Postnatal Depression - PANDAS Foundation UK

 

What is Postnatal Depression?

Postnatal Depression (often known as PND, or postpartum depression) is an illness that usually occurs within the first year after giving birth. It causes depressive symptoms such as low mood, confusion, and withdrawal from others.

PND can follow on from Prenatal Depression (depression during pregnancy), or it can occur on its own. It’s different from the ‘Baby Blues’ (a feeling of low mood or tearfulness, that so often affects women in the first few weeks after giving birth that it’s seen as normal), as PND symptoms are deeper, and more long term. If untreated, PND can have long term effects on the parent, or parents. It most often occurs 4-6 months after giving birth, although symptoms can begin any time.

Postnatal depression can also affect fathers, particularly occurring after a stressful or traumatic birth, and has many of the same symptoms and effects.

 

Symptoms of Postnatal Depression

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  • Low mood for a long period of time
  • Irritability
  • Emotional
  • Panic attacks
  • Lack of concentration and motivation
  • Lack of interest in your new baby and/or yourself
  • Feeling alone
  • Difficulty sleeping or feeling constantly tired
  • Tension – headaches, stomach pains or blurred vision
  • Decrease in appetite or increased appetite
  • Reduced sex drive
  • Feeling useless, worthless and guilty
  • Feeling overwhelmed with situations
  • Unrealistic expectations of motherhood

 

 

Possible Causes of Postnatal Depression

It is very rare for there to be a single cause in any depressive episode, and several factors are normally the cause. The alteration in hormones after child birth has previously been blamed as the cause of postnatal depression. However, in recent years researchers haven’t found any difference in hormones between women which have postnatal depression and those who don’t. It is more likely a result of the combination of life changing events such as childbirth, any previous situations or events. Looking after a new born baby can be demanding, some cry more than others, which may mean they are more difficult to look after. 

There is no single cause of Postnatal Depression. It’s not clear why some people develop PND and other’s don’t, however there are certain risk factors which can make them more likely to experience the illness. These risk factors include:

  • A history of depression, including previous PND
  • Having had Prenatal Depression or other mental health problems during pregnancy
  • A lack of Support Network (friends, family or partner)
  • Stressful Life Events
  • Birth Trauma
  • Socio-economic problems
  • Loss or bereavement

It doesn’t matter if you have not had PND with a previous child, or if you have none of the above risk factors. There is thought to be some link genetically – research has shown people whose sisters or mothers had PND are at an increased risk – but this may be down to environmental factors rather than genetics.

Birth is also a life changing event in itself, regardless of whether the birth was medically simple or complex – and life changing events are, in themselves, sometimes a trigger for depression.

Having certain ‘expectations’ before having a baby that aren’t fulfilled (such as sudden changes to your birth plan, feeling a lack of control or being frightened during labour, being unable to breastfeed if you had planned to, or having the physical effects of a birth slow you down) can also be a risk, as too can having a baby who is born unwell, early, or with complications.

You may have found you are no longer working, have less of a social life, and have a reduced income compared to pregnancy or even before. This change in circumstances can cause added pressure and may be one of the factors to cause postnatal depression.

The main thing to remember, is the having Postnatal Depression is not your fault. It can affect anyone, from any background, and for any reason. It is an illness, and nothing to be ashamed of or embarrassed about. There are many different treatments, but the most important thing to do is speak to someone about how you are feeling.

Awareness of postnatal depression is increasing, so G.P.s, Midwives and Health Visitors should be asking you specific questions regarding your mood during pregnancy and after labour to detect signs of possible postnatal depression. 

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What treatment is available for Postnatal Depression?

It can be difficult to seek help for Postnatal Depression, and parents may delay speaking to their doctor or healthcare provider for fear of being seen as ‘not coping’. However, it’s really important to seek help as soon as possible, as without treatment PND can be a long term illness.

GPs are much more aware now of the symptoms of Postnatal Depression, and are there to guide you and help you choose the most suitable treatment.

 

Some of the possible treatment options include:

Self Help (including Guided, Online, Support Groups)
Your GP can help by providing links to support services in your area, offering guided self help programs (books or online courses, often supported by a therapist), or referring you on to specialist teams.

Talking Therapies
Counselling, such as CBT (cognitive behavioural therapy) or INPT (Interpersonal Therapy), may be offered depending on your area. These encourage you to talk through problems, and address ether the cycle of thoughts and behaviours, or how your relationships with others may contribute towards your feelings.

Antidepressants
Sometimes, antidepressants can be prescribed to help alleviate symptoms of depression. These work by balancing the chemicals in your brain to ease symptoms, which can help you to function while issues are worked through. There are antidepressants which are available while breastfeeding, however this should always be discussed with your doctor.

Specialist Mental Health Teams
For more severe PND, you may be put under care of a specialist team, such as a Community mental Health Team. They can help support your more intensively, or refer you on to other treatments if you are at risk – such as a mental health hospital, or a Mother and Baby Unit. Mother and Baby units are places across the UK where you can remain with your baby while you receive specialist care and support.

 

 

What Support is out there for Postnatal Depression?

Your family and friends can play a big part in helping your recovery. For them to be able to help, it is important you are honest with your friends and family about how you are feeling, and don’t bottle up your emotions.

Allow other people to carry out small tasks for you – such as house work, taking your baby for a walk, or simply looking after your baby for one hour every other day, to allow you to do something you want. It is important you allow yourself to have some ‘me time’. 

Self-help groups can offer you good advice and support on how to cope with postnatal depression as well as comfort to know that other mums are feeling the same as you, hearing other individuals experiences of postnatal depression can be a huge benefit, as you will be able to discuss techniques on how to cope, and have an understanding of each other’s feelings. PANDAS Support Groups offers just that, in a non-judgemental, safe environment. 

The most important support aid you can have is being able to talk to someone and be honest about your feeling and emotions.  Ensure you write down on a piece of paper or a notebook the numbers of people you can call when you are feeling your worst, and make sure the list is readily available, so if you feel you are becoming aggressive, upset, angry or anxious you can call someone and no that you are not on your own. You can add PANDAS Help Line on your list 0843 28 98 401, and we will always be here to listen. 

PANDAS Foundation also offers support via email, our website, PANDAS Help Line and PANDAS Support Groups.

References

Bertrum, Lynn (2008.) Supporting Postnatal Women into Motherhood. A guide to therapeutic group work for health professionals. Oxford: Radcliffe press.

Green J.M. (1998) Postnatal depression or perinatal dysphoriaFindings from alongitudinal community based study using Edinburgh Postnatal Depression Scale. Journal of Reproductive and Infant Psychology. 16, (1).

NHS Conditions: Postnatal Depression 

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