Postpartum Depression: “ Not Just Baby Blues”

A Common Condition

A huge 80% of all mothers experience the ‘baby blues’, which classically arrive in the first week after the birth (often on day four!) and are usually dispelled after a few days with plenty of support from your partner, family and friends.

For one in ten new mums, however, ‘the blues’ last longer than two weeks and are often a sign that postnatal depression is developing. Postnatal depression can begin at any time during the first year. It can be experienced by first time mums, mums who already have several children and even fathers – although theirs usually kicks in later, around 3-6 months after the birth. Postnatal depression can also affect women who have had a miscarriage or stillbirth.

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A Mother's Story

A Mother's story

“Sitting looking at my beautiful baby as he slept, I felt strangely detached from him and although I recognised how happy everyone was with his arrival, I felt empty and sad. I couldn’t muster any enthusiasm; even yesterday when Mum said she would babysit whilst I had my hair done…Why do I feel so inadequate? Why am I a bad mother? These feelings have swamped me for several weeks now, but I can’t get help….”

The excitement leading upto the birth, all the books and magazines with photos of happy, relaxed mothers with their babies – no wonder it can seem hard to admit that you could be suffering from postnatal depression or, to give it its medical name, postpartum depression.

A Common Condition

A huge 80% of all mothers experience the ‘baby blues’, which classically arrive in the first week after the birth (often on day four!) and are usually dispelled after a few days with plenty of support from your partner, family and friends.

For one in ten new mums, however, ‘the blues’ last longer than two weeks and are often a sign that postnatal depression is developing. Postnatal depression can begin at any time during the first year. It can be experienced by first time mums, mums who already have several children and even fathers – although theirs usually kicks in later, around 3-6 months after the birth. Postnatal depression can also affect women who have had a miscarriage or stillbirth.

Can It Be Avoided?

Unfortunately, not much can be done to prevent postnatal depression, as scientists believe it is triggered by a variety of elements such as hormonal changes, genetics, and psychosocial factors, including stress and a lack of social support. 

It has been established that mothers who come from a family with a history of depression can be more susceptible, as can those with bipolar or mums who had difficulties during childbirth. Other factors that have been found to play a role include smoking, severe pre-menstrual symptoms or bottle feeding rather than breastfeeding.

Some medical experts believe that postnatal depression can actually begin in the run-up to the birth, especially when the pregnancy is unwanted, the parents have a bad relationship, or the mother is going to be a single parent.

What to Do

The most important point is that if you think you could be suffering from postnatal depression, seek help from your GP, health visitor or midwife, because it is not going to go away, and they will be able to help. The help you need will depend on how severe your symptoms are. 

These are often evaluated using the Edinburgh Postnatal Depression Scale, which is a series of questions. Admitting that you have postnatal depression is no different from telling someone that you have any other illness or injury.

It is not your fault, as it can happen to absolutely anyone. You will not be seen as a bad parent because you have postnatal depression, nor will your baby be taken away from you. Seeking medical help is the first step to feeling better.

Signs to Look Out For

There are a number of signs that you or someone you know could be struggling with postnatal depression:

  • Feeling unhappy and having a low mood that cannot be shaken off.
  • Feeling anxious, ’empty’ and not being able to concentrate.
  • Experiencing mood swings, irritability and anger.
  • Feeling very tired and exhausted (from more than just a lack of sleep).
  • A changing sleeping pattern and not being able to sleep properly at night.
  • Low self-esteem.
  • Not wanting to see anyone and staying at home.
  • Having difficulty bonding with the baby and possibly having thoughts about harming the baby.
  • Feeling hopeless or inadequate.
  • Not getting enjoyment from the outside world.

You don’t have to be experiencing all of these signs but, most importantly, talk things through with your doctor or health visitor to establish whether you have postnatal depression – don’t suffer in silence. Interestingly, 50% of men who suffer from postnatal depression have partners who have the same illness.

Combating Postnatal Depression

Postnatal depression can take several months or up to a year to shift but the good news is that there are effective cures. Your GP may well refer you for Cognitive Behavioural Therapy (CBT), as part of a group or on a one-to-one basis. CBT is very effective, but you do have to complete the ‘homework’ set to you by the counsellor, which usually involves trying to complete a task that you are currently struggling with. Your GP may also prescribe anti-depressants and, as the condition is so common, there are ones on the market that are suitable for breastfeeding mothers.

There are things that you can do that will boost your spirits, including sharing how you are feeling with your family and close friends – as the saying goes, a problem shared is a problem halved. Accept their offers of help with your baby, as even a relaxing and leisurely bath or doing something you want to do for you really does boost morale. Whenever your baby sleeps during the day, take the opportunity to rest too.

Chores CAN wait – look after yourself first and then the house! It will also give you the opportunity to look at websites on postnatal depression. The London-based Association for Post-Natal Illness (APNI) has YouTube videos and leaflets in a variety of languages, whilst the Pre-& Post-Natal Depression Advice & Support (PANDAS) charity offers telephone and email support.

Try to increase the amount of exercise you do each day, as this has been proven to be beneficial. If you can escape to the gym, that’s great, but even a brisk daily walk with the pram will lift your spirits! As your baby grows, he or she will be happy to get out and about!

Talk to them all the time and sing to them – you might feel slightly daft doing so, but it will help you feel good and you will soon be the proud parent of a smart kid too!

Depression and anxiety in pregnancy and following childbirth affect 25 to 30% of women. When untreated, these illnesses impair women and lead to poor infant attachment, poor cognitive development, and higher rates of psychiatric disorders in their children. My name is Lauren Osborne. I’m the Assistant Director of the Women’s Mood Disorders Center at John Hopkins. And my lab studies the biology behind mental illness during and just after pregnancy.

One question we’re working on is why some women are more vulnerable than others to the hormonal shifts of pregnancy and childbirth. Our lab is studying how the pregnant body processes hormones and examining differences in immune functioning between women who are ill during pregnancy, and those who are well. Our goal is to help find new ways to treat symptoms that can devastate the health of mothers and children at a vulnerable period. .

    Tony

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