Overview - Postnatal depression

Postnatal depression is a type of depression that many parents experience after having a baby.

It's a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners.

It's important to get help as soon as possible if you think you might be depressed, as your symptoms could last for months or get worse and have a significant impact on you, your baby and your family.

With the right support most people make a full recovery.

Symptoms of postnatal depression

Many women feel a bit down, tearful or anxious in the first week after giving birth.

This is often called the "baby blues" and is so common that it's considered normal.

The "baby blues" do not last for more than 2 weeks after giving birth.

If your symptoms last longer or start later, you could have postnatal depression.

Postnatal depression can start any time in the first year after giving birth.

Signs that you or someone you know might be depressed include:

• a persistent feeling of sadness and low mood
• lack of enjoyment and loss of interest in the wider world
• lack of energy and feeling tired all the time
• trouble sleeping at night and feeling sleepy during the day
• finding it difficult to look after yourself and your baby
• withdrawing from contact with other people
• problems concentrating and making decisions
• frightening thoughts – for example, about hurting your baby

Many women do not realise they have postnatal depression because it can develop gradually.

Remember that:

• a range of help and support is available, including talking therapy
• depression is an illness like any other
• it's not your fault you're depressed – it can happen to anyone
• being depressed does not mean you're a bad parent
• it does not mean you're going mad
• your baby will not be taken away from you – babies are only taken into care in very exceptional circumstances

Treatments for postnatal depression

Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available.

These include:

• self-help – things you can try yourself include talking to your family and friends about your feelings and what they can do to help, making time for yourself to do things you enjoy, resting whenever you get the chance, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet
• talking therapy – a GP may be able to recommend a self-help course or may refer you for a course of therapy, such as cognitive behavioural therapy (CBT)
• antidepressants – these may be recommended if your depression is more severe or other treatments have not helped; your doctor can prescribe a medicine that's safe to take while breastfeeding

Local and national organisations, such as the Association for Post Natal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS), can also be useful sources of help and advice.

Causes of postnatal depression

The cause of postnatal depression is not completely clear.

There are a number of things that may make you more likely to have postnatal depression. These include:

• a history of mental health problems, particularly depression, earlier in life
• a history of mental health problems during pregnancy
• having no close family or friends to support you
• a difficult relationship with your partner
• recent stressful life events, such as a bereavement
• physical or psychological trauma, such as domestic violence

Even if you do not have any of these, having a baby is a life-changing event that can sometimes trigger depression.

It often takes time to adapt to becoming a new parent. Looking after a baby can be stressful and exhausting.

Preventing postnatal depression

There are things you can do during pregnancy to help you keep well, such as maintaining a healthy lifestyle and having someone you can talk to and turn to for support.

Going to antenatal classes and making friends with other pregnant women or new parents can also be helpful.

If you are pregnant or thinking about getting pregnant, talk to a GP or your mental health team if:

• you have a history of depression or mental health problems
• someone in your family has had mental health problems after childbirth (for example, your mother or sister)

This is so they can offer you appropriate treatment.

You can also talk to a midwife, who can support you or refer you to specialist mental health services if needed. If you have had a mental health problem while pregnant, your doctor should arrange for you to be seen regularly in the first few weeks after birth.

The mental health team, maternity team and GP will work closely with you during your pregnancy and after you have given birth.

Myths about postnatal depression

Postnatal depression is often misunderstood and there are many myths surrounding it.

These include:

• postnatal depression is less severe than other types of depression – in fact, it's as serious as other types of depression
• postnatal depression is entirely caused by hormonal changes – it's actually caused by many different factors
• postnatal depression will soon pass – unlike the "baby blues", postnatal depression can persist for months if left untreated and in a minority of cases it can become a long-term problem
• postnatal depression only affects women – research has actually found that up to 1 in 10 new fathers become depressed after having a baby

These factors are equally true of antenatal depression.