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), very high or very low moods, 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

Information about postnatal depression by beyondblue

beyondblue information regarding postnatal depression includes symptoms, causes and where to seek help.

http://www.beyondblue.org.au/the-facts/depression/types-of-depression

Postnatal depression fact sheet by depressionNet

depressioNet provides information, help and peer support to people in the community impacted by depression. depressioNet's fact sheet regarding postnatal depression includes information on symptoms and factors that contribute to the onset of the illness.

http://depressionet.org.au/what-is-depression/types/pnd/

Information on postnatal depression in various languages - Mental Health in Multicultural Australia (MHMA)

MHMA provides national leadership in mental health and suicide prevention for Australians from culturally and linguistically diverse (CALD) backgrounds. Information on postnatal depression (under Depressive disorders), is available in twenty-three different languages.

http://www.mhima.org.au/resources-and-information/Translated-information/translated-mental-health-information-resources

A link to the specialist site of PANDA - Post and Antenatal Depression Association

PANDA is an organisation based in Victoria that is a source of knowledge, information and resources about the issues related to post and antenatal mood disorders. PANDA's fact sheet provides information about prevalence, symptoms and contributing factors for postnatal depression.

http://www.panda.org.au/index.php?option=com_content&view=article&id=11&Itemid=31

According to  Post and Antenatal Depression Association (PANDA);

Support and patience from family and friends is often identified by women with PND as the most crucial factor in their recovery.  This support can be practical in the house or with the baby/children, or it can be emotional and social support.

Knowing how to help the mother with PND can be the most difficult aspect as she may be angrily denying that she needs help, she may not be able to say what would be helpful or you may be worried that your help is the wrong kind.  Much will depend on how the PND is impacting on her.

Partners particularly are in the firing line and often feel that they cannot do anything right.  It is important for him to have support and not to take her responses too personally.

Building the woman's options for support in addition to her partner and family can help to share the support.  Encouraging the woman to be a part of a new mother's group or supported PND therapeutic or playgroup will help to build her support networks.  She will need a range of people around her to talk to or to seek support from, not just her partner or family.

beyondblue

beyondblue is a national, independent, not-for-profit organisation working to address issues associated with depression, anxiety and related substance misuse disorders in Australia.

http://www.beyondblue.org.au

PANDA - Post and Antenatal Depression Association

Resources and information on antenatal and postnatal depression and postpartum psychosis. Victorian based organisation.

http://www.panda.org.au/

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