Postnatal depression

Expert review by:

Dr Samantha Wild, Clinical Lead for Women's Health and Bupa GP
Michelle Sheridan, Midwife, Bupa UK

Key points

Postnatal depression is a type of depression you can develop up to a year after having a baby.
It’s different from short-lived ‘baby blues’ and can also affect partners.
Postnatal depression can make you feel very low.
There are self-help measures, as well as treatments and support available that can help you to feel better.

Introduction

Hi. My name's Bianca Clarke, a cognitive behavioural therapist at Bupa.

New mums can feel tearful and low after the birth of a new baby. This is known as the baby blues and this usually passes, but sometimes it can turn into depression.

In fact, postnatal depression is common, affecting around 1 in 10 women. Many new mums feel ashamed about seeking help and finding advice online that you can trust isn't always easy.

I've made this video to bring you clear, evidence-based information. This could be for you or for someone close to you who you know is struggling.

We'll cover what postnatal depression is and how it's different from the baby blues. The signs to look out for. What treatment usually involves and what you can do to help yourself. And I'll also answer two common questions that we hear all the time.

Let's take a look.

What is postnatal depression?

Many women experience low mood and tearfulness immediately after having a baby. This is known as the baby blues and it's very common. These early dips in mood usually pass within the first week.

But postnatal depression is different. It's a period of prolonged low mood, and it can begin during pregnancy or any time after the birth of the baby. Sometimes even months later.

With postnatal depression, the symptoms last longer and they can be more intense.

There's no single cause. For some people, it's to do with changing hormones. For others, it's the huge life change that comes with becoming a parent. Often it's a combination of both.

Signs and symptoms

So how can you tell if what you're feeling is more than the baby blues?

Some signs to look out for include:

Feeling persistently low or sad, being unusually tearful.

Crying all of the time.

Struggling to bond with your baby.

Losing interest in things that you used to enjoy, this might be things that used to give you pleasure, like hobbies or socialising.

Feelings of guilt or being a bad mum.

Sleep problems beyond the usual baby related ones.

Feeling anxious, hopeless or unable to cope.

And some people report having thoughts of harming themselves or their baby.

If these feelings go on for more than a couple of weeks or if they're getting worse, then it's time to talk to someone. You deserve support.

Evidence-based treatments

If you're thinking, should I speak to someone? The answer is yes, and the sooner the better.

Treatment for postnatal depression is very similar to treatment for other types of depression. This can include talking therapies like CBT, which stands for Cognitive Behavioural Therapy. This helps you to manage the thoughts, emotions and behaviours that might be making your depression worse. It gives you the tools to help you adjust to the demands of life with a new baby.

This could include planning activities that you used to love and enjoy before you became a parent.

Other treatment includes medication such as antidepressants. If you're breastfeeding, your doctor will help you find an option that's safe for you and for your baby. There are lots available.

You should also receive support from your health visitor and GP, who can help you navigate what's best for you.

Knowing where to turn isn't always easy when you're already feeling low. Health professionals may also signpost you to useful local services.

Helping yourself

There are things that you can do to support your own recovery. For some mums, the biggest struggle is loneliness. If that sounds familiar, then try reaching out to a parent group in person or online. There are apps that help connect new mums for coffee support or even just for a quick chat.

For others, it's thoughts that provoke anxiety, like am I doing this right? Or is my baby okay? That's where a short course of therapy or some self-help techniques for anxiety can really help.

You can also check out our Bupa Explains Anxiety video.

If you're feeling low, it's okay to start small. Talk to someone you trust. Do one kind thing for yourself each day.

Will it go away?

I often get asked ‘Will it go away?’ Most of the time, yes. With the right help, it does get better. For some women, it can lift in a matter of weeks. For others, it might take a bit longer, especially where hormones or breastfeeding is involved. But the important thing to know is it is treatable.

Will it affect the baby?

Another concern new mothers often have is will it affect my baby? It can, especially if you're finding it hard to bond or care for your baby in the way that you want to. But getting help early makes all the difference.

If you think you might be experiencing postnatal depression, or even if you're just not sure, speak to your midwife, health visitor or other health care professional. Things can get better.

Thanks for watching. You're already taking a positive step by learning more.

About postnatal depression

Postnatal depression is no different to depression you can get at any other time. It’s referred to as postnatal depression if you have recently had a baby. Postnatal depression most often starts within the first couple of months after giving birth. But you may get it up to a year later.

Lots of people feel overwhelmed, tearful and emotional after having a baby. This is sometimes called the baby blues and usually starts within 3 to 10 days after your baby is born. Baby blues usually pass on their own within a few days.

Postnatal depression is more intense and lasts longer than the baby blues. It can affect between one to two in every 10 women in the first year of giving birth.

Depression while you’re pregnant (antenatal depression) and postnatal depression may both be called perinatal depression.

Can partners get postnatal depression?

Partners of people who have recently given birth can also develop depression or anxiety. Some people may refer to this as postnatal depression too. There can be many reasons for this such as extra responsibilities, financial pressure, and lack of sleep. Having a baby can be a huge adjustment. It’s important that partners also seek help and support for mental health problems.

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.

Causes of postnatal depression

Anyone can experience postnatal depression. It's not a personal failure and is very common after having a baby. This is a huge life change and adapting takes time.

