start to feel worse and symptoms of PTSD increase or develop.

If you're concerned that you, or someone close to you, is struggling to come to terms with their birth experience, or is experiencing related distress and/or symptoms of PTSD, please speak to your health care professional about your concerns.

Perinatal PTSD is a treatable disorder requiring psychological help so getting support if you're concerned for yourself or someone close to you will be really helpful. 

Below, in her own words, one of our patients shares her story of her experience of birth trauma and PTSD, and her recovery.

When to ask for help

If any of the signs and symptoms described above last for more than two weeks, or if you’re having thoughts of harming yourself or your baby, speak to your GP, midwife or health visitor as soon as possible.

If your GP or Health Visitor think you require additional support, they can refer you to the specialist perinatal service in Berkshire who look after women with moderate to severe mental health problems. They may be able to recommend a self-help course, or refer you for a course of therapy. If your depression is more server or other treatments haven't helped, your doctor may prescribe an antidepressant that's safe to use while breastfeeding if necessary.

If you’re having thoughts of ending your life, you must tell someone. Use emergency services if you have acted on these thoughts and require immediate medical attention, or tell your GP or Health Visitor urgently so that they can make the referral to the right service to support you.

Visit our perinatal mental health pages for more information on our services.

• Specialist Perinatal Mental Health Service

Helpful resources

• Sands - pregnancy and baby loss charity
• Cry-sis - supporting parents and carers with crying and sleepless babies
• PANDAS - Perinatal mental illness charity
• Mind - Perinatal mental health support and services
• NHS - postnatal depression
• Tommy's - pregnancy and baby loss charity
• The Miscarriage Association - pregnancy loss support charity
• Maternal OCD