Postnatal depression (PND)

What is postnatal depression?

Many new parents feel tired or overwhelmed, but postnatal depression is different. In postnatal depression, feelings of sadness, numbness or hopelessness last longer, are more severe and affect your ability to cope with and enjoy your daily life. A low mood is also often accompanied by physical symptoms such as trouble sleeping and changes in appetite or eating habits. Postnatal depression can last for a long time, and usually gets worse if it’s not treated.

Postnatal depression is common, affecting about 1 in 5 Australian mums and 1 in 10 dads in the first year after they have a baby, but that doesn’t mean it’s normal. If you are struggling with depression, there’s lots of support available to help you get back to enjoying life and your new baby.

What is the difference between ‘baby blues’ and postnatal depression?

About 4 out of 5 new mums experience ‘baby blues’ in the first week or so after having a baby. These feelings are usually due to the hormonal changes that happen after during pregnancy and birth. If you have ‘baby blues’, you may feel moody, anxious, tearful or have difficulty sleeping. Although these feelings can be challenging, they usually pass quickly on their own with no special treatment.

In postnatal depression, your symptoms last longer than 2 weeks, may be more severe and often interfere with your ability to function normally. Unlike ‘baby blues’, postnatal depression doesn’t usually go away on its own. This can be especially tough to cope with when you are recovering from birth and have a new baby to look after.

It can be hard to know if what you’re feeling is normal or might be the start of something more serious. If you’re not sure, it’s a good idea to check in with your doctor or child health nurse.

What is the difference between postnatal anxiety and depression?

Both anxiety and depression are more common after the birth of a baby. Many people who have postnatal anxiety will have postnatal depression at the same time. Some symptoms are similar, but anxiety and depression are different conditions that may need different treatments. In postnatal depression, your mood is usually affected, while in postnatal anxiety, you will have feelings of worry or fear that are difficult to control. In both conditions, you may struggle to cope with your daily activities.

Am I at risk of postnatal depression?

There are risk factors that increase your chance of developing postnatal depression:

• a history of depression or mental illness
• previous pregnancy losses
• a difficult pregnancy or birth
• a baby who is unwell or difficult to settle
• a history of physical, sexual or emotional abuse
• a lack of social support

Having one or more of these risk factors does not necessarily mean that you will develop postnatal depression.

If you have any of these risk factors, make sure you have enough practical and psychological support during your pregnancy and after your baby’s birth. This can help to reduce your chance of developing depression and help you to cope better if you do become unwell.

What are signs of postnatal depression?

People will experience postnatal depression differently, but many people will have similar symptoms or difficulties. It’s a good idea to be aware of the common signs of postnatal depression since they are often missed or dismissed as a normal part of life with a new baby.

Common signs of postnatal depression you might notice include:

• feeling low or not feeling anything (feeling numb)
• feeling hopeless or worthless
• losing interest in others, including your new baby
• sleeping too much, or having difficulty sleeping
• changes in appetite, together with weight loss or weight gain
• difficulty coping with daily activities
• thoughts of harming yourself or your child

How is postnatal depression diagnosed?

If you notice symptoms of postnatal depression, talk to your doctor, midwife or child health nurse. They may ask about how you have been feeling, give you a questionnaire to complete and ask to speak with your partner, if you have one. They may also do a physical examination.

Try to be as honest as you can — this will make it easier for the doctor or nurse to give you the treatment and support you need. Remember, postnatal anxiety and depression are extremely common. There’s no need to feel ashamed.

What is the Edinburgh Postnatal Depression Scale?

The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire used to help identify people who may have postnatal depression and/or anxiety. The questionnaire contains 10 statements about how you have been feeling. For each statement, you are asked to choose the response that best matches how you have felt over the past 7 days. Each response corresponds to a number. If your total score for the questionnaire is over 13 points, you should seek help from your doctor or midwife since you may have postnatal depression.

It’s a good idea to complete the EPDS together with your doctor or midwife, who can provide you with more information and support. You can complete the EPDS at home on the Beyond Blue website.

It’s also important to remember that the EPDS cannot be used to diagnose postnatal depression by itself. Only a trained health professional can fully assess your symptoms, give you a diagnosis and recommend the right treatment for you.

How is postnatal depression treated?

If your symptoms are mild, it might be enough to get extra support from your family, friends, doctor or nurse. If your symptoms are greater, your doctor might recommend psychological therapies or an antidepressant medication. Your doctor will discuss with you the benefits and disadvantages of any treatment, and the impact of any medication on breastfeeding.

If you are struggling with postnatal depression, it’s especially important to look after your physical and mental health. You can do this by:

• accepting practical help and emotional support from friends and friends
• eating a healthy diet
• keeping active
• planning for regular, quality sleep
• using stress-management techniques, such as muscle relaxation and deep breathing

It can be especially difficult to establish and maintain a healthy lifestyle while recovering from birth and looking after your new baby. There is no shame in asking for and accepting help from family and friends. Self-care is important to keep yourself physically and mentally healthy. Remember that looking after yourself benefits your whole family, especially your new baby.

What is postpartum psychosis?

Postpartum psychosis is a rare but serious mental illness that starts soon after someone gives birth. In postpartum psychosis, a person loses touch with reality and may experience confusion, severe agitation, delusions (fixed and untrue thoughts that may be distressing) and/or hallucinations (hearing or seeing things that are not there). The symptoms of postpartum psychosis often come on quickly and can be scary and distressing for the person affected as well as their loved ones.

Postpartum psychosis is a psychiatric emergency and needs to be treated straight away. If left untreated, it can be very dangerous for both you and your new baby. If you are concerned that you or someone you love is affected, get help straight away.