Depression is usually caused by a combination of several factors. There are many factors that affect your chance of getting postnatal depression. You might be more likely to get it if:

you’ve had mental health problems such as depression in the past, including during pregnancy
you had the ‘baby blues’ after you gave birth
you don’t feel that you have enough support
you suffered abuse or neglect in childhood, or had an unstable family life
you have low self-esteem
you are in a stressful situation, such as facing money, housing or employment problems
you’re in an unhappy or abusive relationship
you’ve had a recent major life event, such as a bereavement, relationship break-up or you’ve lost your job
it took a long time for you to get pregnant
your partner is depressed
your pregnancy wasn’t planned
you have two or more children
you have a family history of depression
your baby was premature or has had health problems

You can still become depressed without having any of these risk factors. Or, you may have some of these risk factors and never develop postnatal depression. Having postnatal depression is not something you can help. And it is no reflection on your ability to care for your baby.

Symptoms of postnatal depression

Postnatal depression symptoms start within a year of having your baby. You may:

feel low and tearful much of the time
feel anxious or irritable
not enjoy things you normally do
feel guilty and worthless
feel hopeless
find it hard to concentrate or make decisions
feel like you have no energy
have problems sleeping even when your baby is asleep
not want to see friends and family
lose your appetite
lack interest in your baby or partner, or have negative feelings towards them
have thoughts about harming yourself or your baby

Anyone can have these feelings from time to time after having a baby. But if you’ve been feeling like this most of the time, for two weeks or more, you may have postnatal depression.

What is postpartum psychosis?

Postpartum psychosis (also called postnatal psychosis) is a rare and very serious mental health condition. About one to two in 1,000 people develop it after having a baby. Symptoms of postpartum psychosis include:

rapid mood swings
hallucinations
delusions
feeling confused and disoriented

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, speak to your GP, midwife or health visitor straightaway. If you can’t speak to a health professional, talk to someone who you can trust. They can support you in getting 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. Their focus is getting you the help and support you need to feel better and look after your baby.

Seeking urgent help

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 visit your nearest accident and emergency (A&E) department, or call 999 if necessary.

You also contact support services in our ‘if you need help now’ section.

Diagnosis of postnatal depression

Your midwife, health visitor or GP will usually ask you about your mental health and how you’re feeling at your postnatal appointments. This is a good opportunity to tell them if you’re feeling low or depressed. Be honest if you can, so that you can get help sooner.

Your health visitor or GP can be contacted at any time if you need help. They’ll ask you some questions about how you’ve been feeling. They may use a standard questionnaire to help them assess if you have postnatal depression. They’ll want to know about any physical symptoms you have too, and how you are coping with looking after your baby.

Your health visitor or GP can explain how they can support you and organise any treatments you need. If they think your postnatal depression is severe, you might be referred to:

perinatal mental health services (a specialist service if you’re pregnant or your baby is under a year old)
your local community mental health team

Self-help for postnatal depression

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. They may then be able to help you.
Sleep or rest whenever you get the chance. Try to get some sleep while your baby sleeps, and if you can’t sleep, at least try to rest and relax.
Grow your support network. You could try local groups for new parents. Your midwife or health visitor may be able to give you information on these. Ask someone to go with you if you find it difficult at first. There are also online parenting communities you can join.
Ask for help with caring for your baby when you need it. 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, even taking a few minutes to read a book or watch TV can help.
Try to eat a healthy balanced diet and eat regularly, even if you don’t really feel like eating, having a little bit of something can keep your energy levels up.
If you can, get regular, gentle exercise. Even just a walk in the fresh air with your baby can help.
Don’t use alcohol or drugs to cope with your feelings – they will make your depression worse.

The most important thing is to be kind to yourself. You’re going through a tough time. Take help when it’s offered and remind yourself that these feelings often pass with time. There are organisations that support parents with postnatal depression you can reach out to. For contact details, see our section: Other helpful websites.

How long does postnatal depression last?

This is different for everyone. Most people with postnatal depression feel better within a few months. But it can affect others for a year or more. You will continue to be offered support for as long as needed.

Treatment of postnatal depression

Postnatal depression can be treated with talking therapies and medicines. Which treatment is right for you will depend on several factors. These include how severe your postnatal depression is and whether you’ve had treatment for depression before. It also depends on whether you are breastfeeding. Your doctor can explain the different options and the benefits and risks of each. They will then support you in making a decision.

Talking treatments

The types of talking therapies you might be offered include cognitive behavioural therapy (CBT) or interpersonal psychotherapy (IPT).

CBT aims to change how you think and behave in different situations. In guided self-help, you’re provided with printed information or a web-based programme. A professional trained in CBT supports you on the programme. If you have more severe depression, they may offer you face-to-face CBT sessions.
IPT focuses on identifying how your relationships relate to your feelings. It explores your emotions and looks at how you can change how you respond to people.

Medicines

If you have moderate or severe depression, your doctor may suggest you try antidepressant medicines. You may have these as well as, or instead of, talking therapies.

There are different types of antidepressant. They all work well for postnatal depression but they may have different side-effects. Tell your doctor if you’re breastfeeding. They can advise which medicines are safest to take.

Antidepressants can take at least two weeks to start working and you may need to take them for several months. This helps to prevent your postnatal depression from returning after you start to feel better. Your doctor will advise you on how long to keep taking them.

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

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Find out more about how we support mental health

Postnatal depression

Key points

About postnatal depression

Can partners get postnatal depression?

If you need help now

Causes of postnatal depression

Symptoms of postnatal depression

What is postpartum psychosis?

Seeking urgent help

Diagnosis of postnatal depression

Self-help for postnatal depression

How long does postnatal depression last?

Treatment of postnatal depression

Talking treatments

Medicines

Looking for mental health support?

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