Postnatal depression is depression that is lasting, as opposed to the baby blues, which are typically short lived. It usually occurs shortly after the birth, although it may go unrecognised for quite some time. Postnatal depression affects more than 15% of women and 10% of men. PND can develop between one month and up to one year after the birth of a baby.

There are three recognised mood disorders in the postpartum period.

Baby Blues

The baby blues usually occur between three and 10 days after giving birth. The baby blues are common and affect around 80% of women. Women with the baby blues may feel tearful and overwhelmed, due to changes in hormone levels following childbirth. The baby blues is common and to be expected following the birth of a baby. The baby blues usually disappear within a few days without treatment, other than support.

Postnatal Depression (PND)

PND is treatable illness that can cause fatigue, sadness, loss of enjoyment in activities, irritability, and anger.

PND can occur also occur during pregnancy (antenatal depression).

It can occur in all cultures, equally common in Maori and Europeans, all socio-economic classes and at all ages.

It happens mostly after the first baby but can occur after any other pregnancy. If you do develop postnatal depression there is a 50% chance that you will be affected in subsequent pregnancies.

Postnatal Psychosis

Affects one in 500 women in the first week or so after childbirth. It involves having difficulties thinking clearly (thought disturbance), seeing or hearing things that are not there (hallucinations), feeling everyone is against you (paranoia) and powerful delusions. This is a medical emergency and a doctor should be contacted immediately.

There is a risk to the life of both mother and baby if the problem is not recognised and treated. Postnatal psychosis requires a hospital stay. With appropriate treatment women suffering from postnatal psychosis fully recover.

Signs and Symptoms of PND

Postpartum depression can affect mothers in several different ways. Generally these symptoms are felt regularly over a period of approximately three to four weeks.

Below are some common signs and symptoms:

  • A feeling of being overwhelmed
  • A feeling of being trapped
  • A feeling that it is impossible to cope
  • A low mood that lasts for longer than a week
  • A sensation of being rejected
  • Crying a lot
  • Feeling guilty
  • Frequent irritability
  • Headaches, stomachaches, blurred vision – signs of tension
  • Lack of appetite
  • Loss of libido
  • Panic attacks
  • Persistent fatigue
  • Problems concentrating or focusing on things
  • Reduced motivation
  • Sleeping problems
  • The mother lacks interest in herself
  • A feeling of inadequacy
  • Unexplained lack of interest in the new baby
  • Lack of desire to meet up or stay in touch with friends.

What Causes PND?

Like depression, postnatal depression doesn’t have one definite cause, but it is more likely when a number of factors are combined:

  • A past history of depression and/or anxiety
  • A stressful pregnancy
  • Depression during the current pregnancy
  • Sexual abuse
  • A prolonged labour and/or delivery complications
  • Problems with the baby’s health
  • Difficult breastfeeding
  • Sleep deprivation
  • Being a single parent
  • Having an unsettled baby
  • Having unrealistic expectations about motherhood
  • Isolation and/or lack of support
  • Hormonal changes from childbirth
  • Family history of mental disorders.

Treatment for PND

The type of treatment that is best for you can depend on various things including:

  • How severe your depression is and what symptoms you have
  • The impact of your symptoms on your ability to function (to look after yourself and your baby)
  • Whether you have had depression or other mental health problems in the past
  • Your current situation.

There are many therapies for PND however the most important factor is recognising that it exists. As many depressed mothers don’t know what is wrong with them, it is up to GPs, midwives, partners or family to help spot behavioural changes. All women with postnatal depression need emotional support from family and friends.

It is important that you visit your GP for a full medical assessment.