Postnatal Depression Explained
What is postnatal depression?
Getting pregnant and having a baby can be an exciting and joyful experience. However, it can also be overwhelming. Having a baby is a big life change – it’s a lot of responsibility, you’re probably going to have less sleep, and pregnancy and birth can cause hormonal changes that can impact your mood.
Around 1 in every 5 new mums develops postnatal depression. Postnatal depression is characterised by feelings of dread, guilt, sadness, doubt, fear, and worry that begin just after having a baby. As these feeling often begin during pregnancy, it can also be called perinatal depression (perinatal means ‘around the time of birth’). Another common term is postpartum depression.
Most women with postnatal depression also experience anxiety. Depression is characterised by long-lasting low mood, low energy, and low motivation. Anxiety, on the other hand, is characterised by excessive and persistent doubt and worry.
Most people experience these emotions at some point around giving birth – having a baby can be exciting, overwhelming, happy, and terrifying all at once! For some people however, these emotions can become persistent and intense, preventing them from enjoying this special time.
These conditions can impact people’s physical, emotional, and social well-being, from their sleep, to their concentration, to their ability to stay calm and communicate clearly. As a result, they can also impact women’s confidence in their ability to be a good mum.
In rare cases, some women can experience postpartum psychosis after giving birth. Postpartum psychosis is very different from postnatal depression – it involves hallucinations, delusional and paranoid thinking, and confusion. Postpartum psychosis is a medical emergency. If you are worried that you or someone you know is experiencing postpartum psychosis, contact emergency services immediately.
What are the signs of postnatal depression and anxiety?
Anxiety Symptoms
Worrying excessively about bad things that are unlikely to happen
Muscle tension
Difficulty thinking clearly
Feeling persistently irritable and 'on edge'
Difficulty relaxing
Repeatedly asking friends, family or doctors for reassurance
Persistent feelings of doubt
Depression Symptoms
Feeling emotionally numb
Being extremely tired
Feeling flat or hopeless
Being unable to enjoy the things you used to
Feeling persistently sad or guilty
Any of these features may serve as warning signs of postnatal depression or anxiety. Remember, only a qualified mental health professional can diagnose depression or anxiety following a thorough assessment of your personal situation and circumstances. If you’re concerned about the way you’ve been feeling, please don’t delay speaking with your regular healthcare provider or check out our anonymous online assessment below and see if one of our online programs could help.
Not sure whether to seek help?
If you’re unsure about the way you feel, take our anonymous Wellbeing Test to check whether your levels of stress, anxiety, or depression are within a healthy range, and see if one of our online programs could help.
What causes postnatal depression and anxiety?
There isn’t one specific thing that causes depression and anxiety. In fact, they’re most likely caused by a combination of factors.
There’s good evidence that genes play an important role here. These disorders run in families and having a parent or sibling with a mental health disorder can increase your risk of having anxiety or depression.
Stress can also play a part in the development of perinatal anxiety and depression. You might be juggling bodily changes, medical appointments, work commitments, feeling isolated, and changes in your relationships, all at once, while being very sleep deprived, which can understandably leave you feeling overwhelmed.
Previous mental health difficulties can also be a risk factor. For example, you’re more likely to experience postnatal depression if you’ve had depression before (either from a previous pregnancy or depression during another time in your life), or if you’ve had a pregnancy loss, still birth, or traumatic birth experience.
Your personality structure can also influence how you feel. For example, being self-critical or a worrier, or setting unrealistically high standards for yourself can make you more vulnerable to experiencing postnatal depression symptoms.
How can I deal with postnatal depression and anxiety?
Psychoeducation
Psychoeducation helps people answer the question, ‘What is postnatal depression?’ – it means learning what causes postnatal depression and anxiety, the signs of postnatal depression and anxiety, and what keeps these conditions going. This kind of information is extremely valuable – it can help women understand that what they’re going through is common and treatable (and not a sign of being ‘a bad mother’).
Partners, friends, and family can also benefit from learning about anxiety and depression. Having this knowledge base can help them understand what a new mum might be going through and provide them with appropriate support.
