The “baby blues” is such a common phenomenon for new mothers - affecting over half of us - that it is considered normal. Attributed to the massive hormonal changes that take place after birth, it usually starts at around 2-4 days postnatally and can last up to 10 days.
So don’t worry when - after two days of glorious elation - suddenly everything your husband says and does annoys you; tears flow because there was no cucumber in your tuna sandwich; or you wonder whether you’re really ready for motherhood.
For 10-15% of new mothers, these inevitable mood changes that occur after childbirth go beyond this normal pattern. Depression remains a taboo subject for many: some find it hard to admit that they’re suddenly less-than-thrilled about having a new baby. Because of this, the condition can often go unrecognised for weeks or months. Postnatal depression (PND) is thankfully well-known, is usually temporary, and is easier to treat than other forms of depression.
We don’t yet know exactly what causes PND, but we do know some of the rick-factors: The most obvious is where the mother has a history of depression, anxiety or other mental health problems. A small minority of women develop an underactive thyroid gland which can cause mood changes.
Stressful life-events can also provoke PND, including bereavement, illness, unemployment or moving house. PND is more common in women who’ve had traumatic births, or whose babies were premature or unwell. The huge change in lifestyle having a baby brings, coupled with chronic lack of sleep and a perceived loss of freedom, can also lead to feelings of depression.
A new baby profoundly impacts relationships with husband, family and friends, and can lead to a sense of isolation, which increases the risk of developing depression. Media portrayals of “perfect” mothers may exacerbate feelings of inadequacy.
Symptoms of PND include irritability, anxiety, constant exhaustion, insomnia, increased or decreased appetite, poor concentration, tearfulness, and feelings of hopelessness, or inability to cope with caring for the baby, oneself, or household tasks. Conversely, the mother may show obsessive behaviours such as meticulous cleaning. Panic attacks can occur, and some women stop socialising or even leaving the house. Recurring thoughts about harming baby may occur, though it is rare for women to act on this. Some women feel suicidal. Very rarely the mother may develop psychotic symptoms, where they lose touch with reality and may hear voices. This is called puerperal psychosis, and requires treatment in hospital.
If you think you or your loved one may have, or be at risk of developing PND, the most important thing to do is seek help; talk to your GP, public health nurse, midwife or obstetrician. Treatments for PND include talking therapies and medication. It is rare to need inpatient treatment for PND.
Living with a depressed person can be frustrating, but there are ways in which loved ones can help. Finding ways for the mother to rest is very important. As is allowing someone to help bottle feeds, housework and childcare.
Mothers should be encouraged to talk through their feelings. It’s helpful to limit feelings of isolation by joining support groups, socialising with other new mums and spending time with friends and loved ones. Self-help books and websites help some women, and there are many dedicated to PND. Regular exercise has been proven to help treat depression. Eating regular, healthy meals also helps.
For more information on postnatal depression speak to your GP.