Most people today have heard the term ‘baby blues’ used to describe a mild short, period of depression which many women experience after childbirth. Fewer people are aware that as many as 10% of all recently delivered women develop postnatal depression. In a proportion of these mothers, the depression may be of such severity that they need psychiatric help and many need drug therapy.
After the birth
The ‘baby blues’ usually arrive within the first week after the birth of the baby usually corresponding with when the milk ‘comes in’. The mother may feel very emotional and find that she keeps bursting into tears. She cannot explain why she is upset and is not easily cheered up.
Some mothers begin to feel depressed, increasingly despondent and hopeless soon after the baby is born. They may feel terribly miserable and sad for no particular reason and may find that they spend a large part of each day in tears. Sometimes the mother may feel rejected by her partner, family, friends’, or even by the new baby; these feelings usually have no foundation.
The depressed mother may feel permanently tired and lethargic, unable to cope with household chores. She may give up bathing, dressing properly or applying make-up.
Sometimes the care of the baby is too much for the mother whilst she is unwell and someone else must be found to ‘take over’ until she has recovered. It is usually inadvisable to separate the mother from her baby, as this may serve to deepen the depression.
A depressed mother may feel extremely anxious about a variety of subjects and situations. She may be worried about her health, possibly having felt unwell since the birth of the baby. She may experience severe pain for which the doctor can find no satisfactory explanation. This pain is often in the head or neck. Other mothers suffer a backache, and chest pains which they fear are due to heart trouble but are most probably symptoms of panic. The mother may have a number of minor medical complaints which can cause undue distress.
Pain and a general feeling of illness or constant tiredness are very common symptoms of depression. and can become worse if the depression remains untreated.
Causes of postnatal depression
The cause of postnatal depression isn’t completely clear. Most experts think it’s the result of a combination of factors.
These may include:
- depression during pregnancy
- a difficult delivery
- lack of support at home
- relationship worries
- money problems
- having no close family or friends around you
- physical health problems following the birth, such as urinary incontinence (loss of bladder control), or persistent pain from a Caesarean section scar or stitches. Even if you don’t have any of these problems and your pregnancy and labour are straightforward, having a baby can be a stressful and life-changing event that can sometimes trigger depression.
People often assume they’ll naturally adapt to parenthood overnight. However, it can take months before you begin to cope with the pressures of being a new parent. This is true even for those who already have children.
In addition, some babies are more difficult and demanding than others and don’t settle so easily. This can lead to exhaustion and stress.
Who’s at risk?
Factors that can increase your risk of experiencing postnatal depression include having:
- a family history of depression or postnatal depression (genetics appears to play a role in both of these conditions but exactly how is still unclear)
- previously experiencing depression, postnatal depression or other mood disorders
Treating postnatal depression
Speak to your GP, midwife or health visitor as soon as possible if you think you have postnatal depression.
It’s important for you and your family to remember it can take time to recover fully from the condition.
Common treatments and help for postnatal depression include :
Support and advice
The most important first step in managing postnatal depression is recognising the problem and taking action to deal with it. The support and understanding of your partner, family and friends play a big part in your recovery.
However, to benefit from this, it’s important for you to talk to those close to you and explain how you feel. Bottling everything up can cause tension, particularly with your partner, who may feel shut out.
Support and advice from social workers or counsellors can also be helpful. Self-help groups can provide good advice about how to cope with the effects of postnatal depression, and you may find it reassuring to meet other women who feel the same as you.
Ask your health visitor about the services in your area.
Exercise has been proven to help depression, and it’s one of the main treatments for mild depression. A postnatal exercise programme has helped many women with mild depression and anxiety.
Psychological therapies are usually recommended as the first line of treatment for mild-to-moderate postnatal depression for women with no previous history of mental health conditions.
Some common ones are discussed below.
Guided self-help is based on the principle that your GP can “help you to help yourself “ by recommending books interactive computer programmes or talk therapies
An online interactive computer programme called Beating the Blues is one such programme This uses a cognitive behavioural approach (CBT) to battling depression.
Cognitive behavioural therapy
CBT is a type of therapy based on the idea that unhelpful and unrealistic thinking leads to negative behaviour.
CBT aims to break this cycle and find new ways of thinking that can help you behave in a more positive way. For example, thinking there’s a perfect ideal of “motherly behaviour” that is both unrealistic and unhelpful. All mothers are human and humans make mistakes. It’s neither necessary nor helpful to try and be “Supermum”.
These medications work by balancing mood-altering chemicals in your brain. They can help ease symptoms such as low mood, irritability, lack of concentration and sleeplessness, allowing you to function normally and help you cope better with your new baby. Contrary to popular myth, antidepressants aren’t addictive. A course usually lasts six to nine months.