One of the most common mental health concerns after becoming a new mother is postnatal depression. With up to 15 mothers out of every 100 challenged by this treatable condition, today I’ll show you how to identify this condition early, and what to do if it happens to you. 

As a teenage mother, I can remember how difficult it was to pluck up the courage to approach my GP and ask for help, only to be told to go and read a book in the library! Thankfully, in recent years things have improved – credit to the tide of mothers, fathers and influencers speaking openly without shame, fear or guilt about their own experiences. Postnatal depression is now widely recognised as the debilitating illness it is. Support and treatments are now more accessible, compassionate and non-judgemental than in previous years. That said, way too many mothers and fathers suffer in silence. Particularly sad, when support and treatment to get better is easily accessible but maybe the awareness of how to access support isn’t quite there yet.  

And in this no-fluff guide, I’ll cut out all the noise and show you exactly how to identify early warning signs of postnatal depression and what to do about it.  

What is Postnatal Depression?

Postnatal depression is a type of depression that can affect both mothers and fathers after having a baby. If a mother has had a stressful pregnancy, a traumatic birth or suffered with depression and anxiety during pregnancy, she is more vulnerable to the risk of developing postnatal depression. 

Post natal depression can impact relationships both with baby and partner. Mothers may not look after their baby, or themselves. Postnatal depression may impact a child’s development and behaviour even after their mothers depression has ended. So the faster this illness is recognised, the faster treatment can begin and the shorter it will be for mother to feel well again.

Unfortunately postnatal depression is common, with up to 15 women out of every 100 experiencing this form of depression. Early warning signs may be feeling low, emotionally unstable, having intrusive thoughts, feeling drained all the time and, not able to enjoy the simple pleasures of daily life.

Any emotional instability that continues for more than a couple of weeks after having a baby should not be ignored or dismissed as baby blues. Postnatal depression can start at anytime and left without treatment can be debilitating for both mother, baby and the family unit. It may last for months or even years! The good news is that it is a highly treatable condition and the earlier support is sought the faster new parents can enjoy the many wonders of a new baby. 

Pro Tip: If you are struggling in pregnancy with worry, fear or decline in your mental health. Let  your midwife and doctor know so they can make a care plan for you with additional appointments and extra support both during pregnancy and after having your baby. This extra reassurance often goes a long way to reduce risk of postnatal depression.

How long does illness from postnatal depression last?

Within 3-6 months most women get better without any treatment. But up to a quarter of mothers with postnatal depression will still have symptoms by their baby’s first birthday. Without help this can mean a lot of suffering and cast a shadow over the experience of new motherhood.

What is the difference between baby blues and postnatal depression?

Mood changes are very common after having a baby and are part of a healthy return to normal. As your body returns to it’s pre-pregnancy state the high levels of pregnancy hormones decrease rapidly and it is common, especially around day 3 to feel teary and emotional. You may hear this described as the ‘baby blues’ and these feelings can take a couple of weeks to resolve. I’d certainly expect the emotions influenced by hormones to find a natural balance within 2 weeks after having a baby. Occasionally, getting back to feeling like you may take a little longer. You should be feeling a noticeable improvement each day that goes by and at your 6 week postnatal check when you are asked about your mental health you will be able to say there are no concerns. 

N.b Part of a six week postnatal check should absolutely cover questions on how you are feeling. This is as important as any physical check. 

What happens if I still feel bad after two weeks?

If mood instability continues longer than two weeks it could be an early indicator of postnatal depression and that you should alert your loved ones and health care practitioner about the way you are feeling. This will help them to keep a closer eye on you and start to think what additional support you may need. For some parents, symptoms of postnatal depression can appear out of the blue, months or even up to two years later. What is important to remember, is asking for help as soon as possible will mean treatment can be started and recovery time can be shorter. 

What are symptoms of postnatal depression?

Now that you better understand what postnatal depression is. It’s time for me to explain what symptoms that may be experienced. Here are some common symptoms of postnatal depression that may alert support is required. 

• Feeling low, unhappy and tearful for much or all of the time or at certain times of the day, like mornings or evenings.
• Feeling irritable or angry with your partner, baby or other children.
• Feeling completely drained, exhausted and lacking in energy. But even though you are tired, you struggle to fall asleep. 
• Racing thoughts, ruminating about things that make you worry. 
• Changes in appetite 
• Not being interested or enjoying anything. You may not enjoy being with your baby.
• Feeling little or no desire or interest in sex.  
• Negative, guilty, resentful or intrusive thoughts.
• Loss confidence in yourself and finding it difficult to cope with things. 
• Anxiety, sometimes overwhelming anxiety about baby’s health and safety.  
• Feeling isolated.
• Becoming withdrawn, not wanting to see friends and family or leaving the house. 
• Feeling like things will never get better and life is not worth living. 
• Considering if your family would be better off without you. Any urge to cause yourself or your baby harm needs an immediate doctors review or contact with emergency services. If you have these thoughts tell someone and ask for someone to be with you until a doctor can review you. 
• A small number of women with very severe depression may hear voices and act out of character with confused thoughts, or unusual beliefs. This may suggest a postpartum psychosis. If you or a loved one notices this behaviour they should treat it as an emergency needing an immediate mental health review. Treatment for this may be medication and for an even smaller number of women, possible admission to a mother and baby unit. If these symptoms are noticed the midwife, doctor or emergency service should be alerted straight away.
  
