Postnatal Depression (PND): key facts
Postnatal depression - Louise's story
Louise is a young mother who developed postnatal depression (PND)
following the eventful birth of her first child. Here, she
discusses with Raj Persaud her experiences, and what it was like to
be admitted to a Mother and Baby Unit.
How does it feel to have this disorder?
- feeling anxious or irritable
- not sleeping even when your baby sleeps
- poor appetite (or comfort eating)
- guilty and negative thoughts
- being unable to enjoy things
- feeling that life just isn't worth living
- finding it hard to look after yourself and the baby.
PND often starts within 1-2 months of giving
birth, but can develop later in some women. In many ways it feels
similar to depression at other
times of life (and depression in pregnancy can continue after
birth). The difference in PND is that, understandably, there is
often a great deal of focus on the baby and in being a mother. For
example, it can be difficult to bond with your baby which can lead
to worries about the baby's welfare or anxiety about your qualities
as a mother.
It is important for you and those around you to be aware of
these feelings persisting, because PND is a very treatable
condition, and the risks of missing it can be very distressing.
What causes Postnatal Depression?
Many causes have been suggested. It is more
likely if you have:
- had depression or other mental health problems before
- had depression or anxiety in pregnancy
- no support
- had a recent stressful event, such as a relationship
Treatments that can help
Why is treatment important?
Most women will get better without treatment in 3 to 6 months. 1
in 4 mothers with PND are still depressed when their child is
one-year-old. Depression can affect your relationship with
your baby and partner. It can also affect your child's development.
So the shorter it last, the better.
Where to get help for Postnatal Depression
Talk to your GP or Health Visitor. For urgent
help, go to the Accident and Emergency Department or contact your
GP or your mental health service.
The help you need depends on how severe your depression is.
Everyone can try the self-help suggestions below. If this is
not enough, you might benefit from a talking therapy. For more
severe depression, you may need medication, with or without talking
Talking helps. Your GP can refer you for counselling. Cognitive Behavioural
Therapy helps you to see how some of your ways of
thinking and behaving may be making you depressed. Other therapies can help you
understand the depression in terms of what has happened to you in
What about antidepressants?
These may help if your depression is severe or not improving.
There are several types of antidepressants. They all
work equally well, but have different side-effects. They are not
addictive. They can all be used in PND, but some are safer than
others if you are breastfeeding.
Antidepressants take at least 2 weeks to start working. You need
to take them for around 6 months after you start to feel
Are there alternatives?
Hormones probably don't work well and they may have their own
dangers, particularly if you have had thrombosis (blood clots in
St John's Wort
is a herbal remedy. There is evidence that it is effective in mild
to moderate depression. There is not enough information to
say that it is definitely safe in breastfeeding.
St John's Wort can interact with other medicines. Check with
your doctor before you take it. This is very important if you are
taking the oral contraceptive pill. St John's Wort might stop your
pill working. This can lead to an unplanned pregnancy.
Even if you have been depressed for a while,
support, counselling and medication can all help. It's never too
How to help yourself
- Do tell someone how you feel - your partner, a
relative, a friend, your health visitor or your GP.
- Do sleep or rest during the day or night when
- Do try and eat regularly.
- Do find time to do things you enjoy or help
- Do go to local groups for new mothers or
postnatal support groups.
- Do let others help with housework, shopping
and looking after other children.
- Do exercise.
- Do use self-help books and websites.
- Do contact organisations that support women
with Postnatal Depression.
- Don't blame yourself, your partner or close
friends or relatives.
- Don't use alcohol or drugs.
Can Postnatal Depression be prevented?
We don't know enough about PND to prevent it.
These things make sense:
- Don't try to be 'superwoman' - do less and
try not to get over-tired.
- Make friends with other pregnant women or new
- Find someone you can talk to. If you don't have a close friend,
try the National Childbirth
Trust or the Pandas Foundation.
They have support groups.
- Go to antenatal classes.
- Don't stop antidepressant medication in pregnancy without
advice. Discuss this with your GP. Around 7 out of 10 women
who stop antidepressants in pregnancy relapse.
- Keep in touch with your GP or health visitor if you have had
depression before. They can recognise any signs of depression
- Make sure you have treatment for depression in pregnancy.
- Accept offers of help from friends and family.
How can partner, family or friends help?
- Take time to listen.
- Try not to be shocked or disappointed by the diagnosis - it can
- Encourage your partner, relative or friend to get the help and
treatment she needs.
- Give practical help like shopping, feeding, changing the baby,
For more in-depth information see our main leaflet:
This leaflet reflects the most up-to-date evidence at the time
Produced by the RCPsych Public Education Editorial Board.
Series Editor: Dr Philip Timms
Main author: Dr Lucinda Green
Reviewed by Dr Michael Yousif
© February 2014. Due for review: February 2016. Royal
College of Psychiatrists. This leaflet may be downloaded,
printed out, photocopied and distributed free of charge as long as
the Royal College of Psychiatrists is properly credited and no
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