Postnatal Depression

I think I have postnatal depression!

Baby blues

After having a baby, up to 80 per cent of women may develop the ‘baby blues‘. This most common when milk is coming in which is on about day three after birth. You will typically may by tearful, crying with minimal or any provocation, feel overwhelmed and feeling you are not able to cope as a new mum. This feeling passes in a day or two and is different to postnatal depression.

Postnatal depression

Postnatal depression (PND) is a depression that comes on within 12 months of having a baby, usually during the first few weeks or months. It can range in severity from very mild and transient, to severe and lingering. For most mothers, it passes quickly; for others, professional help is needed.

Some women may experience depression during the pregnancy (this is called antenatal depression).

About one in eight mothers develop postnatal depression. Postnatal depression is most common after the first pregnancy.

What are the symptoms of postnatal depression?iStock_000010568823XSmall_thumb

Symptoms depend on the severity and may include:

  • Low self-esteem and lack of confidence
  • Feelings of inadequacy and guilt
  • Negative thoughts
  • Rejection of your new baby
  • Feeling that life is meaningless
  • Feeling unable to cope
  • Tearfulness and irritability
  • Anxiety, panic attacks or heart palpitations
  • Difficulty sleeping or changes in sleeping patterns
  • Difficulty concentrating or remembering things.
  • Low sex drive
  • Loss of appetite

Often it is the partner/husband who will recognise the symptoms first.

What is the cause of postnatal depression?

The cause of postnatal depression is still not known. Some contributing factors might include:

  • Hormone changes. Sex and other hormone changes after the birth may well be a significant trigger as the depression is temporally related to the postnatal period.
  • Adjusting to motherhood. A new mother has to deal with the constant demands of a baby, learning mothering skills, the challenges of breast feeding, and a different dynamic to her relationship with her husband/partner and the loss of her own independence. And all this happens in a background of broken sleep with chronic sleep deprivation and exhaustion

I find professional women significantly are more at risk of postnatal depression. Suddenly they have to adjust and find a life focus about ‘career success’ is now challenged by the new role of being a mother. Plus if this new mum had been very organised and used to ‘being in charge’ suddenly she is disorganised and her daily timetable centers on her baby’s needs. This can be very daunting for her. She can start to miss her work friends, challenges of the workplace, etc and is wondering about life-work balance for the future. Adapting to living on one wage may also be difficult.

  • Personality. We are all made up of different personality combinations. The person who has a personality tendency to structure, organisation, needing to know what to do next, or the opposite of taking charge is more at risk than those with a more laid back, no stress, personality style.
  • Adjusting to body image change. Having a baby will often have a significant impact on how a woman looks and feels about herself. She may not fit into her prepregnancy clothes, can?t lose the weight she put on in pregnancy, have stretch marks, be aware of loss of tone in her abdominal wall, and more. All this can have a huge psychological impact on her.
  • Loneliness. I find new mums who are isolated from family support by distance and who have no significant back up for helping with mothering challenges are more prone to postnatal depression. This is the time typically when a new mother wants her mother around. If this is not possible because of distance, her mother having to work, relationship issues with her mother or loss of her mother then she is more prone to postnatal depression.
  • Unresolved issues in the past If  there has been physical or emotional abuse as a child, relationship issues that are unresolved especially with a new mother?s mother then this is the time a new mother can decompensate and these past issues can trigger significant postnatal depression.
  • History of depression If a new mum has a history of depression before her pregnancy then she is more prone to postnatal depression.

What do if you think you have postnatal depression?

If you or your husband/partner recognise symptoms suggestive of postnatal depression then contact me or your general practitioner in the first instance.

You may also need the support of a psychologist who has a special interest in postnatal depression. Occasionally you may need to be admitted to a special hospital such as St John of God or other psychiatric facility. The help of a good psychiatrist is important. The St John of God web site (http://www.beatbabyblues.com.au) has lots of helpful information as well as their location details.

If you have psychologist or psychiatrist already then contact him/her also in the first instance.

Support and patience from your husband, family and friends are amongst the most crucial factors in your recovery. For you to talk about you feelings, particularly with another other woman who you know well and who is emotionally mature or joining a postnatal depression support group can be helpful. In more severe cases, antidepressants and other prescription medications might be needed.

Impact of postnatal depression on your relationship with your husband/partner

Having postnatal depression can put an enormous strain on any relationship, even when your husband/partner is patient, loving and supportive. It isn’t unusual for a couple battling postnatal depression to think that their relationship has soured beyond repair. Generally, this is not the case, since most relationships return to normal once the depression lifts. It is a good idea to postpone any major life decisions while in the grip of postnatal depression.

Impact of postnatal depression on your relationship with your baby

A woman with postnatal depression tends to withdraw from everyone, including her baby. This is a symptom of the disorder and doesn’t mean that she is a ‘bad’ mother. Some people think that bonding between the mother and child has to happen within the first few days or weeks of birth, or else it won’t happen at all. This is not true. Their relationship is an ongoing process. Once the depression lifts, the mother will be able to once again feel her full range of emotions and start to enjoy her baby. In the meantime, she might need some extra help from family and friends.

Posted by Dr Gary Sykes on -

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