home

Postnatal depression

Published by Bupa’s Health Information Team, October 2011.

The factsheet is for women who have postnatal depression, or anyone who would like information about it.

Postnatal depression is depression that develops within a year of having a baby. If left untreated, it can cause serious problems with the mother’s relationships with her baby and partner.

About postnatal depression

It’s very common to feel tearful and low for a few days after the birth of your baby – this is known as the ‘baby blues’. At least of half of all mothers are affected, especially if it’s your first baby. Usually your mood will improve after 10 to 14 days. Postnatal depression is much more than the ‘baby blues’.

Postnatal depression is common and affects about one to two out of every 10 mothers. It often starts within one or two months of giving birth, however, it can start several months after having a baby.

Typical symptoms are similar to those of depression at other times. You may feel low all the time, find simple tasks difficult to manage and have reduced energy levels. Depending on the severity of your postnatal depression, you may find it difficult to look after yourself or your baby.

Puerperal psychosis

About one in 1,000 women get a mood disorder called puerperal psychosis. You may have severe depression with symptoms such as hallucinations, loss of contact with reality, thought disturbances and out of character behaviour. If you get puerperal psychosis, you will need to go to hospital and see a psychiatrist (a doctor who specialises in mental health). Ideally this will be in a specialised mother and baby unit where you can have your baby with you.

Symptoms of postnatal depression

Many symptoms of postnatal depression are similar to depression at other times of life, but they start within the first year after your baby is born. Symptoms usually begin within three months, although there are almost always signs of depression after one month.

Symptoms can often come on gradually, or you may notice them all of a sudden.

It’s common for women to dismiss their feelings, or hide them through fear of being labelled a bad mother.

You may feel unable to cope with your baby or get into a routine. You may also feel detached from your baby and not close to him or her. If you have postnatal depression, you may worry constantly, thinking that something bad will happen to you or your baby.

It’s very rare for women with postnatal depression to harm their babies, but out of desperation or tiredness you may worry that you’re going to. Mothers who don’t have postnatal depression can also feel like this sometimes.

Other symptoms may include:

  • low mood or tearfulness
  • loss of appetite or comfort eating
  • tiredness or fatigue
  • feelings of guilt and worthlessness
  • not wanting to see friends and family
  • anxiousness
  • loss of interest in sex
  • difficulty sleeping
  • irritability

These symptoms aren’t always caused by postnatal depression, but if you have them, see your GP.

Causes of postnatal depression

There is rarely a single cause for a bout of depression and several factors usually work together.

Adjusting to the extra responsibility of looking after a totally dependent infant can be demanding. All babies are different, for example some cry more than others, which can make them more difficult to look after.

You may find that your relationship with your partner has changed as you focus your energy on childcare. It’s common to be less interested in sex for a time after childbirth, which may put additional strain on your relationship. Giving birth can be traumatising, and you may feel out of control and frightened. You may have stopped work and find that you have less social life, lower status and reduced income.

Depression tends to run in families so it’s likely that some genetic factors are important, although these aren’t clearly understood.

Other causes include:

  • depression or postnatal depression in the past
  • having had the ‘baby blues’
  • not getting support from family and friends
  • recent stressful life event, for example bereavement

Some studies have also shown that you may be more likely to be affected by postnatal depression if:

  • it took a long time to conceive
  • the father is depressed
  • your pregnancy wasn’t planned
  • you’re not breastfeeding
  • you have two or more children
  • you’re unemployed

Diagnosis of postnatal depression

Many women feel bewildered or ashamed of their symptoms and delay seeking help. However, it’s important you get help – if left untreated, postnatal depression can last for many months or, more rarely, for years. It can damage your relationships with your baby and partner and have a negative effect on your baby’s development.

Midwives, health visitors and GPs usually ask new mothers about their mental health. You may be asked the following questions.

  • During the past month, have you often been bothered by feeling down, depressed or hopeless?
  • During the past month, have you often been bothered by having little interest or pleasure in doing things?

Depending on your answers you may also be asked:

  • Is this something you feel you need or want help with?

A questionnaire to help health professionals spot women at risk is regularly used with new mothers. The most commonly used is the Edinburgh Postnatal Depression Scale, which has 10 simple questions and a scoring system.

Treatment of postnatal depression

For most people postnatal depression usually gets better over time. The type of help and treatment you need will depend on how severe your postnatal depression is. Your GP can advise you on the type of help you may need.

If you have very severe postnatal depression, you may be admitted to hospital. Ideally this will be to a mother and baby unit so your baby can stay with you.

Self-help

There are some things you can do to help your postnatal depression. These include:

  • parenting classes with your partner
  • attending local groups for new mothers or postnatal support groups
  • getting support with childcare or help around the house
  • taking time out for yourself – even if it’s just visiting friends or reading a magazine
  • thirty minutes of exercise a day to boost levels of endorphins, your body’s ‘happy hormones’
  • eating healthily
  • getting as much sleep as you can – try to sleep when your baby does
  • complementary therapies, such as massage and reflexology for relaxation
  • talking to friends, family or other mothers who have been affected by postnatal depression

Talking treatments

Talking about your feelings can be helpful no matter how severe your postnatal depression is. Your GP can arrange counselling, sometimes you can see a counsellor at your local practice. Other types of talking treatments are listed below.

  • Cognitive behavioural therapy (CBT). This helps to challenge negative thoughts, feelings and behaviour.
  • Interpersonal counselling. This focuses on your past and present relationships.

Medicines

If you have severe postnatal depression, there are several types of antidepressants available. They all have different side-effects, so you may have to try several before you find the most suitable one for you. Your GP may prescribe you selective serotonin re-uptake inhibitors (SSRIs) or tricyclic-related medicines. Some antidepressants take at least two weeks to start working and you may need to take them for several months. To help prevent your postnatal depression returning, your GP may advise you to keep taking them for some time once you start to feel better.

It’s possible to continue breastfeeding if you’re taking certain antidepressants. Small amounts of the medicine can be passed on to your baby through your breast milk. Some antidepressants are thought to be safer for your baby than others. It’s important to discuss with your GP what type of antidepressant may be suitable for you if you’re breastfeeding. You will be prescribed the medicine that has the least risk for both you and your baby, and you will usually be started on the lowest possible dose.

Always ask your doctor for advice and read the patient information leaflet that come with your medicine.

 

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.

Share with others


  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

    Approved by Plain English Campaign The Information Standard memberHON Code

     

  • Publication date: October 2011

Already a Bupa Member?

Find a mental health therapist near you.

Search for a therapist