Understanding postnatal depression (PND)

Postnatal depression (PND) is more common than you might think – affecting between 10-20% of new mums. It can hit you days, weeks or months after the birth of your baby. But help is at hand, and you’re not alone. Remember that although PND can be a bewildering and frightening experience, with the right support and treatment, you will be able to make a full recovery.

Symptoms of PND

PND commonly appears as overwhelmingly negative feelings – of loneliness and guilt, anxiety and irritability, tearfulness and exhaustion, anger and frustration. It may affect your appetite, your sleep patterns, your interest in sex and your concentration. For some women the feelings are quite mild, for others they are overwhelming.

Help is available

PND varies from woman to woman – as do its causes, and its treatment. But for every woman there is treatment and support available. The sooner you seek help, the sooner you’ll be back to feeling like yourself again.

What causes PND?

Medical experts don’t completely understand what causes PND, but it is clear that different factors can trigger PND in different women. These can range from stressful events and circumstances in your life to the sheer pressures and expectations of parenthood. In particular, it can affect you if your new baby is very demanding or if you don’t feel an immediate bond with her. For some women, these feelings can just come out of the blue, and that in itself is extremely stressful and upsetting.

Risk factors and triggers for PND

Evidence suggests that risk factors for developing PND include a personal or family history of mental health problems, stressful experiences in your life, recent difficult events or situations, domestic abuse or substance abuse. Mums are therefore encouraged to share that information with their midwife or GP before their baby is born, so that signs of PND can be spotted early on.

For some women, a poor birthing experience, or giving birth to a premature baby, or a baby with a health problem, or disability can trigger PND. For other women, lack of support from a partner, friends or family can be the cause, as can anxieties about finances, housing or lifestyle.

There is no hard medical evidence to support the claim that hormonal changes in your body after the birth can cause PND, although for some women, this may be a factor. It is important to remember that PND is very different from the hormonal ‘swing’ of the baby blues and doesn’t pass after a few days. Some women can even experience antenatal depression during their pregnancy.

How PND might make you feel

PND can be exhausting and frightening. Feelings of loneliness and guilt, tearfulness and frustration, irritability and anxiety are all common. You may feel worried and pessimistic about the future or overly concerned about your baby’s health.

Feeling lonely

For many new mums, it’s not unusual to feel lonely after the birth of your baby – particularly if you’ve given up work, or are no longer able to go out shopping, or on nights out with your friends. And if you don’t have a partner, or close friends and family around you on a regular basis, then it’s especially tough.

Feeling guilty

Society seems to expect all new mums to be delighted when their baby is born and to fall naturally into motherhood. Often, this just isn’t the case and if you don’t bond with your baby straight away you might feel guilty as a result. Guilt can sometimes trigger depression – as well as being a symptom of it.

Feeling down

Sometimes, even when things seem to be going really well, PND can just come right out of the blue. This can be confusing and upsetting. Feeling down for no reason may make you feel anxious and guilty – and that can make your PND worse. It’s a vicious circle.

Puerperal psychosis

Very rarely, mothers can suffer from a condition called puerperal psychosis, a severe mental illness which is different from PND. Puerperal psychosis affects one to two out of 1,000 new mums and can involve severe mood changes, loss of touch with reality, and hallucinations.

Often it begins within a few days of childbirth and almost always within the first three months. It is most likely to be caused by the hormone changes that occur shortly after childbirth. The risk of puerperal psychosis is much higher if you have had a similar illness before, or if you, or a member of your family, suffers from a manic-depressive disorder (such as bipolar affective disorder). It’s important to be aware of this, as there are treatments for women at high risk that can lower the risk, or even prevent the illness completely.

Unlike PND, where the symptoms can be hidden, with puerperal psychosis you are usually obviously ill and need psychiatric help, possibly in hospital. Here you’ll be in the right surroundings, supported by trained staff, who’ll help you and your baby get the care you need.