It's UK Maternal Mental Health Week, a week dedicated to talking about mental illness during pregnancy or after having a baby and signposting support for all mums. The focus is on advocating for mums affected by maternal mental health and helping them to access the information and help they need to enable recovery.
This year’s theme for the third annual UK Maternal Mental Health Matters Awareness Week is Mums Matter.
It’s common for mothers to start experiencing symptoms of depression after giving birth. The change can be so overwhelming that many feel like they cannot cope with the burden of expectation.
Struggling through clinical depression is tough, and experiencing depression after pregnancy may feel unbearable. However, treatment and support is available - all you have to do is open up and accept any help that comes your way.
If you’re currently coping with postnatal depression or know somebody else who is showing symptoms, here’s a handy guide to this unexpected and unwelcome episode of new parenthood.
What is postnatal depression?
Also known as postpartum depression or antenatal depression, postnatal depression (PND) is the name for when a new mother experiences symptoms of depression in the weeks and months after giving birth.
How common is it?
Quite common, actually: it’s thought to affect 1 in 10 women within a year of giving birth. There were 774,835 live births in the UK in 2016, so this means that roughly 70,000 new mothers each year will experience postnatal depression symptoms.
What are the symptoms of postnatal depression?
During the first two weeks after giving birth, it’s common for many women to feel down, weepy, or anxious. This is known as the “baby blues” and it happens so often that it’s considered normal. If these feelings persists longer than a fortnight or develop later on, there’s a chance you could have postnatal depression.
Symptoms of postnatal depression include:
- feeling low or despondent for a prolonged period of time
- lacking in energy and constantly feeling tired
- having difficulty sleeping at night
- having difficulty bonding with your baby
- feeling guilty about not coping
- withdrawing from social interaction
- having problems with concentration and decision making
- losing enjoyment and interest in things
Many new parents won’t initially realise they have postnatal depression because the symptoms can develop gradually. If you woke up this morning with the baby blues, speak to your GP - it might only be a phase and not clinical PND.
What causes postnatal depression?
We don’t have a definitive answer to what causes PND, though there are factors that are often associated with it. These include:
- a history of mental health problems, particularly depression
- a history of mental health problems during pregnancy
- having a difficult labour and experiencing related health problems afterwards
- having no close family or friends to support you
- a poor relationship with your partner
- recent stressful life events, such as a bereavement or a redundancy
- experiencing the “baby blues”
It’s also worth noting that women can experience PND after their second pregnancy, even if they experienced no symptoms during their first.
What’s more, recent research suggests that PND is more prevalent at certain times of the year.
Where can I find help for postnatal depression?
No new parent should feel ashamed or embarrassed to admit they are struggling, and having postnatal depression does not make you a bad mother. Depression can affect anyone at any time, so there’s no chance your baby will be taken away from you.
Although you may feel the weight of the world on your shoulders and be hesitant to open up, by seeking help you’ll already be on the first step to recovery. Your GP or health visitor will want to do everything they can to aid your recovery, so talk to them if you feel unable to share how you feel with friends or family.
If you don’t feel ready to speak to someone in person, these online resources offer readily available and confidential support.
What is the treatment for postnatal depression?
Like the majority of mental health problems, there are two types of treatment for postnatal depression: talking therapies and therapeutic treatment.
Talking therapies tend to be recommended for milder cases of PND, and your GP may be able to arrange cognitive behavioural therapy (CBT) or interpersonal therapy (IPT) sessions for you. CBT helps you notice patterns in your behaviour and applies problem-solving techniques to teach you coping strategies, while IPT gets you to identify whether any problems in your relationships are contributing to your depression.
For more severe cases, antidepressant treatment may be suggested by your GP. Antidepressants are thought to work by balancing the chemicals in your brain, with the intention to lift your mood, improve your sleep, and make you less irritable. Antidepressant treatment usually last for six months, and it can take a few weeks for the effects to kick in.
What if I’m breastfeeding? Which meds are appropriate?
