Postnatal Depression

Postnatal depression is depression which is diagnosed within a month of childbirth.^3,4 Powerful emotions are expected after childbirth, ranging from excitement and happiness to fear and anxiety. This is generally called ‘The Baby Blues’ and usually settles within two weeks.¹

If it lasts longer, it may be postnatal depression and require treatment. Sadly, up to 50% of postnatal depression cases go undetected.³ Recognising postnatal depression and seeking early treatment is vital to manage symptoms and help parents bond to their babies.¹

Yes.^1,3 Postnatal depression may affect up to 10% of fathers.³ While fathers don’t experience the hormonal changes associated with pregnancy and birth that mothers do, it has been shown that they may also experience changes in hormones during the pregnancy of their partners.³

Having a baby is overwhelming, for both partners, and new fathers may have anxiety, changed eating and sleeping patterns, and depression during the first year of their child’s life.³ Prompt treatment and support – as for mothers – is key.

It is important to differentiate between ‘The Baby Blues’ and postnatal depression. Baby blues usually resolve within two weeks and tend to be less intense (sadness, crying, irritability).¹ More intense symptoms which last longer may indicate postnatal depression.

Symptoms of postnatal depression include:^1,3,4

• Excessive/unstoppable crying.
• Depressed mood.
• Severe anxiety and/or panic attacks.
• Severe mood swings.
• Irritability and/or anger.
• A feeling of being overwhelmed/fear of not being a good mother.
• Feelings of worthlessness, shame, guilt and hopelessness.
• Difficulty falling asleep or staying asleep, other than being disturbed by their newborn.
• Lack of energy, feelings of overwhelming fatigue.
• Reduced concentration/decision-making ability.
• Changes in appetite: overeating or loss of appetite.
• Withdrawal from support systems like family and friends.
• Suicidal thoughts or thoughts of harming the baby.

Postnatal depression is treatable, and treatment/support should be sought immediately to safeguard the health of both mother and baby.¹

There is no single cause of postnatal depression. Biological, psychological and social factors all play a role.³ Hormone levels drop significantly after birth, which contributes to mood changes.^1,3,4

Having a baby is overwhelming and new mothers are often sleep-deprived, anxious, and struggling with their sense of identity, which may all contribute to postnatal depression.¹

Like many mental health conditions, genetics play a role. People with a history – or family history – of mental illness are at higher risk of postnatal depression.³

There are a number of factors that may increase the risk of postnatal depression. These include:^1-4

• Previous episodes of depression, including postnatal depression.
• Environmental factors, e.g. lack of support, financial issues, stressful experiences during pregnancy.
• Alcohol and/or drug addiction.
• Difficulty breastfeeding.
• Multiple births, e.g. twins, triplets.
• Young age (< 20 years old).
• Unplanned or unwanted pregnancy.

Untreated postnatal depression may impair normal development.⁴ Mothers with postnatal depression who are not treated also tend to struggle to bond with their babies.¹

Children of mothers with untreated postnatal depression may be more likely to have emotional and/or behavioural problems, excessive crying and sleeping or eating issues.^1,4

Remember: postnatal depression is treatable, and treatment/support should be sought immediately to safeguard the health of both mother and baby.¹

Treatment of postnatal depression is not the same for every person. The best treatment will depend on several factors including the severity of the depression, any underlying conditions (e.g. thyroid issues) and each person’s individual needs.

Psychotherapy (counselling) may be used with/without medication. With appropriate treatment, postnatal treatment should improve.

Therapy/counselling provides an outlet for talking through issues and concerns. Therapists can help to establish coping mechanisms, realistic goals and ways to respond to stressful situations.^1,2

Interpersonal psychotherapy (IPT), cognitive behaviour therapy (CBT) and psychodynamic therapy may all be useful in the treatment of postnatal depression.⁴

Counselling can be face-to-face or through free online counselling helplines, like the 24-hour Cipla Mental Health Helpline (0800 456 789).

Antidepressant medication may be prescribed by your doctor. They will take into consideration breastfeeding and prescribe the best option for each patient.^1,3

There are a number of ‘non-drug measures’ that may be helpful for those with postnatal depression, to support their treatment. They include:¹

• Exercise daily: take your baby for a walk, get some fresh air, get the blood flowing.
• Eat healthily and drink plenty of water.
• Avoid alcohol.
• Get enough sleep.
• Be realistic with expectations. Having a baby is a huge adjustment. Just do what you can manage when it comes to household chores: everything doesn’t have to be perfect!
• Me-time is vital! Get your partner or a trusted friend/family member to look after the baby for an hour or two and go and do something just for you.
• Talk, talk, talk! Chat to your partner, family, friends, and especially other mothers about how you’re feeling.
• Remember you’re not alone! Many people are going through the same thing and talking to each other helps.
• Ask for help. Don’t be shy to ask for help, and to receive help when it’s offered.

While postnatal depression may not be preventable in some people, there are several important points to ensure early diagnosis and treatment:^1,3

• Discuss your – and your family – mental health history with your healthcare professional.
• Tell your doctor as soon as you are planning a pregnancy so they can monitor closely throughout the pregnancy and postpartum and treat, if necessary.
• Regular check-ups after the birth of your baby are especially important: early diagnosis and treatment (with therapy/support groups and/or medication) is key.

Following the lifestyle recommendations above, throughout the pregnancy and after the baby is born, is also important. Remember: you are not alone. There is help out there.

For more information on counselling services offered by the South African Depression and Anxiety Group, click here.