Mumszone - A site for all parents

Postnatal depression (PND) is a depressive illness that occurs after having a baby. It is common for women following childbirth to experience a period of 'low' mood. This can range in severity from a mild and normal period of mood disturbance ('baby blues'), through to PND and the most severe and rarest problem (postnatal psychosis).

Who can get postnatal depression? Anyone can, on average 7 out of 10 women will experience some degree of PND after the birth of a child.

PND is more common in mothers who have previously had episodes of depression.A history of depression in family members also increases the risk, probably via genetic (inherited) factors. PND is also more common in mothers who have experienced stressful life events during the pregnancy, those who do not have support at home, in those in whom the baby was unplanned or unwanted, and when the baby has been born with some problem.

Even if any of the above applies to you may still not suffer from postnatal depression.

•  Feeling 'low', 'miserable' and tearful for no apparent reason. These feelings persist for most of the time, though they may be worse at certain times of day, particularly the morning.
•  Being unable to enjoy yourself. This may be particularly prominent in new mothers who feel that they are not enjoying having a new baby in the way they expected to.
•  Irritability is common. This may be with other children, the new baby and particularly with the partner.
•  Sleep disturbance is part of looking after a new baby. However in PND there may be additional problems of finding it hard to go to sleep even though you are tired, or waking early in the morning.
•  Given that looking after a young baby means having less sleep than usual, it is no surprise that mothers often feel they have no energy. This can be even worse in mothers with PND.
•  Appetite is sometimes affected, with mothers not being interested in food. This can be a particular problem since new mothers need all the energy they can get to look after their babies.
•  Anxiety frequently occurs in PND. This may take many forms. It may be feeling tense and 'on edge' all the time. Normal concerns and anxieties that any mother feels for a new baby may become overwhelming. In addition mothers may experience 'panic attacks' which are episodes lasting several minutes when they feel as if something catastrophic is about to happen - such as collapsing, having a heart attack or stroke. These are extremely frightening but they get better on their own.
•  Depression is often accompanied by feelings of being 'worthless' and 'hopeless'. These feelings are common in PND. All mothers are faced with new and sometimes difficult problems with a new baby. However, mothers with PND feel all the more 'not able to cope' and unable to see a way through their difficulties.
•  When people are depressed, they sometimes feel that there is no way out of their problems and that they, and their family, would be better off dead. Thoughts of suicide are therefore not uncommon. If you feel this way, it is important that you talk to somebody about how you feel, since there are ways out of your difficulties other than suicide. You should also be aware that your child would be at increased risk of developing mental health problems of their own if you do commit suicide. If you fear that somebody you know feels suicidal, take this seriously and try to talk to them about it. Talking about suicide does NOT increase the risk of the person committing suicide. Strongly advise the person to visit their doctor.

There are a few ways of diagnosing PND, your health visitor will use the Edinburgh Postnatal Depression Scale which is a series of questions, the answers you get will give them a good idea if you have PND or are heading towards having PND. Also your GP can diagnose PND and either start you on a course of antibiotics or refer you for counselling. Some people are diagnosed and watched over by the hospital, I personally was under my GP for care after my first pregnancy but subsequent PND after the birth of my second and third child were dealt with by the hospitals Motherhood and Mental health team.

Anti-Depressants

Post natal depression can be treated successfully with anti-depressants (using either tricyclics TCAs, or selective serotonin re-uptake inhibitors, SSRIs), so long as social and psychological factors have been taken into account. Although some people start feeling better quite soon after starting medication, it may take up to 4-6 weeks for the effects of anti-depressants to become evident.. None of these drugs are without side-effects (which vary according to drug type) and the choice is more on what is most acceptable to the mother. Your doctor or pharmacist should be able to advise you of possible side effects. Certain Anti-depressants  are not suitable for use when breasfeeding,  your GP can advice you on the best medication for you. Remember to make it clear to your GP that you are breastfeeding when you discuss your treatment. The most commonly known anti-depressants are Prozac, Seroxat , Diazepam and Dothiapin. Dothiapin is thought to be suitable for breastfeeding mothers. 

Counselling

The main aim of counselling is to raise self estem and try to give you some insight as to why are feeling the way you do, this could stem back to something in your childhood or a traumatic event that has happened in your life or surrounding your pregnancy or birth of your child.

Family support

It helps a lot to have someone else there, who even if they don’t understand why you feel like this are there and are supporting you, telling you that you will get better, and you will get better, I have!

No one really knows why we get PND, some suggest it’s a chemical inbalance, others say its due to lifesstyle factors such as a unhappy childhood or a unexpected pregancy, or being unhappy with the situation you have found yourself in. PND can make you feel as if your world is collapsing around you and that you have no control, you can feel silly for crying at the smallest thing, It can make you feel like you are left alone while the rest of the world moves on around you.

I had my first child in January 1999 and she was a much longed for wanted child. I had tried for a long time in a previous relationship for a child but it never happened. I met my now husband and found myself pregnant, I was so happy right through my pregnancy and couldn’t wait to meet my daughter.  Within 5 days of her birth I felt so low, that her father took over her care as I fell apart and couldn’t cope. At some points I felt as if it would all be made better if she were to go and live somewhere where I could see her grow up but not with me, but I never hated her,  I loved her so much and these feelings made me feel worse. I would cry all the time. I couldn’t understand why I felt this way about the child I had wanted to badly for so long, but I did get better with the help of the medication I was on, and in Dec 2000 we had our second child, another girl. This time my care was being managed by the local hospital and when the PND hit again it wasn’t on the scale it was the first time, and within 9 months I was off the medication.  My son was born in May 2002 and again I suffered with PND again, not as bad as the first time but equal to the second time, and again within 9 months I was off the medication and on the road to recovery. I have since had some relapses but each time I bounce back faster. I’ve not had medication since 2002.