Postnatal Depression

Adjusting to life as a mother can be difficult. In fact, for many women, having a baby is the most significant life-changing event they will ever experience. Adjusting to this major life change, as well as coping with the day-to-day stress of a new baby, can make some women more likely to experience depression at this time, particularly if they’ve experienced depression in the past.
Some women may experience depression during pregnancy and this is referred to as Antenatal Depression. Around 10 per cent of pregnant women in Australia experience antenatal depression and it is less common than depression which is experienced after the birth of a baby.  Postnatal depression (PND) is the name given to depression that a woman experiences in the months after the birth of her baby. Postnatal depression affects almost 16 per cent of women giving birth in Australia. Perinatal depression is the collective term used to describe both antenatal and postnatal depression.

The Baby Blues
In the first week after the birth of a baby, up to 80 percent of all women will experience a period of mild depression commonly called the ‘baby blues’. This is usually a time of extra sensitivity and symptoms include tiredness, anxiety, tearfulness, insomnia and mood changes that tend to peak between 3-5 days.  The ‘baby blues’ is common and to be expected following the birth of a baby. The ‘baby blues’ usually disappear within a few days without treatment, other than support.

Postnatal Depression
Postnatal depression has a much slower insidious onset. It is most likely to occur between one month and up to one year after the birth of a baby. It is not a transitory condition and it may persist for 6-15 months or longer. Experiences vary considerably but usually include several of the following symptoms. PND has the same signs and symptoms as depression experienced by people who have not just become mothers.  Some symptoms may not indicate a severe problem. However, persistent low mood or loss of interest or pleasure in activities, along with four other symptoms occurring together for a period of at least two weeks indicate clinical depression and require treatment.

Feelings

  • Persistent low mood
  • Feelings of inadequacy, failure, hopelessness, helplessness
  • Exhaustion, emptiness, sadness, tearfulness
  • Guilt, shame, worthlessness
  • Confusion, anxiety, panic
  • Fear for the baby and of the baby
  • Wanting to run away

Thoughts

  • Inability to think clearly and make decisions
  • Lack of concentration and poor memory
  • Running away from everything
  • Fear of being rejected by partner
  • Worry about harm or death to partner or baby
  • Thoughts of suicide

Behaviour

  • Lack of interest or pleasure in usual activities (including sex)
  • Insomnia or excessive sleep, nightmares
  • Not eating or overeating
  • Decreased energy and motivation
  • Withdrawal from social contact
  • Poor self care
  • Inability to cope with routine tasks

What Puts a Person at Risk?
Like depression which occurs at any other time, PND doesn’t have one definite cause – but it’s likely to result from a combination of factors. A mixture of physical, biological and hormonal factors seem to put women at risk of experiencing depression following the birth of a baby including:

  • a past history of depression and/or anxiety
  • a stressful pregnancy
  • depression during the current pregnancy
  • a family history of mental disorders
  • experiencing severe ‘baby blues’
  • a prolonged labour and/or delivery complications
  • problems with the baby’s health
  • difficulty breastfeeding.

Sometimes the reality of motherhood doesn’t match the ‘warm and fuzzy’ images often portrayed in the media. Unfortunately, for many women, the early weeks and months of motherhood is a constant, tiring and demanding job.

Some new mothers can find it hard dealing with the changes in lifestyle – like spending less time with colleagues in the paid workforce and having little time to go out with family and friends. These adjustments and other psychological and social risk factors can make some women more likely to develop depression.

Social and psychological risk factors may include:

  • a lack of practical, financial and/or emotional support
  • past history of abuse
  • difficulties in close relationships
  • being a single parent
  • having an unsettled baby (i.e. difficulties with feeding and sleeping)
  • having unrealistic expectations about motherhood including:
    o mothers bond with their babies straight away
    o mothers know instinctively what to do
    o motherhood is a time of joy
  • moving house
  • making work adjustments (e.g. stopping or re-starting work).
  • sleep deprivation

Source: Beyondblue; Mental Health Information Service

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