Postnatal depression

Your health experts: Dr Samantha Wild, General Practitioner, Bupa UK and Michelle Sheridan, Midwife, Bupa UK
Content editor review by Pippa Coulter, August 2021
Next review due August 2024

Postnatal depression is a type of depression that many people develop after having a baby. It can make you feel very low. But getting the right help and support will help you to feel much better.

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 and usually starts within three to 10 days after your baby is born. Baby blues usually pass off within a few days, without the need for treatment or additional support. Postnatal depression is more intense and lasts longer than the baby blues.

Postnatal depression is common – it affects between one and two in 10 women within a year of giving birth. You can get depression while you’re pregnant too. This is called antenatal or prenatal depression. You can also experience mental health problems if your partner is pregnant or has recently given birth.

Postnatal depression is an illness that can happen to anyone and it’s not something that’s your fault. But it can seriously affect you, your baby and your relationships. So if you think you might be depressed, it’s really important to get help as soon as possible from your midwife, health visitor or GP.

If you need help now

This page is designed to provide general health information. If you need help now, please use the following services.

Samaritans. 116 123 (UK and ROI) - This helpline is free for you to call and talk to someone.
NHS Services has a list of where to get urgent help for mental health.
Mind website. Click the ‘Get help now’ button on 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 think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999 or go to your local accident and emergency department.

Symptoms of postnatal depression

Postnatal depression symptoms start within a year of giving birth, often within a couple of months of having your baby. You’ll have symptoms most of the time, for two weeks or more. You may:

feel low and tearful much of the time
feel anxious or irritable
not enjoy things you normally do
feel guilty and worthless
find it hard to concentrate
feel exhausted and lacking in energy
have problems sleeping even when your baby is asleep
not want to see friends and family
lose your appetite or comfort eat
lack interest in your baby or partner, or have negative feelings towards them
have thoughts about harming yourself or your baby

Having a baby takes a lot of adjustment for anyone. But if you have postnatal depression, you may feel that you can’t cope and worry constantly about your baby. You may also feel detached from your baby and find it hard to bond with them.

Seeking help

If you think you may be depressed, tell your GP, health visitor or midwife. They won’t judge you – they’re used to helping women who have postnatal depression. They will be focused on getting you the help and support you need to feel better and look after your baby.

If you feel that you can’t look after your baby or are having thoughts about harming yourself or your baby, get urgent help. Either go to your nearest accident and emergency (A&E) department or contact one of the services listed in our section: If you need help now. You can also call 999 if necessary.

Postpartum psychosis

After having a baby, about one to two in 1,000 people develop a rare and very serious form of depression called postpartum psychosis. If you have postpartum psychosis, you may:

feel really happy and excited then severely depressed – often with rapid mood swings
have hallucinations where you see or hear things that aren’t there or have delusions where you may believe things that aren’t true
feel confused and disorientated

The symptoms usually start within days or weeks of having a baby and come on quite suddenly. 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 you need to, go to your local A&E department or contact one of the services in our section: If you need help now.

Diagnosis of postnatal depression

At your postnatal appointments, your midwife, health visitor or GP will usually ask you about your mental health and how you’re feeling. This is a good opportunity to tell them if you’re feeling low or depressed. You can also contact your health visitor or GP at any time if you need help for mental health problems. They’ll ask you some questions about how you’ve been feeling and talk to you about what help or support you might need.

Your health visitor or GP may be able to support you with your mental health and offer any treatments you need. Sometimes, they may suggest referring you to specialist mental health services. This might be perinatal mental health services (a specialist service for pregnant women and those with babies under a year old). Or it might be your local community mental health team. These specialist services are usually only needed if you have more severe postnatal depression.

Self-help

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

Talk to someone you trust such as your partner, a friend or family member about how you’re feeling. If they know what the problem is, they can support you in getting the help you need.
Sleep or rest whenever you get the chance. Try to get some rest while your baby sleeps, and if you can’t sleep, at least try to rest and relax.
Find local groups for new parents. Ask someone to go with you if you find it difficult at first.
Take up any offers of help with housework, cooking meals, shopping and childcare – don’t feel guilty about accepting support.
Make time for things you enjoy. If you can, try to spend time with your partner or friends.
Try to stick to a healthy balanced diet and regular meals, even if you don’t really feel like eating.
Get some regular exercise. Perhaps a parent-and-baby exercise class or just a walk in the fresh air.
You may find a self-help book or website useful. Ask your health visitor about these.
Don’t use alcohol or drugs to cope with your feelings – they will make your depression worse.
Get in touch with organisations that support parents with postnatal depression. For contact details, see our section: Other helpful websites.

The most important thing is to be kind to yourself — you’re going through a tough time. Do take help when it’s offered to you and remind yourself that things will get better with time.

Treatment of postnatal depression

Treatment options for postnatal depression include talking therapies and medicines. Which treatment is right for you will depend on several factors. These include how severe your postnatal depression is, if you’ve had depression before, and your personal preferences. Your doctor can explain what options are available and the benefits and risks of each. Together you can make a decision that’s right for you.

Talking treatments

Your doctor may suggest trying a type of talking therapy called cognitive behavioural therapy (CBT). CBT involves looking at how you think and behave in different situations and how you can change this for the better. Your doctor may suggest a guided self-help programme based on the principles of CBT. A professional trained in CBT will support you on this programme. There may be a computer or web-based programme you can do too. If you have more severe depression, they may offer you face-to-face CBT sessions.

CBT technique for unhelpful thoughts (animation)

Cognitive behavioural therapy (CBT) is a type of therapy that can help to improve your mental health. It aims to change negative thoughts and beliefs you may have, that can affect how you feel and behave.

Hundreds of automatic thoughts pop into our head every day. Sometimes these are negative and unhelpful. But thoughts are not facts, so it’s helpful to challenge our thinking. A ‘thought record’ is one CBT technique that can help you look at negative thoughts in a more balanced way.

This exercise works well if you have a notepad and pen to write down your answers.

Step 1. Think about the situation that’s upsetting you. What emotions and feelings do you have?

How intense are they? Rate the intensity from one to 10, with 10 being the most intense.

Step 2. What is the negative thought?

Try and be specific about the thoughts running through your mind and write them down. Perhaps something hasn’t gone as well as you’d have liked. Your thoughts start spiralling and you start to think that everything always goes wrong and maybe even that you’re a bad person.

Step 3. Now it’s time to put your thoughts on trial. Focus on the facts – is there any factual evidence that this thought is true?

Does everything always go wrong? Are you really a terrible person? Was what happened your responsibility entirely? Would you say the same things to someone you cared about who was in this situation?

Step 4. Now, what is the evidence that this thought is not true?

Can you think of a time when something you did went well? What about your friends and family and how much they care and value you? What are the good things in this situation?

Step 5. Weigh up the evidence. Is there an alternative thought? A more balanced and realistic way of looking at things?

Perhaps alternative thoughts could be: Things didn’t go as well as I’d liked, but that’s ok. Everyone makes mistakes sometimes. I am a good, kind person. I am human and doing the best I can.

Step 6. Check back in with yourself. How do you feel now? Rate the intensity again from one to 10.

Remember, the way that you think about a situation affects how you feel. Try this exercise next time automatic negative thoughts start to affect you.

If you are worried about your mental health, please see your GP for help and support.