The most important pieces of information for mums-to-be or new mums are:
- Perinatal anxiety and depression are very common.
- Feelings of sadness, guilt, dread, worry, and anxiety are very normal, and not a sign that you’re ‘going crazy’ or ‘a bad mum’.
- It’s okay to have frightening or upsetting thoughts about your baby sometimes. Having a thought is not the same as acting on that thought.
- Help for perinatal depression and anxiety are available, and there is a suitable treatment for most people.
Cognitive Behavioural Therapy (CBT)
CBT is the recommended treatment for perinatal anxiety and depression. CBT involves learning skills to:
- Combat the negative and unhelpful thoughts that contribute to anxiety and depression.
- Shift any unhelpful behaviours that might be maintaining anxiety and depression.
- Manage the emotions of sadness, anxiety, and dread, so that you can enjoy this special time.
Some perinatal CBT courses also teach people assertive communication and self-care skills.
CBT will often be recommended when:
- The person has found CBT helpful in the past.
- The person wants to take an active role in their recovery.
- The person wants to learn practical skills to help them get well and stay well.
- A competent, trained clinician who has expertise in CBT is available, or the person is prepared to use internet CBT (iCBT) if this is more convenient or accessible to them.
- The person does not want to take medication or there is a medical reason that they cannot take antidepressant medications.
- The person prefers CBT or iCBT.
Medication
Perinatal or postnatal depression and anxiety can sometimes be treated with psychiatric medications called antidepressants. Antidepressants might be recommended for women with severe anxiety or depression, or who have experienced mental health problems in the past and have found medication useful before. Although birth defects from antidepressants are rare, some can have side-effects. Pregnant and breast-feeding women should work closely with their doctor, who can provide advice and support based on your personal circumstances. Some things to remember when taking these medications are:
- Don’t start taking these medications without talking to your doctor about pregnancy and breastfeeding.
- Take the medication as prescribed.
- Don’t stop the medication without contacting the health professional who prescribed it.
- Side effects lessen as your body adjusts. If the side effects don’t diminish, or are unreasonable, contact your health professional.
How can Cognitive Behavioural Therapy (CBT) help with postnatal depression and anxiety?
Cognitive Behavioural Therapy or CBT is considered to be one of the leading psychological treatments for depression. All of our online programs use CBT strategies to help ease symptoms of anxiety and depression. Click below to see if CBT can help you tackle your symptoms to improve the way you feel.
Frequently asked questions
How long does postnatal depression last?
Postnatal depression can last for months, or sometimes years, after a baby is born. Exactly how long it lasts varies from person to person, depending on individual circumstances.
Postnatal depression and anxiety generally get better with time; however, these conditions are very treatable and women who seek generally get better faster.
Although it’s normal to experience symptoms of depression and anxiety every now and then (especially after having a baby), if you’ve had signs of depression or anxiety for more than 2 weeks, then you could benefit from having a check-in with your doctor.
Can postnatal depression start late?
Postnatal depression typically begins a few weeks or months after birth. However, the term ‘postnatal’ can refer to up to two years after a baby is born, and it’s not uncommon for women to develop postnatal depression symptoms a year or so after giving birth.
Postnatal depression isn’t normally diagnosed within the month after birth, as this is an adjustment period where it’s very normal to be feeling tired and irritable.
Will I have postnatal depression?
There’s no set formula that can identify exactly who will develop postnatal depression and anxiety. There are some common risk factors, including:
- Having a history of anxiety, depression, or other mental health issues
- Having problems with drugs and alcohol
- Having a complicated or traumatic pregnancy or birth
- Your baby having health difficulties or complications during pregnancy or after birth
- Experiencing very stressful situations (e.g. divorce, losing your job, domestic violence) during pregnancy or birth
- Having limited social support
However, not everyone with these risk factors will develop postnatal depression, and some people will develop postnatal depression due to other circumstances.
Overall, although this condition is common, most women who have a baby won’t develop postnatal depression.