Postnatal depression (PND) is a depressive illness that occurs after having a baby. It can be triggered by something obvious, such as a traumatic birth, money, work or relationship troubles, but often there’s no clear reason as to why some mums suffer from it.
The illness can range in severity from a mild and normal period of mood upset, known as the baby blues, through to the most severe and rarest affliction, postnatal psychosis. PND makes you feel low and unhappy. Often you feel worse at particular times of the day and you may experience good days followed by bad ones. There will often be irrational feelings of guilt and shame about being a bad mother.
“Sadly, many mothers experience severe depression without recognising it as a treatable illness,” says Diane Nehmé from The Association of Post-Natal Illness. “This can mean the mother suffering needless distress.”
It’s important to remember that if you’re suffering, it can be treated. “This is a condition which always results in complete recovery,” says Diane. Read on to find out how…
- Don’t put off getting help
- Don’t feel guilty, you’re not a bad mother
- Do remember, you’re not alone – around one in 10 mothers suffer from PND
What are the symptoms for PND?
A lot of help, support and information is available for women suffering with PND
Spotting the signs
You feel low and unhappy most of the time, but you may feel worse at particular times of the day.
You occasionally get snappy with your baby, but most often with your partner.
All new mums get weary, but PND can make you so exhausted that you feel physically sick.
Even though you’re tired, you can’t fall asleep. Or if you do manage to drop off, you wake up at the crack of dawn.
Loss of appetite
You forget to eat, which can make you feel irritable and run down. Some mums eat for comfort and then feel bad about putting on weight.
Inability to cope
PND makes you feel that you’ve got no time, can’t do anything well, and that you’re powerless to do anything about it.
Depression changes your thinking and makes you see things negatively. You feel guilty, useless or that you’re responsible for feeling like this.
You worry so much that your baby might scream, or choke, or be harmed in some way that you’re afraid to be alone with her.
Read more symptoms here.
How do you get help?
A Mum opens up about coping with PND
4 steps to getting help
1. “As soon as a mum realises she needs help, she should to speak to the health professional she feels most comfortable with,” says PND expert Diane Nehmé.
2. “This is normally her health visitor or GP,” says Diane. “If you’re booking a GP appointment, make sure you get a double appointment so you have plenty of time to talk it through.”
3. “You may be asked a set of questions to produce a score, which is then compared to a scale to decide whether or not you have PND,” says Diane.
4. The next step is to get treatment. The most common forms are antidepressants, counselling and self-help methods, such as hypnotherapy. Some mums recover using only one treatment. Others may need a combination.
How do antidepressants work?
The Edinburgh Scale test can help identify mums suffering with PND
Antidepressants work by balancing the chemicals in your brain. They raise levels of the hormone serotonin to lift your mood.
“If your GP finds the right antidepressant for you first off, you can expect to start feeling the benefits after two to three weeks,” says Dr Andrew Kent, consultant perinatal psychiatrist at St Georges, University of London. “But you shouldn’t be tempted to stop taking them at this stage as you’ll be at a high risk of a relapse.”
Treatment is usually for four to six months, but it can vary.
Don’t worry, antidepressants aren’t addictive and some are still safe to take if you’re breastfeeding.
“I was diagnosed with PND when Lucy was 3 months old. It was my husband who first suggested I talk to my health visitor as I’d been feeling quite low and she rated how depressed I was by asking a series of set questions. After the results, she sent me to my GP who confirmed I had PND and prescribed antidepressants.
At first I felt even lower, which I was told was normal, but after not feeling any better they increased my dosage. After about a month I stopped taking the anti-depressants but a few weeks later I had a relapse and my husband found me in tears, screaming hysterically, so I knew I hadn’t recovered properly. I went back to the GP and was given the same antidepressants but this time I was told not to stop taking them even if I felt better. It’s been six months now and although I’m still on the medication, on the whole, I feel a lot better. I do have a few down days, but I know I’m on the road to recovery.”
Penny Lanning, 27, from Cambridgeshire, mum to Lucy, 9 months
Don’t want to have antidepressants? Find out about counselling…
Hormones could hold the key to PND
Counselling is basically talking about your feelings while a professional listens. Your GP will refer you for the treatment.
If you’re feeling like you’re not a good mum, or know you should be feeling really happy with your new baby but aren’t, a counsellor will look at all the times where you’ve shown you’re a good mum so you can turn this negative thought into a positive one.
