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Postnatal depression


Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
Next review due March 2022

Postnatal depression is a type of depression that you can develop after having a baby. At a time when everyone expects you to be feeling happy, you may be feeling very low. But with the right help and support, postnatal depression can be treated successfully.

A woman is holding her baby

What is postnatal depression?

It’s very common to feel overwhelmed, tearful and low for a few days after your baby is born — this is sometimes called the ‘baby blues’. Baby blues usually start two or three days after your baby is born and are over within two weeks. But postnatal depression is more than the baby blues.

Postnatal depression is common; it happens to more than one in 10 women. It often starts within a month or two of giving birth but it can start several months after having a baby. Postnatal depression doesn’t just affect a baby’s birth mum — dads can also feel depressed after having a baby. Studies suggest that around one in 10 men may be affected. And partners in same sex couples can get postnatal depression too.

Postnatal depression is an illness that can happen to anyone and it’s not your fault. It’s really important to get help quickly from your midwife or GP if you think you might be depressed. This is because postnatal depression can seriously affect you, your baby and your family. There are successful treatments that will help you feel better. If you think your partner may have postnatal depression, see our FAQ: My partner has postnatal depression — how can I help? for tips and advice.


If you need help now

This page is designed to provide health information about postnatal depression. If you need help now, the following helpline is free for you to call and talk to someone.

  • Samaritans
    116 123 (UK and ROI)

Alternatively, follow this link to Mind’s website and click on the yellow ‘I need urgent help’ button at the top left of the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you need immediate help or are worried about someone, call the emergency services.

Symptoms of postnatal depression

Postnatal depression symptoms are similar to depression at other times of life. But they start within a year of giving birth.

It’s common for people to dismiss their feelings or hide them through fear of being judged and labelled a bad parent by others.

Other signs of postnatal depression may include:

  • feeling tired (as do all new parents) but you’ll be completely lacking in energy
  • feeling low and tearful
  • problems sleeping (again, like all new parents) but you may lie awake worrying or wake early even if your baby is asleep
  • changes to your weight
  • losing your appetite or comfort eating
  • not enjoying your usual activities
  • feeling guilty and worthless
  • problems concentrating
  • not wanting to see friends and family

You may find it hard or even impossible to get into a routine or cope with your new baby. You may also feel detached from your baby and unable to bond with them. If you have postnatal depression, you may worry constantly, thinking that something bad will happen to your baby.

It’s very rare for parents with postnatal depression to harm their babies but out of desperation or tiredness you may worry that you’re going to. If you feel this way, it’s important to get some help straightway.

Postpartum psychosis

There’s a very serious form of depression that can happen after having a baby, called postpartum psychosis. It’s rare — it only affects about one in 1,000 women. If you have postpartum psychosis you may:

  • have a high or low mood, and rapid mood swings
  • have hallucinations where you see or hear things that aren’t there or lose touch with reality — you may believe things that aren’t true (delusions) and show behaviour that is out of character

The symptoms usually start within a couple of weeks of having a baby.

Postpartum psychosis is a serious condition. If you’re having any of these symptoms, contact your GP immediately so you can have an assessment and be treated as soon as possible. If your thoughts are affecting how you’re caring for your baby or are about harming yourself or your baby, get urgent help. Go to the accident and emergency department of your local hospital. If your thoughts are strong and intense, call 999.

If you suspect that someone close to you is having these symptoms, contact their GP or the emergency services and stay with them.

Effective treatments for postpartum psychosis are available. You’ll need immediate treatment in hospital under the care of a psychiatrist (a doctor who specialises in mental health). Sometimes a specialised parent and baby unit can provide treatment, so that your baby can stay with you. But this isn’t always possible — the important thing is to get effective treatment early.

The rest of this topic covers postnatal depression only.

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Diagnosis of postnatal depression

If you think you may be depressed, the most important thing to do is to tell your GP or midwife. They can help you get the help and support you need to feel better and look after your baby. Some women feel bewildered or ashamed of their symptoms and put off telling anyone. But getting help as soon as possible is the best thing you can do for you and your baby. Postnatal depression can cause you suffering and can affect the relationships you have with your baby and partner. It’s important for everyone that you get treatment quickly.

Postnatal depression can also affect your baby’s development. See our FAQ: Will postnatal depression affect my child? for more information about this. Remember that postnatal depression can be treated.

Your midwife, health visitor or GP will often ask you about your mental health and how you’re feeling. They may ask you 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?

Your GP, midwife or health visitor may use other sets of questions to help diagnose postnatal depression. For example, the Edinburgh Postnatal Depression Scale has 10 simple questions and a scoring system.

Treatment of postnatal depression

You may find that treatment for postnatal depression takes a bit longer than you expected. For most parents, it usually lasts about three to six months, but for some it may be a year or longer.

The type of help and treatment you need will depend on how severe your postnatal depression is and if you’ve had depression before. Your GP or health visitor can explain what help and support is available and together you can make a decision that’s right for you.

Self-help

There are many things you can do to help yourself cope with postnatal depression. Here are some suggestions.

  • Talk to your partner, friends or family about your feelings and how they can help you. Tell your health visitor or GP how you’re feeling.
  • Sleep or rest whenever you can — get some rest while your baby sleeps.
  • Find local groups for new parents. Ask someone to go with you if you find it difficult at first.
  • Accept offers of help with housework, shopping and childcare, and don’t feel guilty about accepting support.
  • Take up any babysitting offers so you can find time to do things you enjoy. Go out with a partner or friend to get a break.
  • Get in touch with organisations that support parents with postnatal depression. See our ‘Other helpful websites’ section for contact details.
  • You may find a self-help manual useful. Ask your health visitor about these.
  • Eat a healthy balanced diet even if you don’t really feel like eating.
  • Get some regular exercise. Perhaps a mother-and-baby exercise class or just a walk in the fresh air.

