:::::

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.

Postnatal Psychosis

- 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.

Postnatal Depression

- 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