A guide to postnatal depression

Welcoming a baby into the world is a huge life event and brings with it a whole range of feelings - some good, some difficult to manage.

Up to one in seven women in Australia will experience postnatal depression (PND) after the birth of their baby. It's important that parents are aware of the signs and symptoms, and that they know when and how to seek help if it's needed.

In this guide, we'll cover what postnatal depression is, what symptoms you should look out for, and how it can be treated.

What is postnatal depression?

Postnatal depression (also referred to as postpartum depression) is a common form of depression that occurs after a person has had a baby. It's different from the post-birth 'baby blues' that people talk about that affect up to 80% of new mums.

It can develop suddenly, or gradually over time which can make it tricky to identify and can be mild to very severe.

Many people are so wrapped up in caring for their newborn that they don't stop to check in with themselves, so understanding postnatal depression is an important step in being able to take the best care of yourself and your baby.

How long does postnatal depression last?

Because every situation is unique, there's no definitive timeline for how long postnatal depression lasts. It can start anytime within a year of a baby's birth. It is important to recognise that depression also starts in pregnancy for up to one in ten women. 

Postnatal depression is different from the 'baby blues' in that it can last for an extended period if not treated, and does not go away on its own. In some of cases, it can become very severe and impact on your ability to function and care for your baby - so it's important to seek help early and not wait until things get worse.

What causes postnatal depression?

There's no clear cause for postnatal depression, but there are some factors that can make it more likely that you'll experience postnatal depression. These include:

• Having a family history of mental health problems after childbirth.
• Dealing with anxiety or depression while pregnant or if you were already managing mental health issues before becoming a parent. If you have a history of depression or mental health problems and are thinking about getting pregnant it's a good idea to speak to your GP so that they can support you and offer you appropriate, safe treatment.
• Experiencing a stressful event after the baby arrives such as moving house, a relationship breakdown, or the death of a loved one.
• Having twins. Mums of multiple births can be more at risk.
• Lack of support from a partner, close family, or friends.
• Experiencing domestic violence or trauma.

Having a baby is a life-changing event that can sometimes trigger depression, even if none of the above points apply to you.

Common postnatal depression symptoms

Unfortunately, postnatal depression often goes undiagnosed because people either don't recognise that they have it, or they overlook their symptoms because they're worried about judgement from others.

It's important to know that PND is common, and you'll never be judged for speaking out about how you're feeling. Being aware of and spreading knowledge about the symptoms of postnatal depression is an important step in raising awareness and reducing the stigma around it and helping more parents get the support they deserve.

Signs that you or someone you know might be depressed that people should be mindful of include:

• A feeling of sadness or a low mood that doesn't go away
• Lack of interest or enjoyment in things that once brought joy
• Avoiding contact with others and withdrawing from social situations
• Trouble sleeping in the evening
• Feeling tired or lacking energy during the day
• Finding it difficult to take care of the baby or yourself
• Problems with decision-making and concentration
• Under or overeating
• Thinking that you're a bad parent
• Feeling overwhelmed, anxious, or guilty
• Lacking confidence or feeling low in self-esteem
• Having concerning or intrusive thoughts about things like hurting the baby or yourself

If you are struggling to get through the day, care for yourself or your baby, thoughts of suicide or harming yourself or your baby you should seek help right away. Start by asking your GP to arrange for you to see a mental health professional that day or going to your local Emergency Department.

It can be a really difficult time, but it's important to remember that there's always support available if you or someone you know is dealing with postnatal depression.

GPs, midwives, and health visitors can be great first points of contact when it comes to getting support, and the following charities are dedicated to supporting the mental well-being of parents.

Options for treating postnatal depression

Although experiencing postnatal depression can be isolating and distressing, there are safe and effective treatments available, and with the right support, people can and do recover. The outcomes of treatment are more positive when parents are diagnosed and treated early. 

Recovery is often gradual and can take time. The right treatment for you can depend on several factors. Your healthcare providers can help guide your recovery journey.

Attending talking therapy

Your GP, midwife or health visitor may refer you for a course of talking therapy like interpersonal therapy (IPT) or cognitive behavioural therapy (CBT) that can help you to reframe your thinking and change your thoughts to help improve your other symptoms.

It may be recommended that you take guided self-help sessions with a therapist. You might also be signposted to a local postnatal support group where you can talk about how you feel with other parents who're going through the same thing in a safe, non-judgmental environment.

Being prescribed antidepressants

You may be prescribed antidepressants if your depression is more severe, and your symptoms haven't improved with other treatments. There are several types of antidepressants. Your doctor will be able to advise you which one is best for you, particularly if you're breastfeeding.

Prioritising self-care

You should always speak to a healthcare provider if you're feeling depressed, but sometimes self-help techniques can work well alongside other treatment methods.

Things like talking to your family and friends, asking for more help with your baby, making time for yourself to do the things you enjoy, eating healthily, and exercising regularly can help boost your mood and lighten the load of new parenthood.

Sources

• Postnatal depression (PND) - Better Health Channel
• Postnatal depression | healthdirect
• Postnatal depression - COPE
• Postpartum Depression Statistics | Recent Research and Data About PPD
• Resources for Parents - ForWhen (forwhenhelpline.org.au)
• Statistics - Beyond Blue
• Depression-during-pregnancy.pdf (blackdoginstitute.org.au)
• Postnatal-Depression_Consumer-Fact-Sheet.pdf (cope.org.au)