Thanks to celebrities such as Adele and Gwyneth Paltrow opening up about their experiences, public awareness of postnatal depression (PND, also known as postpartum depression) is greater than ever before. However, preconceptions (and misconceptions) about the disorder still abound. Adele admitted that, before experiencing the condition herself, her understanding of postnatal depression was, “you don’t want to be with your child; you’re worried you might hurt your child. But I was obsessed with my child. I felt very inadequate; I felt like I’d made the worst decision of my life.” Gwyneth Paltrow concurred, “I thought postpartum depression meant you were sobbing every single day and incapable of looking after a child, but there are different shades of it and depths of it.” Postpartum depression hit the actress with the birth of her second child, Moses. “I couldn’t believe it wasn’t the same; I just thought it meant I was a terrible mother and a terrible person,” she says. Drew Barrymore, who battled postnatal depression for six months following the birth of her daughter, Frankie, agrees. “It’s a different type of overwhelming with the second. I really got under the cloud,” she says. Brooke Shields, meanwhile, has admitted to being so badly affected by postnatal depression that “I really didn’t want to live anymore.”
Read on to learn how to recognise the signs of postnatal depression, and what to do if you think you, or someone you are close to, may be suffering from the condition.
What is postnatal depression?
Most new mothers experience the ‘baby blues’ after giving birth, but around 1 in 10 will develop postnatal depression, along with 1 in 25 new fathers.
The baby blues usually begin 3-4 days after giving birth and last for around a week. It’s completely normal to experience mood swings, low mood, anxiety, tearfulness and irritability during this time. However, if the blues persist for more than 2 weeks, or begin more than 2 weeks after giving birth, you may be suffering from postnatal depression.
The causes of postnatal depression are still unclear, but you are more likely to develop the condition if you have a history of depression or other mental health problems, have been hit by the baby blues, experienced other stressful life events during your pregnancy (e.g. a relationship breakdown or bereavement) or lack emotional support.
What are the symptoms of postnatal depression?
Symptoms of postnatal depression begin during pregnancy for up to a third of sufferers, but may begin any time during the first year after giving birth. The development of the disorder is often gradual, but the most common signs include:
- Persistent feelings of sadness and low mood
- Feelings of guilt, hopelessness and self-blame
- Agitation, irritability or apathy
- Lack of enjoyment in activities you previously enjoyed, and a loss of interest in the wider world
- Withdrawing from contact with others
- Problems concentrating and making decisions
- Lack of energy and chronic feelings of exhaustion
- Difficulties sleeping
- Difficulties bonding with your baby
- Frightening thoughts, e.g. about harming your baby
- Thoughts of suicide or self harm
Most women will recover within 3 to 6 months, but, without treatment, 1 in 4 women with PND will not recover within a year.
Where can I go for help?
If you experience the symptoms of postnatal depression for more than 2 weeks, visit your GP. They may suggest a self-help course – this can be done online or using a book and usually takes 9-12 weeks to complete. Alternatively, you may be referred for a course of one-to-one or group talking therapy such as cognitive behavioural therapy (CBT). The aim of CBT is to identify and challenge the unhealthy thought patterns and beliefs which may underlie and maintain your depression – for example, you may have unrealistic expectations of how a ‘good’ mother should behave. National guidelines state that patients with PND should be seen within a month. However, waiting lists are long, and you may have to wait much longer. Those suffering from moderate or severe depression who don’t want to try talking therapy or whom talking therapy hasn’t helped may be offered antidepressants.
PANDAS (Pre and Postnatal Depression Advice and Support) offers telephone and email support between 9am and 8pm, 7 days a week. Call 0843 289 8401 or email firstname.lastname@example.org.
The Association for Postnatal Illness operates a helpline which you can call on 020 7386 0868 between 10am and 2pm, Monday to Friday.
You may also be able to find a local support group at NHS Choices.
What else can I do?
There is some evidence that effective pain relief during labour may guard against the onset of PND.
It is also important to eat well in order to minimise the effects of hormonal disturbances. Omega 3 fatty acids, which encourage the production of ‘happy hormone’ serotonin, become depleted during pregnancy, so try to eat plenty of omega-rich foods such as salmon, avocado and nuts. Many new mothers also suffer from zinc deficiencies, which can cause sleep disturbances, anxiety, paranoia and even hallucinations, so consider taking a supplement.
Experts recommend eating small, frequent meals containing complex, unrefined carbohydrates (so choose wholemeal bread, pasta and rice over white) in order to keep blood sugar levels balanced, and avoiding caffeinated drinks. Nutritionist Shona Wilkinson recommends taking a milk thistle supplement to support the liver and gall bladder as they process toxins and excess hormones from the body.
Meditation may be as effective as antidepressant medication, and could even help to prevent postnatal depression, according to researchers.
Exercise is one of the most effective treatments for depression. Start gently – walking with a pram is a good start. Yoga or mother and baby exercise classes may also help.
Getting enough sleep can make a big difference. Try to sleep whenever the opportunity arises, particularly when your baby is sleeping. Give yourself permission to forget the chores you ‘should’ be doing for a while – your health is more important.
Don’t be afraid to ask for help with housework, shopping and other chores, and try to get out of the house without baby in tow (preferably accompanied by a partner or friend) at least once a week.
Seek the support of other new mothers at a local mother and baby or postnatal support group.
If you are struggling to bond with your baby, consider attending a baby massage class – touch can help.