The most important thing is to be kind to yourself — you’re going through a tough time. And try not to blame others or take it out on your partner and family who are supporting you.

Talking treatments 

Talking therapies can be used to treat mild or moderate postnatal depression. An example is cognitive behavioural therapy (CBT). CBT looks at how you think about a situation and how you act and how both of these things can affect each other. You will work with a therapist to change the way you think about things and how you behave.

Medicines

If you have severe postnatal depression, your doctor may prescribe antidepressant medicines. Alternatively, you can request these medicines if you think you have severe or moderate depression. Your GP may offer antidepressants if you have mild or moderate depression and other treatments haven’t worked for you. You can have talking therapies at the same time as taking antidepressants.

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 doctor may advise you to keep taking them for some time once you start to feel better.

If you’re breastfeeding, let your doctor know. 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. Your doctor will advise which medicines are best to take while you’re breastfeeding.

Always read the patient information leaflet that comes with your medicine carefully. If you have any queries about your medicines or how to take them, ask your pharmacist.

Causes of postnatal depression

There’s rarely a single cause for depression and several factors usually work together. Postnatal depression can happen to anyone and it’s important to know that it’s not your fault. Having a baby is a huge life change. Adjusting to the extra responsibility of looking after a totally dependent infant is demanding.

There are many factors that affect your chance of getting postnatal depression. You’re more likely to get it if:

  • you’ve had mental health problems, including depression before
  • you’ve had depression or anxiety during your pregnancy
  • you’ve had the ‘baby blues’
  • you don’t feel that you have adequate support
  • you had relationship problems with your partner that were happening during your pregnancy
  • you’ve had a recent stressful life event; for example, bereavement or you’ve lost your job

You may also be more likely to develop postnatal depression if:

  • it took a long time for you to get pregnant
  • your partner is depressed
  • your pregnancy wasn’t planned
  • you’re not breastfeeding
  • you have two or more children
  • you’re unemployed
  • you have a family history of postnatal depression
  • you’re struggling with the extra responsibility, money worries or the changing relationship with your partner after having a baby

But remember, you can become depressed without any of these. And if some of these factors apply to you, it doesn’t mean that you will get postnatal depression.

Frequently asked questions

  • If you have postnatal depression, you may not be able to look after your baby as well as you would if you were well. You may find it hard to interact with or respond to your baby in a positive way.

    We know that this can affect your child’s development in both the short and the long term. Having a parent with postnatal depression can affect a child’s social relationships and behaviours, how they develop at school and their emotional development.

    Ask for help and support from your GP or health visitor if you think you might have postnatal depression. By getting help for yourself quickly, you’ll be doing the best for your baby.

  • If someone you care about has postnatal depression, there’s a lot you can do to support them. Here are some suggestions.

    • Encourage them to talk to their health visitor or GP, and to follow any advice. Postnatal depression is treatable.
    • Spend time with them, listen to them and don’t be dismissive about their worries. Reassure them that they’ll get better.
    • Be careful with the language you use. Ask a GP or health visitor if you need help with this.
    • Offer practical help with the baby and with jobs such as cooking, housework and shopping.
    • Try and arrange some time for them without their baby, so they can do something enjoyable just for themselves.
    • Encourage them to get out and meet with family and friends. Help them find local groups for new mums and dads.
    • If you’re their partner, try not to feel resentful if you’re getting less attention from them. They need your help and support.

    Remember, parents with postnatal depression often find it hard to talk about it or even let others know what they’re feeling. You can help by reassuring them that it’s not their fault. Help them realise that seeking help is the best thing they can do for themselves and their baby.


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Related information

    • Postnatal depression. BMJ Best Practice. bestpractice.bmj.com, last reviewed December 2018
    • Postnatal depression. Royal College of Psychiatrists. www.rcpsych.ac.uk, published July 2015
    • Carlberg M, Edhborg M, Lindberg L. Paternal perinatal depression assessed by the Edinburgh postnatal depression scale and the Gotland male depression scale: prevalence and possible risk factors. Am J Men’s Health 2018; 12(4):720–29. doi: 10.1177/1557988317749071
    • What issues do lesbian co-mothers face in their transition to parenthood? NCT. www.nct.org.uk, published March 2017
    • Abelsohn KA, Epstein R, Ross LE. Celebrating the “other” parent: mental health and wellness of expecting lesbian, bisexual, and queer non-birth parents. 2013. doi: 10.1080/19359705.2013.771808
    • Depression – antenatal and postnatal. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised November 2018
    • Antenatal and postnatal mental health: clinical management and service guidance. National Institute for Health and Care Excellence (NICE). April 2018. www.nice.org.uk
    • Antidepressant drugs. NICE British National Formulary. bnf.nice.org.uk, reviewed 18 December 2018
    • Postnatal depression and perinatal mental health. Mind. www.mind.org.uk, published July 2016
    • Sign 127 Management of perinatal mood disorders. Scottish Intercollegiate Guidelines Network (SIGN). March 2012. www.sign.ac.uk
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, March 2019
    Expert reviewer, Dr Rahul Bhattacharya, Consultant Psychiatrist
    Next review due March 2022



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