Postnatal Depression
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Symptoms
Some signs & symptoms to look out for include:
- A persistent feeling of sadness or a low mood
- A lack of enjoyment or loss of interest in the wider world
- A lack of energy, or feeling tired all the time
- Having trouble sleeping at night and feeling sleepy during the day
- Difficulty bonding with your baby
- Withdrawing from making contact with your loved ones
- Having problems concentrating and making decisions
- Having frightening thoughts – for example, about hurting yourself or your baby
Postnatal depression can range from mild to very severe. If you think you might be depressed, or someone you love may be suffering from postnatal depression, it’s important to seek help from your GP or health visitor as soon as possible. Without the right help, the symptoms may last for a long time or get worse and have a significant impact on you and your family.
Postnatal depression can sometimes affect fathers and partners too, but this is less common.
Causes
What causes postnatal depression?
It’s not completely clear what causes postnatal depression. Having a baby is a life-changing event, and the impact it has on your life can sometimes trigger mental health problems such as depression, as it can take time to adapt to all the changes. Getting used to new routines can at times feel very stressful and exhausting, and these are feelings that most new parents experience.
A history of mental health problems earlier in life or during pregnancy may increase your chances of developing postnatal depression, alongside those who struggled with the ‘baby blues’, which shouldn't last for more than two weeks after giving birth. It’s also been associated with people who have been through recent stressful life events like bereavement, and those who have a poor relationship with their partner or don’t have close friends or family to support them.
Understanding more about postnatal depression
In short, no. Many parents feel worried, down or a bit tearful in the first week after giving birth. This is known as the ‘baby blues’ and is so common that the NHS actually considers this to be normal. You’re likely to be learning to cope with new demands, adjusting to new routines and getting little sleep, so it’s natural to feel a little overwhelmed.
But these ‘baby blues’ shouldn’t last for more than two weeks after you give birth. If they start to last longer, or you start to feel them at any point in the first year after giving birth then this could be postnatal depression, which may develop suddenly or gradually.
Postnatal depression and postpartum psychosis both occur after childbirth, but postpartum psychosis is much rarer, affecting around 1 in 500 people.
Unlike postnatal depression, which may come on gradually, symptoms of postpartum psychosis tend to occur suddenly, within two weeks of childbirth. Often symptoms of postpartum psychosis come on within the first few hours or days after giving birth. Rarely, symptoms can occur several weeks after childbirth.
Symptoms of postpartum psychosis can include:
• Hallucinations
• Delusions
• Mania – talking and thinking too much or too quickly, feeling extremely high
• Low mood with symptoms of depression
• A combination of mania and low mood, or rapidly changing between the two
• Loss of inhibitions
• Feeling suspicious or fearful
• Restlessness
• Confusion
• Acting out of character
Postpartum psychosis is a rare and very serious mental illness and should be treated as a medical emergency. It can get worse very quickly, and put the safety of both mother and baby at risk.
If you think you or someone you know has symptoms of postpartum psychosis you should speak to your GP immediately, or call NHS 111 and request a same-day assessment.
Managing & treatment
Getting help from your GP or health visitor for postnatal depression is the best thing you can do – don’t struggle in silence, hoping it will go away on its own.
Depression is an illness just like any other – it can happen to anyone and it’s not your fault. Struggling with your mental health does not make you a bad parent, and it’s important to remember that asking for help is important for your own well-being and those around you.
There are a range of treatments for postnatal depression that your GP or health visitor may recommend. These include the following:
Self-help techniques
These can include:
• Continuing to talk to your family and friends about your feelings and letting them know what they can do to help you
• Finding time to do the things you enjoy
• Resting whenever you get the chance
• Getting as much sleep as you can at night
• Exercising regularly
• Eating a healthy diet
• Looking after your hygiene (take a shower and get dressed every day)
Most importantly, be kind to yourself. Don’t beat yourself up if things don’t go the way you’d planned or if you begin to feel worse again. You might find it helpful to keep a mood diary to keep track of how you are feeling. As well as helping you notice if any activities, places or people are impacting your mood, it might help remind you that you’re having more good days than you think.
