Up to 20% of mothers suffer from an episode of depression lasting longer than a month, inside the 12 months following childbirth.
Whilst maternal mental health experts apply quite strict criteria to the term ‘depression’, there are typically three types that they identify. These are ‘the baby blues’, 'post natal psychosis', and 'post natal depression'.
the baby blues
Up to 80% of women experience a feeling of emotional distress and tearfulness during the week after the birth of their baby. Tearfulness, for no apparent reason, is the outstanding feature, along with increased sensitivity, anxiety, low spirits and irritability. Although distressing, the important fact with ‘the blues’ is that no treatment is necessary as the feelings usually pass within a few hours or days. Mothers should, however, talk their feelings over with an understanding friend to receive some reassurance and support.
post natal psychosis
If ‘the blues’ is the mildest form of depression, post natal psychosis is at the other end of the spectrum.
This is a severe psychiatric disturbance where the mother is ‘out of touch’ with reality. Fortunately it is rare, affecting one in 500 women. The sufferer may have suicidal thoughts or thoughts of harming the baby as well as being very hostile towards the father of the baby or close family members.
It is imperative that psychiatric help is sought since medication is always required for this condition. The onset of the illness is usually within the first three months after childbirth with the vast majority occurring in the first two weeks.
post natal depression
In between these two forms of depression is post natal depression. This can happen to any woman, after any pregnancy. A fact not commonly known is that post natal depression is as common in fathers as in mothers.
symptoms of post natal depression
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Depression: feeling low and unhappy for much of the time
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Irritability: mostly towards the father of the baby
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Fatigue: feeling utterly exhausted most of the time
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Insomnia: even though exhausted, the mother cannot fall asleep
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Loss of appetite: no interest in eating
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Not coping: a feeling of having too little time, doing nothing well and not being able to establish routines
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Anxiety: is acute
treatment for post natal depression
Much can be done to treat post natal depression, but the most important factor is recognising that it exists. As many depressed mothers don’t know what is wrong with them, it is up to GPs, midwives, partners or family to help spot behavioural changes.
It is very important that if a mother identifies with any or all of the symptoms of PND, that she talk to a GP or Health Professional who can help her.
Medication is a major player in the treatment of post natal depression but it is not the only treatment. In the majority of cases, anti-depressants are given. Most patients notice a mood swing within two weeks, and after one month, most report that they are feeling ‘80%’.
At this stage, GPs or members of the Maternal Mental Health team can start to challenge the mother’s thinking of ‘being hopeless’ as the other half of treatment is all about cognitive therapy. This entails reviewing self management issues, learning about behavioural patterns and how to deal with them.
can post natal depression be prevented?
Whilst there is no definite answer yet to stopping post natal depression from occurring, some condsiderations applied before and after the birth do make sense.
- Don’t have high expectations or try to be a superwoman. Know that there will be times when nothing is right. Remember that the baby hasn’t done any of it before and is learning too.
- Dads need to be prepared for babies too. If working, ‘put away’ the day on the drive home and arrive ready for family time. Give the mother breaks from the routine, and other time out opportunities.
- Put a ‘things to do’ list on the fridge so family or friends visiting can see how they can help.
- Eat regularly and eat healthy food to keep vitality up.
- Make sure time is put aside to enable the new parents to spend some time together and have some fun.
- Don’t blame yourself or your partner for the things that the baby can or can’t do.
- Most importantly, don’t be afraid to ask for help. Talk to family, friends and Health Professionals about your feelings and how you are coping. If symptoms start to appear, getting on top of it earlier can make a big difference.
for further information
Contact your Plunket Nurse, GP, or your local Community Mental Health team. The Citizen’s Advice Bureau has a list of numbers.
Dr Helen Cooney, Maternal Mental Health, National Women's Hospital
