Post-Natal Depression

There are three types of depression that may affect women within the first year after their baby's birth.

'Baby Blues'

- This is often regarded as normal because it is so common. Symptoms develop around the 3 rd day after birth but have usually disappeared by the 10 th day and do not require any medical attention. It is a time of extra sensitivity with a tendency towards tearfulness, anxiety, insomnia and mood swings.

- The least common but most serious form of post natal disorders, this usually appears within the first few months after childbirth, to mothers with a personal or family history of bipolar disorder or schizophrenia.

- This generally has a much slower insidious onset, most likely occurring between 3 - 9 months after the baby's birth and occurs in 1 in 10 mothers. It may persist 6 -15 months, or even longer, especially if it is not treated. Symptoms vary and are discussed further on in this article.

Causes of Postnatal Depression (PND)

There are no clear causes of this illness but several triggers have been identified that may lead to PND. Any mother can develop it but some, even with multiple factors of stress in their lives, do not.

Physical reasons:

• Family history of depression
• Having previously had depression or PND
• Experiencing a difficult delivery and /or pregnancy
• Anaemia
• A caesarian operation if a natural childbirth was wanted
• Low levels of thyroid hormone

Psychological reasons:

• Existing low self esteem
• Memories of being poorly parented
• Being a perfectionist and/or a need to always be in control
• Unresolved past grief from a loss of a child or miscarriage

Social reasons:

• Feeling alone or isolated from friends and family
• Relationship problems with her partner
• Relationship problems with her parents
• The pregnancy having been unwanted
• Major social changes in her life e.g. independence, financial status, employment, activities etc.

Symptoms of PND

Feelings:

• Persistently low mood
• Inadequacy, helplessness and hopelessness
• Exhaustion
• Tearfulness
• Guilt, shame
• Confusion, panic and anxiety
• Fear of and for the baby
• Wanting to run away

Thoughts:

• Inability to make decisions
• Lack of concentration and poor memory
• Fear of being rejected by partner
• Worry about harm to partner or baby
• Thoughts about self harming the baby
• Ideas about suicide

Behaviour:

• Lack of interest in usual activities
• Insomnia or excessive sleep
• Eating disorders
• Lack of motivation
• Withdrawal from social contact
• Poor self care
• Inability to cope with routine tasks

Treatment

Not all PND requires medical or psychological intervention but help must be sought immediately if the mother is suicidal or has contemplated harm to herself or the baby. Taking care of herself and seeking support from others, whether they be a partner, family or friends, is very important to get through this time. Some of the areas to look at are:

• Learning to take one step at a time and not be overwhelmed by what is happening.
• Setting small goals for the next hour or day, that can be easily achieved
• Doing some physical exercise
• Eating a balanced diet, with particular attention to consumption of enough calories to allow the body to stabilize after pregnancy and childbirth
• Stop trying to achieve perfection
• Accepting all reasonable offers of help
• Involving partner in care of the baby and household chores
• Taking 'time out' everyday just for self
• Trusting own judgement
• Talking to someone trustworthy about thoughts, feelings and fears
• Seeking professional help

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