Speaking to people with a similar experience to you can help you feel more understood and less like you’re tackling this all alone. Your health visitor or midwife may know of some local support groups near you. You can also access information and support through national organisations like Pre and Postnatal Depression Advice and Support (PANDAS) and the Association for Post Natal Illness (APNI).
Psychological therapy
Your doctor may recommend you take a self-help course, or may refer you for a course of talking therapy, such as cognitive behavioural therapy (CBT). These short-term therapies are often recommended to treat depression. During a CBT session, you’ll be encouraged to tackle specific and current problems in your life through practical day-to-day interventions.
Find out more about therapy treatments for depression with our Boots Mental Health Services page.
Medication
If your depression is more severe and you’ve found other treatments haven’t helped, your doctor may feel it’s appropriate to prescribe antidepressants. If you’re breastfeeding, talk to your doctor about suitable medicine.
How to help a loved one with postnatal depression?
Many women may not realise they are struggling with postnatal depression. Sometimes, partners or loved ones will be the first to notice that something isn’t right, like a change in physical wellbeing or behaviour. Some people may worry about talking honestly to family and friends in case they are judged for not being happy, or for people thinking they’re not coping well. Some changes in behaviour to look out for are:
• Frequent crying for no obvious reason
• Withdrawing from contact with other people
• Speaking negatively all the time, or claiming that they’re ‘hopeless’
• Neglecting themselves, such as not washing or changing clothes
• Losing their sense of humour
• Constantly worrying that something is wrong with their baby, despite reassurance
• Having difficulty bonding with their baby or not wanting to play with them
If you suspect a loved one is experiencing depression, regularly check in with them and ask open-ended questions to encourage them to share their feelings. Offer practical support, such as sharing feeding duties or assisting with household tasks, and help them access the necessary support from a GP, health visitor, or trusted individual.
How can I support someone with postpartum psychosis?
Most people experiencing postpartum psychosis won’t realise they have it. If someone you love has been diagnosed with postpartum psychosis, there are things you can do to help support them. These include:
• Staying calm and supportive – it may help to lean on another loved one during this time, to help support yourself
• Staying patient and taking time to listen
• Helping with housework, cooking, shopping and childcare
• Encouraging them to get as much sleep as possible
• Helping keep the home as calm and quiet as possible
• Avoiding having too many visitors
If you think someone with postpartum psychosis is in immediate danger, take them to A&E or call 999 straight away.
If someone you care about is experiencing postpartum psychosis, it can be distressing for you too. Don’t be afraid to seek help for yourself and speak to your GP about how you're feeling.
Can postnatal depression be prevented?
Unfortunately, there’s no evidence to suggest that there’s anything specific that can be done to prevent someone from developing postnatal depression, aside from trying to maintain a healthy lifestyle once baby arrives.
If you have a history of mental health issues but you’d like to have a baby, speak to your doctor or a mental health team to seek advice. This is also so they can offer you any appropriate monitoring or treatments if they feel necessary.
If you find you’re struggling with your mental health during pregnancy, tell your doctor so they can arrange for you to be seen regularly in the first couple of weeks after giving birth.
Explore our articles on mental health support
Frequently asked questions
Postnatal depression can last for months or even longer if untreated, but many people start to feel better within 3 to 6 months with proper support and treatment.
Yes, partners can also experience depression and anxiety after the birth of a baby, which is sometimes referred to as paternal postnatal depression. Read more about postnatal depression in partners in our editorial.
Yes, you can have postnatal depression and still love your baby; the condition does not affect your capacity to love but can make it harder to feel connected.
Yes, postnatal depression can go away with time, proper treatment, and support, although the duration varies for each individual.
The three stages of postnatal are the acute phase (the first 6-12 hours after giving birth), the subacute phase (from 24 hours after giving birth to two – six weeks), and the delayed phase (up to six months after birth).
2Access to prescription-only treatment is subject to an online consultation with a clinician to assess suitability. Subject to availability. Charges apply.
