The weeks and months after giving birth can be a vulnerable time for new parents. If you think you may be suffering from postnatal depression, here’s how you can find help.
- Depression among new mothers has almost tripled since the start of
- Up to a third of new fathers can experience depression, yet only 1 in 5
- Support and therapy are available through your doctor
Having a baby can be one of the happiest times. But it can also be stressful — one that can bring feelings of confusion, loneliness and for many, depression.
‘Adjusting to motherhood can be a challenge under normal circumstances,’ says Dr Elisabeth Rosen, medical doctor at Livi.
‘But giving birth during a pandemic presents extra concerns — social distancing, changes in hospital procedures and worries about exposure to Covid-19, can make women feel even more susceptible to anxiety and depression.’
You’re not alone
Postnatal depression is a common problem that affects 1 in 10 women in the UK, within a year of giving birth.
A new study shows that depression among expectant and new mothers has almost tripled since the start of the coronavirus pandemic – going from 15% to 41% of new mothers. It also showed moderate to high anxiety rose from 29% to 72% in pregnant women and new mothers.
Postnatal depression or ‘baby blues’?
‘It‘s perfectly normal for many women to experience what‘s commonly known as the ‘baby blues‘ in the first week or so after giving birth,‘ says Linda Karlsson, Licensed Psychologist at Livi.
‘This can last anything from a few days to a week or so.‘ Typical symptoms include feeling emotional and bursting into tears for no apparent reason, feeling irritable or touchy, low mood, anxiety and restlessness.
‘If you’re still feeling low after 2 weeks, this may be a sign of postnatal depression. This can also affect fathers and partners.’
Symptoms of postnatal depression
Postnatal depression can occur at any time in the first year after giving birth. ‘All women are different and not all women with postnatal depression get all the symptoms,’ says Karlsson. If you get any of the symptoms below, talk to a doctor or psychologist.
Main symptoms include:
- Persistent depression, sadness and low mood
- Lack of energy and feeling tired all the time
- Lack of enjoyment and interest in the wider world
Other symptoms may also include:
- Problems sleeping at night and feeling sleepy during the day
- Difficulty bonding with your baby
- Withdrawing from other people
- Lack of concentration and finding it hard to make decisions
- Disturbing thoughts, for example, about hurting your baby or suicide
How your hormones can affect your mood after childbirth
‘We don’t know exactly why postnatal depression occurs,’ says Dr Rosen. ‘But one of the reasons (although there’s no conclusive evidence for this) may be the rapid drop in the hormones oestrogen and progesterone straight after you give birth.’
‘Low progesterone can cause anxiety, mood swings, irritability and depression,’ says Dr Rosen.
‘The drop in oestrogen can also trigger depression and anxiety. While the increase in the calming, bonding hormone oxytocin (that occurs during breastfeeding) should help to compensate for this, it seems that in some women this doesn’t happen. Once you stop breastfeeding, hormones should gradually go back to normal.’
Be aware, though, that postnatal depression can be triggered by many other factors, and it differs from person to person.
Breastfeeding and emotions
Some women who are breastfeeding experience abrupt dysphoria, or negative emotions like sadness, depression, anxiety and irritability just prior to the moment milk is released. This is a condition called Dysphoric Milk Ejection Reflex (D-MER).
These feelings are usually brief and pass in 30-90 seconds. While they can be distressing, it can be reassuring to know that these are not a sign of postnatal depression.
But if you‘re experiencing postnatal depression, D-MER will be harder to handle.
So it’s important to get help from a doctor or a psychologist.
Who’s at risk of postnatal depression?
Some people will be more at risk of developing postnatal depression — these include:
- Women (and men) with a history of mental health issues, particularly
- A history of mental health problems during pregnancy
- Having no close family or friends to support you
- A poor, troubled or abusive relationship with your partner
- A history of substance abuse
- Lack of sleep after the baby is born
- A stressful or traumatic labour
- Feeling overwhelmed and worried about being a parent
- Having experienced recent stressful events like a bereavement or
separation from your partner
- Experiencing the baby blues
- Financial worries
Postnatal depression in men
It’s not just women who are at risk of developing postnatal depression – men can get it too.
Until recently, it was believed approximately 10% of new fathers experience postnatal depression. But a recent study suggests this figure might be as high as 27%. Yet fewer than 1 in 5 fathers who were depressed sought help, and a third had considered self-harm.
The study showed that while many women are screened for postnatal depression, the mental health of fathers is rarely assessed. What’s more, postnatal depression in men may show itself in different ways, like anger, irritability, working longer hours and drinking too much.
Read more about the signs of depression in men.
Help for postnatal depression
‘To meet the criteria for postnatal depression, symptoms need to last for at least 2 weeks,’ says Dr Rosen. ‘It usually happens between 4 and 6 weeks after giving birth, but may be any time after pregnancy. ‘There is an expectation of women that they should feel super-happy after having a baby, but many women are hesitant to admit they don’t feel this way.
‘In fact, it’s common for new parents to feel depressed, confused, frustrated, tired and disillusioned — that’s nothing to feel ashamed of.‘Support and treatments are available, so speak to a doctor, who can help you to work out what are the best options for you.’
In the UK, many healthcare visitors have been trained to recognise postnatal depression and can help advise you on strategies that can help. ‘Whatever you do, don’t suffer in silence,’ says Dr Rosen. ‘If you think your partner is having problems, encourage them to get help too.’
Postnatal depression self-help
Talk to family and friends. Tell them how you’re feeling and don’t be afraid to ask for help with things like looking after the baby, so you can catch up on sleep or have a night in with friends.
Find local support. If you don’t have anyone to turn to, for example, you’re a single mother with no friends or family close by, look for local support groups. A doctor should be able to help you find one in your area.
Rest. Try not to be a perfectionist. It doesn’t matter if your house doesn’t look immaculate, or if not all the chores are done. It’s more important that you catch up on sleep and rest when you can.
Eat healthily. Having a baby makes demands on the body. So eating a healthy diet and exercising regularly (or when you can) is crucial. If you haven’t the energy to go shopping or cook properly, ask friends and family to help out until you get back on your feet again.
Expert help available
Psychological therapies. Your doctor can refer you for a course of therapy with a psychologist. Cognitive behavioural therapy (CBT) is shown to be effective in treating postnatal depression.
Medication. Antidepressants may be recommended in certain cases where depression is severe and other treatments haven’t helped. Your doctor will advise you on the safest options to take if you’re still breastfeeding.
If you have a history of mental health issues or depression, or a family history, talk to a doctor or mental health team if you’re thinking about having a baby.
Your doctor should arrange for you to be seen regularly in the first few weeks after giving birth.
This article has been approved by Dr Elisabeth Rosen, medical doctor, Livi