Cognitive behavioural therapy is seen as one of the most effective types for dealing with severe PND. “It helps you change your negative feelings in a structured way,” says Dr Andrew Kent, “so you can work out what those negative thoughts are, what triggers them and how to turn them around into something more positive.”
“Counselling has the added advantage that it teaches you coping skills to use after you’ve recovered,” says Dr Andrew Kent.
“I was diagnosed with PND when Max was 4 months old. I knew things weren’t right when I found myself crying in bed for hours every morning, so I went to my GP who referred me to the perinatal psychiatry unit at the hospital.
After speaking to a counsellor, the hospital put me on anti-depressants and suggested counselling. To begin with I saw someone every week and found it really useful to talk through my feelings. Although Max’s birth wasn’t particularly traumatic, the first few weeks had been tough as I was coping on my own without my husband’s help – he’d had an operation on his back, which left him unable to do much.
The sessions taught me how to talk to my husband about how I was feeling. Neither of us had discussed it, as he was so ill and I felt bad for piling my problems on to him when he had enough to deal with already.
I had counselling for six months in total, and everything I learnt from it helped me overcome what had happened and I’d definitely recommend it to other mums going through PND. Talking about it meant I could move on and not blame myself.”
Ellie Aindow, 27, from Nottinghamshire, mum to Max, 2
Your partner can help too…
Partners and families can provide much needed support for those suffering with PND
How your partner can help you
Depression makes you feel extremely tired, and small tasks feel like huge ones, so get some assistance from your other half so you can rest.
He should let you talk freely and express your fears without showing shock.
You need to be reminded that you’ll recover and praise helps when you have a breakthrough, no matter how small.
Nagging and unhelpful advice such as being told to ‘Pull yourself together’ isn’t helpful.
Looking after himself
He’s probably feeling exhausted and stressed, so make sure he talks to others about his feelings and accepts any offers of help.
When you’re feeling really low, it’s important to remember you won’t feel like this forever. “PND is a temporary illness and you will get better,” says Diane Nehmé.
Will PND happen if you have another child?
1 in 3 women will suffer with postnatal depression
Will I get PND with my next baby?
PND can occur again if you have another baby but you won’t definitely get it just because you’ve had it already,” says Diane Nehmé from The Association of Post-Natal Illness. “But a mum who has had PND before will be more aware of the signs, giving her the chance of early diagnosis and treatment.”
Other things can be done to help prevent PND if you’re worried you might suffer again. These include getting a support network ready for the first few months after the birth, and in some cases starting a low dose of antidepressants during pregnancy and upping it as soon as the baby arrives.”
Does self help work?
Could PND soon be preventing?
As well as counselling and anti-depressants, there are also things you can try at home to help PND. “The most important area to concentrate on is rest,” says Diane Nehmé. “This may mean some time out from your baby so ask family members for help.”
“It’s also not a good time to be making important decisions like moving house or changing careers, so avoid doing this until you’re better,” says Diane.
You may also think making ‘to do’ lists will help, but your only goal in the early days should be to get better.
“And if you do have an up day, don’t overdo it by racing to do all the housework you haven’t got through in the last few weeks as this will only make you feel worse later,” says Diane.
“I suspected I had PND a few months after the birth of my second daughter Millie as I was cutting everyone out of my life. The final straw was when I found myself in floods of tears while walking down the street.
I was diagnosed with PND when Millie was 6 months old and after a week of being on antidepressants I felt a huge improvement but I found self-help techniques, particularly hypnotherapy, were good for keeping my depression under control.
I had two sessions of hypnotherapy when Millie was 1 and found this really helpful for putting me in the right mindset to help myself, as it changed my thought patterns so I could think more sensibly. This meant I could do more positive things for myself such as booking the odd treat like a facial, or even more simple things like just getting outside with the children.
Millie’s 2 1/2 now and things are so much better and luckily PND never affected the bond we have. After my experience I wanted to help others going through the same thing so I retrained as a maternity nurse specialising in PND and set up the company Baby Ladies (www.babyladies.com), who are on hand to help you take the stress out of having a baby.”
Laura Campbell, 31, from London, mum to Skye, 4, and Millie, 2
For more help and advice on PND, contact The Association for Post-natal Illness and the Royal College of Psychiatrists.