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Recognising postnatal depression

Postnatal depression affects 10-15% of mothers in Ireland, while 10-25% of mothers suffer from low mood or anxiety during pregnancy. Some women develop more serious symptoms after giving birth, which develop into full-blown postnatal depression. Problems can begin anytime during the first year after childbirth, and if it’s not treated it can cause difficulties for several years.

What are the symptoms?

Postnatal depression is sometimes called ‘the hidden condition’ as many mothers do not know what is wrong with them or what to do about it. A partner or family member is usually the first person to notice that the mother is not her usual self.

Symptoms can include extreme fatigue, feelings of sadness, frequently tears, hopelessness and a lack of appetite. Postnatal depression can also cause a mum to feel extremely anxious, scared and panicky during the day, and she may have difficulty sleeping at night. Some women also report an inability to cope with every day situations, have unrealistic concerns for their baby’s well-being and thoughts of self-harming, or even of harming the baby.

What causes postnatal depression?

The causes are not clear, but postnatal depression occurs at a time of change and upheaval in life that’s further complicated by the hormonal changes that are going on in your body. There are some other factors that can put you more at risk of postnatal depression.

Suffering with depression or anxiety during your pregnancy

If you’ve already suffered with these problems during your pregnancy, it’s more likely that they’ll re-occur or continue when you have a new baby in your life as well.

Stress

It’s very likely that you’ll find the sheer amount of work involved in looking after your new baby is both tiring and stressful. In some women, the stress of the new experience is thought to cause postnatal depression to develop.

Other life stresses to take into consideration are: any marital problems you may be having, stresses in your personal life such as moving house, or the illness or death of a close relative or friend. Be aware of everything that’s going on for you, and accept that sometimes life can be difficult to cope with.

Previous depression problems

Suffering with depression or mood disorders outside of your pregnancies, or having had postnatal depression before, also makes it more likely that you could suffer again at this time of your life. Studies show that a third of women who’ve suffered with depression before will experience it again after giving birth. Half of all women who’ve had postnatal depression before will also experience it again in subsequent pregnancies.

Lack of social support systems

You may be in a situation that’s left you feeling socially isolated or without the support of friends or relatives.

Medical issues

If giving birth to your baby was a difficult experience medically, if you were discharged early from hospital, or if you have a history of severe premenstrual syndrome (PMS) you are also more likely to suffer from postnatal depression.

Hormonal changes

After you give birth, the extremely high levels of oestrogen and progesterone that have been in your blood will decline extremely quickly. After about three days they’ll be back to ordinary levels. Some research suggests that this sudden dip in hormones can cause symptoms of depression.

Other research suggests that as the amounts of the breastmilk stimulating hormone prolactin rise, depression can occur. Changes in the levels of adrenal steroids such as cortisol and aldosterone also occur in the postnatal period which could also cause feelings of depression.

What sort of treatment is available for post-natal depression?

The most important thing to do is to visit your Public Health Nurse or GP at the first signs of any of the symptoms of postnatal depression. Your GP will talk to you about how you feel and may give you some tests to see whether there’s a physical reason for your feelings such as, thyroid disease or anaemia.

Medications are one alternative, and your Public Health Nurse or GP will assess you carefully to see if this will be an advantageous course of treatment for you. However, if you’re breastfeeding it may not be an option. Also, some antidepressants can have long-term side effects that you may not want to risk.

Share your worries

It’s thought that the best remedies are preventative ones. Getting plenty of help from others, talking to experienced parents and sharing your worries and fears with someone you trust are all really good practical ways of preventing yourself from slipping into depression. You can always talk to your Public Health Nurse or GP if you don’t feel able to talk to anyone else.

Be practical

Learn as much as you can about motherhood from reliable books, friends and relatives, rest and sleep as much as you can and don’t try and be superwoman. Relax your standards on domestic chores and cooking – you can’t achieve perfection, and you don’t have to.

Ensure that any major life changes you want to make, like moving house are carried out a good while after you give birth so you have time to get used to new routines and habits.

Take time out

Arrange for babysitters and get some time away from your baby. Keep up with outside activities and interests if you can – it will help you feel more connected to the rest of the world.