Affecting a huge seven out of out ten new mums in the UK, postnatal depression is surprisingly common. But what differentiates the illness from the baby blues? We sat down with Dr Rafael Euba, consultant psychiatrist at The London Psychiatry Centre to find out more – from what can trigger postnatal depression to how to help a friend you think may be struggling…
What exactly is postnatal depression?
Feeling low after giving birth – also referred to as the ‘baby blues’ – is very common. It’s a general feeling of anxiety, unease and dissatisfaction that usually lasts around two weeks post-delivery. But in comparison, postnatal depression (PND) is a serious mood disorder that lasts much longer, with symptoms worsening over time. PND is referred to as a series of depressive episodes that happen during the perinatal period (the weeks before and after birth); around ten out of every 100 women will be affected by PND.
What are the symptoms?
The symptoms of PND are very similar to those seen in ‘ordinary’ depression and include:
- Anhedonia – not getting pleasure out of things that usually make you happy
- Feeling low and/or sad
- Lacking in energy and a general feeling of fatigue
- Changes in appetite
- Panic attacks
- Excessive anxiety about your baby’s routine/health/development
- Thoughts of hurting yourself or others
- Suicidal thoughts
What causes PND?
The simple answer is we don’t know. It’s likely that a number of factors are involved and research suggests the illness may arise partly because of the hormonal changes following childbirth. The stress of looking after a young baby and having your sleep disrupted may also bring on the illness in susceptible people.
Are some mothers more likely to get PND than others?
PND is more common in mothers who have previously had episodes of depression or those with a family history of depression. At the same time, PND is also more common in women who have experienced stressful life events during their pregnancy or those who have had a difficult or traumatic birth. A lack of support has also been shown in studies to be a risk factor for developing PND.
And it’s pretty common?
Postnatal depression is surprisingly common. Recent estimates suggest 7% of women experience an episode of major depression in the first three months following delivery, and the prevalence increases to 20% when episodes of minor depression are also included. Interestingly, PND is less likely in older mothers, mothers of other young children and those who are happy with the level of support they have around them.
When is it most likely to happen?
PND usually occurs in the first four weeks after birth but can occur anytime during the first year. However, in a third of cases, the onset of depression occurs during pregnancy – this is a major indicator that a woman will go on to develop PND.
How can it be treated?
With the right help, PND is entirely treatable. Sometimes, antidepressants are necessary although none have been specially developed for pregnant and breastfeeding women. Your GP may be able to refer you to a support group, counsellor, psychotherapist or cognitive behavioural therapy (CBT), which can teach you coping strategies.
Is there anything new mums can do to avoid PND?
If you have a history of depression or mood disorders it’s important you flag it up with your healthcare provider during your maternity health checks. At the same time, remember taking care of yourself is important both during pregnancy and after birth. Ensure you get enough rest – excessive fatigue will exacerbate the symptoms of depression. Make an effort to incorporate gentle exercise into your daily routine and don’t be afraid to ask for the support of others – there is evidence to suggest that having good emotional and practical support will lessen the likelihood of you developing PND.
Can PND ever affect men?
Yes – it is possible. Fathers also experience huge lifestyle changes when a baby comes along and it’s thought around one in 15 fathers experience paternal PND. Paternal PND tends to develop more slowly than maternal PND, increasing over the course of the first year of a baby’s life, and is much more common when the mother is also depressed. Nervousness about being a new father, irritability caused by fatigue and worry can also contribute to the onset of PND for a new dad.
How can you help a friend who you think may be suffering from PND?
Encourage them to see a doctor: If they are reluctant to do so, point them in the direction of the Edinburgh Scale (an online self-diagnosis tool) so that they can assess for themselves the severity of their situation.
Don’t mention PND: Some new mums struggling with PND worry about people’s perception of them as a parent, so avoid making overt statements about PND when you’re chatting to them, instead hinting at various issues, such as asking them if they’re getting enough rest.
Show them you care: Supporting a new mum practically is a great way to show that you care. Cooking a meal, looking after the baby while they have a bath, encouraging them to go for a walk in the fresh air are all good ideas.
Listen: While it may seem natural to want to give advice, listening is much better when someone is dealing with depression.
Be there: If a friend or family member is finding it hard having other people around and doesn’t want to see you, make sure you text or email her so she knows that you’re there.
For more information and advice on postnatal depression, visit PsychiatryCentre.co.uk