  Important note:  If you experience scary thoughts, urges to harm yourself or your baby please don’t be afraid to tell someone. No one will judge you or take your baby away. Postnatal depression is a recognised illness and everyone will want to help you get better as soon as possible and most importantly keep mothers and baby’s together while they get treatment. 

What should I do if I have symptoms of postnatal depression?

Now that you understand postnatal depression is a recognised illness, just like any physical illness. it’s time for me to explain more about how to get help and treatment. 

Step 1: Tell someone how you are feeling

The help and treatment you need depends on how severe the postnatal depression is. The first step is to tell someone. Partner, friends or family can be more helpful and understanding if they know what the problem is.

Midwives, GP’s and health visitors can talk through which kind of help you need. Depending on the symptoms they may encourage you to self-refer to talking therapy. A small number of women will need help from mental health services. Your Midwife, GP or Health Visitor can refer you to a perinatal mental health service – this is a specialist service for pregnant women or women with a baby under a year old. 

Step 2: Ask for help

Sometimes it can feel difficult to ask for help because of the way it makes you feel. But, remember it’s never too late to seek help, even when you have been suffering for a long time. I think it is one of the most courageous actions when someone at their most vulnerable is able to say ‘Hey Im not doing so good’. Often it can be a huge relief to talk to someone understanding and realise you are not alone. 

Step 3: Make a self-referral to IAPT

All areas in the UK should have a NHS funded talking therapy service to provide psychological help. They accept self referrals. They can be found online by searching for talking therapy or your local IAPT service and choosing a local one. Important to say you are pregnant or have just had a baby as this will help to prioritise you. Many new dads and partners may feel increased stress and can also suffer with post natal depression. The same advice applies, to seek early support. Dads and partner can self refer to talking therapy/IAPT services and will also be prioritised for treatment. 

Step 4: Get reviewed by your GP

For more severe depression, you may need medication, with or without talking therapy.  Your GP can advise you about these treatments. The treatment you need depends on how unwell you are. You should be told about all the likely benefits and risks of treatment so you can make the best choice for you.

Step 5: Make self care your top priority

When you are feeling down, sometimes the first thing that goes out the window is self care. Numerous psychology studies have shown that taking any form of action helps to break the cycle. Taking even the smallest actions like having a shower, putting on uplifting music, taking a nap or a short walk, drinking more water and eating well will all have a compounding effect on the way you feel. Accept all help that is offered and don’t go it alone. Join a support group and talk to loved ones. Give yourself permission to leave unessential tasks, take a break from social media and activities that drain you and instead use the time for nourishing and replenishing self care activities like a five minute guided meditation, thinking about three things that you are grateful for – this doesn’t have to be big things, maybe it will be just taking a moment to appreciate sipping a nice cup of tea, or maybe the sky is a beautiful blue and the sun is shining. It doesn’t matter what you think of as long as for a moment you appreciate it. Reprogramming your mind to notice these things will help to decrease stress hormones and increase the balance within you. 

Recommended: Oliiki app is a confidence boosting and fun app for pregnancy and new mothers. Written by a leading expert in gentle parenting and child development it gives daily simple and fun activities to bond with your baby, whilst developing their brain through these targeted interactions. Having a guide to get you through the moments when it all feels too much can literally turn a day around when you aren’t feeling your best! 

“I literally, almost instantaneously, felt better after doing the things on the Oliiki app. It was incredible! I’d love it if Oliiki was part of a welcome pack that you get when you go to the midwife or the doctor.” ~ Monika – Mum of 3-month-old

As you saw in the guide, postnatal depression is a recognised and common illness after having a baby. Suffering in silence can make the illness worse with longer lasting symptoms. Without treatment it is common for symptoms of postnatal depression to resolve within 3-6months. However and less commonly, this can last much longer. Postnatal depression can have dire impact on maternal and infant mental health with long lasting effects. This is why it is important to the condition very seriously and seek treatment and support. Mothers should not be scared of telling their healthcare practitioner how they are feeling, by alerting them to early warning signs and seeking help, there is every chance of a swift recovery and feeling well again. 

Now you have a better understanding of postnatal depression, talk to your partner, best friend or family about it. Ask them to tell you if they notice any concerns and be someone to talk if you need. Sometimes the people closest to us can see changes even before we do!