What is postnatal depression?
Postnatal depression (PND) is a very common type of depression that occurs after having a baby. It affects more than 1 in 10 women within a year of giving birth. Fathers and partners can also be affected.
The symptoms are similar to those in depression at other times. These include low mood and other symptoms lasting at least two weeks. Depending on the severity, you may struggle to look after yourself and your baby. You may find simple tasks difficult to manage.
Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault.
Some of the symptoms are similar to those of depression that occurs at other times. Symptoms include:
- A persistent feeling of sadness and low mood
- Feeling irritable or angry with your partner, baby or other children
- Feeling unable to enjoy or be interested in anything
- Feeling hopeless
- Lack of energy and feeling tired all the time
- Trouble sleeping at night (even when your baby is asleep) and feeling sleepy during the day
- Appetite changes
- Difficulty bonding with your baby
- Withdrawing from contact with other people
- Difficulty concentrating and making decisions
- Negative thoughts - for example, that you are not a good mother, that your baby doesn’t love you or that you can’t cope
Contact a GP, or call 111, immediately if:
- You are unable to look after yourself or your baby
- You have frightening thoughts about hurting your baby. These can be scary, but people with these kinds of thoughts rarely harm their baby
- You are thinking about suicide or self-harm
- You develop unusual beliefs (delusions) or hallucinate (seeing and hearing things that are not real, like hearing voices) - this may be postpartum psychosis
Always call 999 or go to A&E if you think there is a danger of immediate harm to yourself or others.
It is not known exactly what causes postnatal depression, but several causes have been suggested. It is likely that a number of different stresses may add up to cause it.
Anyone who has had a baby can develop postnatal depression, but some of the risk factors that mean you are more likely to experience postnatal depression are:
- Previous mental health problems (particularly depression) earlier in life
- Depression or anxiety during pregnancy
- A poor support network, for example having no close family or friends to support you
- A difficult relationship with your partner
- Recent stressful life events, such as death of someone close to you or relationship breakdown
- Physical or psychological trauma, such as domestic violence or abuse
More than half of new mothers will experience the "baby blues”.
They start in the first week after having a baby, usually about three to four days after birth. Symptoms include feeling down, tearful or anxious. You may be irritable, or over-react to certain situations. The “baby blues” usually stop by the time your baby is about 10 days old. They do not last longer than two weeks after giving birth. If your symptoms last longer or start later, you might have postnatal depression.
Postnatal depression usually starts within one or two months after having a baby, but it can start any time in the first year after giving birth.
Postnatal depression sometimes begins during pregnancy, but it would only be called postnatal depression if it continues after you have had your baby.
For some women, postnatal depression can develop suddenly. For other women, it can develop gradually, so many do not realise they have it.
This video produced by NHS features three women discussing their personal experiences of postnatal depression and the symptoms they had.
If you recognise any of these signs or symptoms, you are not alone. Postnatal Depression is a depressive illness which affects between 10 to 15 in every 100 women having a baby. You can talk to one of Keeping Well practitioners who can signpost you to the right available support.
- Don't be shocked or disappointed if your partner, friend or relative says she has postnatal depression. It is common and can be effectively helped.
- Make sure that you understand what postnatal depression is. Ask the health visitor or GP if you need more information.
- It's helpful just to spend time with someone who is depressed. It is important to listen and to offer encouragement and support. Reassure her that she will get better.
- Be mindful of language you use – this is an illness, not something someone can ‘snap out of’, ‘get on with’ or cure by ‘thinking positively’.
- Take your partner, relative or friend seriously if she talks about not wanting to live or about harming herself. Make sure she seeks help urgently (see our Urgent Help page).
- Encourage your partner, relative and friend to get the help and treatment she needs. If you have any worries about treatment, discuss these with the doctor.
- Do all you can to help with the practical things. This includes feeding and changing the baby, shopping, cooking or housework.
- If you are the mother's partner, make sure that you have some support yourself.
- If this is a first baby, you may feel pushed to one side, both by the baby and by your partner's needs. Try not to feel resentful. Your partner needs your help and support.
- Ensure you are a good role model and take care of yourself.
- Fathers can also get depressed after the birth of a baby. This may be more likely if the mother also has postnatal depression. If you are a father and think you may have depression, talk to your GP. It is important for you and your family that you get the help you need.
If you think you might be experiencing postnatal depression, it’s important to seek help as soon as possible. The support of your GP, a midwife or health visitor can be really helpful. Remember, it’s never too late to reach out for help.
The good news is that there are lots of effective treatments available, and most women make a full recovery with the right support.
The type of support you need will depend on how severe your depression is. Treatments include:
- Self-help – things you can try yourself such as talking to your family and friends about how you are feeling and what they can do to help you.
- resting or sleeping whenever you get the chance
- maintaining a healthy, balanced diet
- eating regularly (even if you don’t feel like eating)
- exercising and making time for yourself to do things you enjoy - for example, reading a book, meeting a friend for lunch or going for a walk. It can also be really helpful to try some relaxation and mindful breathing techniques.
Find more information about maintaining a healthy lifestyle after having a baby.
- Psychological therapy – Improving Access to Psychological Therapies (IAPT) services offer evidence-based talking therapies to help treat depression. The type of therapy offered will vary depending on your local IAPT service. Therapy may include guided self-help sessions with a therapist, cognitive behavioural therapy (CBT) or counselling. Women who are pregnant or have recently given birth are usually given priority. At Keeping Well, we can make a rapid referral to IAPT services on your behalf.
- Medication – If your depression is more severe, or it has not improved after trying other treatments, your doctor may prescribe medication such as antidepressants. If you are breastfeeding, you can talk to your doctor about medicines that are safe to take while breastfeeding.
At Keeping Well BLMK, we can provide a safe, supportive space for you to talk about what’s going on for you. We can also help think with you about how you might want to access support and make onward referrals if needed.
Postnatal Depression: an NHS self help guide
In this self-help guidebook from the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, they provide information on identifying whether you are suffering from postnatal depression, explain the causes of postnatal depression, help you consider the best ways to support yourself, and suggest other places you can seek support.
Understanding postnatal depression and perinatal mental health
In this booklet produced by Mind it explains postnatal depression and perinatal mental health. Including causes, sources of treatment and support and advice for friends and family. It also includes chapters on PTSD and childbirth trauma, postpartum psychosis and perinatal anxiety.
- Association for Post Natal Illness (APNI) - provides support to mothers suffering from postnatal illness including postnatal depression. They can also support husbands/partners and families.Helpline: 020 7386 0868 or Email: firstname.lastname@example.org
- Birth Trauma Association - support for women who have experienced traumatic childbirth, and their partners. Email: email@example.com
- The Breastfeeding Network - useful information on breastfeeding and mental health, including a helpful guide on antidepressants.
- National Childbirth Trust (NCT) - charity for parents, providing support, information and local networks. Helpline: 0300 330 0700
- Maternal Mental Health Alliance - search for local support groups and find details of national telephone or email support lines.
- Mind - the mental health charity. Infoline: 0300 123 3393 or Email: firstname.lastname@example.org
- Pre and Postnatal Depression Advice and Support (PANDAS) - information and support for anyone experiencing a mental health problem during or after pregnancy. Helpline: 0843 28 98 401
- Samaritans - confidential support for anyone in a crisis. Helpline: 116 123 or email email@example.com
See these pages for more information about postpartum depression and how you can get support: