Postnatal depression

It is important to distinguish postnatal depression (PND) from the 'baby blues' and postnatal psychosis. The 'baby blues' occur between three and ten days after giving birth. The 'baby blues' are common and affect around 80 per cent of women. Women may feel tearful and overwhelmed, due to changes in hormone levels following childbirth. The 'baby blues' usually disappear within a few days without needing treatment, other than support.

PND is the name given to depression that develops between one month and up to one year after the birth of a baby. Postnatal depression affects almost 16 per cent of women in Australia and can begin suddenly or develop gradually.

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.

What are the signs?

The severity of PND depends on the number of symptoms, their intensity and the extent to which they interfere with normal functioning. PND tends to be characterised by a combination of the following symptoms. The combination and severity of symptoms will be different for every woman, resulting in many different appearances of postnatal depression.

  • Sleep disturbance unrelated to baby's sleep needs
  • Appetite disturbance
  • Crying or not being able to cry
  • Inability to cope
  • Irritability
  • Anxiety
  • Negative, morbid or obsessive thoughts
  • Fear of being alone or fear of being with others
  • Memory difficulties and loss of concentration
  • Feeling guilty and inadequate
  • Thoughts of suicide or harm to self or baby.

What are the causes?

There are often numerous causes of PND. They can be biological - a predisposition towards or previous episodes of depression; psychological, low self-esteem, experiences of bad parenting and social - lack of support or relationship/familial difficulties.

How is PND treated?

The experience of PND is unique to each individual, caused by unique combination of factors/stressors and presenting in a combination of symptoms.  Treatment therefore needs to take many different forms.  It is important that a doctor is kept informed of the different forms of treatment and strategies for recovery.

Ideally treatment should address all aspects of a person's functioning - physical, psychological, emotional, social, spiritual - and be offered by services that understand PND and the need for recovery.

Sources of information:

beyondblue website

Post and Antenatal Depression Association

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