Antidepressants may pass into your breastmilk in very small amounts, although most are usually safe.
SSRIs such as fluoxetine and sertraline are commonly prescribed for those with PND, while TCAs like nortriptyline and imipramine are also considered appropriate during breastfeeding.
MAOIs are discouraged because they may cause side effects due to adverse interactions with a number of foods, drinks, and substances.
Speak to your GP if you have any concerns or questions about the use of antidepressants during breastfeeding.
Does it just affect women?
Like breast cancer, there’s a widespread misconception that the illness can only affect women. In actual fact, postnatal depression in fathers is relatively common - NCT research finds that more than a third (or 38%) of new dads are worried about their mental health.
General studies have shown that new fathers suffer postnatal depression at around the same rate as new mothers (1 in 10) and also that fathers are likely to suffer from depression between three and six months after the baby is born.
The causes of PND among men can be similar, from a history of mental health problems to a strained relationship with your partner.
If you are a new father experiencing the symptoms of postnatal depression, take solace in the fact that you are not alone. The stigma around male mental health in general is fading, and getting help for your problems will help not only you but your partner and your child.
How does it compare to “normal” depression?
This is a frequently asked question, and the two share a lot of symptoms. Despite the overlap, there are certainly key differences. PND encompasses many of the typical symptoms of depression such as anxiety, tearfulness, sleep deprivation, though GPs will diagnose the symptoms as postnatal depression if you are:
- hormonally unsteady
- struggling to adjust to motherhood
- breastfeeding or weaning
- excessively worrying about your baby and your ability as a mother
- consumed with guilt at feeling the way you do
When you consider that someone is experiencing all this on top of depression - as well as caring for a newly-formed human - you begin to realise just how harrowing PND can be.
Is postnatal depression preventable?
We’re not sure. If you’re at high risk of developing PND after giving birth, some GPs may prescribe you antidepressants or suggest you for oestrogen therapy (in extreme cases).
The best way to keep the onset of PND at bay is to look after yourself as best you can. Reduce your stress levels and accept any help that’s offered. The more support you have during your pregnancy, the stronger you’re likely to feel after giving birth.
What can I do to overcome postnatal depression?
Although it’s advisable to seek support and follow treatment plans that your GP or health professional have suggested, there are also several steps you can take to help you kick the baby blues into touch.
1) Get lots of rest. Being a new parent can be taxing at the best of times, so make sure you get enough sleep and rest whenever you can. Try to have a nap whenever your baby’s sleeping, too.
2) Exercise regularly. Exercise is a tonic for the mind and body, so getting your trainers on can do wonders for your outlook. Choose an exercise regime that suits you, but be careful not to overdo it. Ask your GP if you have any questions or want some suggestions.
3) Eat well. Giving birth brings a host of new demands on your body, and so having a healthy, balanced diet is vital to how you function. By getting all the nutrients you need, you’ll sleep better and feel less run down.
4) Meet with other mothers. Depression is an isolating condition, especially when you’re trying to look after a baby. Joining a baby massage group (available at your local children’s centre or GP surgery) is a great way to combat feelings of loneliness or helplessness. It may even help you bond with your bairn.
5) Be good to yourself. Don’t sweat the small stuff, and leave any big decisions for when you’re feeling better. Looking after yourself and your baby is the most important thing for you right now. And remember, you’re doing a great job!
The Association for Post-Natal Illness (020 7386 0868) can put you in touch with trained volunteers who are available to offer guidance and support.
The PANDAS Foundation UK (0843 23 98 401) aims to provide support every individual with pre- or postnatal depression in England.
MumsMeetUp is an app that connects mums locally and across the UK.
Dads Matter UK is a great resource for fathers looking for support and info on postnatal depression.
If you’d just like someone to speak to about overall issues related to your depression, Samaritans (116 123) provides confidential emotional support.
Check out the Maternal Mental Health Alliance, (organisers of Maternal Mental Health Week). It's a fantastic source of information and support for new parents.
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Clinically reviewed by Pooja Raichura MRPharmS: 2/5/19
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