There are four main types of Postnatal Depression;
On average 15% of women will suffer from a form of postnatal depression following the birth of their child. The three main types of postnatal depressive illness are
Situational Postnatal Depression (which 12% of women may suffer from) covered in pink text below,
Hormonal Postnatal Depression (which 2% of women may suffer from) covered in blue text below,
Pueperal Psychosis (which less than 1% of women may suffer from) covered in red text below and
there is also Postnatal Anxiety Disorder (covered below in orange text) and
Birth Trauma (covered in a separate section on this website).
Postnatal Depression-How can I help?
I can offer your tailored client centred support in a safe & confidential environment with practical help where appropriate. All sessions are completely confidential and I do not share information across other networks such as social services or the NHS.
Talking about your feelings can be helpful, however depressed you are. Sometimes, it’s hard to express your feeling to someone close to you. Talking to a trained counsellor or therapist within a confidential environment can be easier. It can be a relief to tell someone how you feel. It can also help you to understand and make sense of your difficulties.
Above all remember that help is available and you don’t have to continue feeling as you have been.
Please don’t hesitate to talk to me. Even if I am not the right counsellor for you I can help you find someone that is. Calling me is the first step to feeling more balanced & supported.
What is Postnatal Depression?
Postnatal Depression is a depressive illness which affects between 10 to 15 in every 100 women following the birth of their child. Depending on the severity, you may feel you are struggling to look after yourself and your baby. Even simple tasks can appear difficult or daunting.
What causes PND?
PND can be broken down into two distinct categories; Situational PND orHormonal PNDhowever surprisingly there is currently no evidence that the majority of postnatal depression is due to hormonal imbalance. What is currently known as Hormonal PND is usually a disorder affecting the womans thyroid. A very small proportion of women are believed to make thyroid antibodies and this puts them at particularly high risk of postnatal depression, as well as damage to the thyroid gland. A simple test can detect whether this is the cause and treatment with a thyroid hormone should resolve the issue. If women are found, during pregnancy, to be producing thyroid antibodies, treatment with thyroxine after the birth may prevent the development of depression altogether.
Situational PNDoccurs after childbirth when a woman has little support from a partner, friends or family and who are trying to manage in highly stressful circumstances. This type of depression affects approximately 92% of women diagnosed with PND and if you are reading this because you have been diagnosed with PND or wish to support someone with PND then there are certain factors to be aware of in order to support yourself/your loved one.
Psychologists have established 5 universal & core psychological human needs & 2 physical human needs. Having these basic needs met can mean the difference between not developing PND or developing PND.
1) SLEEP-to be supported to have adequate sleep & have chance to rest in bed for a minimum of 2 weeks postnatally but ideally 6 weeks.
2) FOOD/WATER-to be supported to eat healthily & regularly. For wholesome meals to be prepared & brought to the new mothers.
3) WARMTH-to live in a warm environment that protects mother & baby.
4) ATTACHMENT-to be loved & nurtured by partner, family & friends, and to be given the space to love & nurture in return.
5) EMPATHY-to be heard and understood by those close to us. For a mothers wishes & feelings to be heard & understood.
6) HOME/FAMILY/IDENTITY-to feel we belong and are safe/secure without financial worry.
7) FULFILLMENT-for a mother to feel they have achieved and are capable of achieving. To feel confident in themselves.
8) MEANING-to have belief in something & hope for the future.
Women who are most likely to develop depression after childbirth are those who don’t have their own needs met and who receive little support to be a mother.
It’s never too late to seek help. Even if you have been depressed for a while, you can get better & heal. PND can be helped by increased support from family and friends. Talking & good support really help.
When does PND happen?
The timing varies. PND often starts within one or two months of giving birth. But it can start several months after having a baby depending if the level of support changes and if the mother feels she is coping less well. About a third of women with PND have symptoms which started in pregnancy and continue after birth. I have worked with women for whom their PND didn’t start till their baby was a strapping toddler. There are no rules as to the timing of it, just approximations.
What does it feel like to have PND?
(The following symptoms have been taken from the Royal College of Psychiatrists website. I feel its a solid comprehensive list that deserves inclusion in this section of my website. I have added comments of my own based on my previous clients experiences).
You may have some or all of the following symptoms:
Depressed, you feel low, unhappy and tearful for much or all of the time. You may feel worse at certain times of the day, like mornings or evenings. It may feel like premenstrual low mood but as one of my clients said “ten times worse”.
Irritable, you may get irritable or angry with your partner, baby or other children.
Tired, all new mothers get pretty tired. Depression can make you feel utterly exhausted and lacking in energy. You may lack the ‘high’ some mothers feel despite being tired. Some women have described it as “feeling flu-like” or unable to get out of bed.
Sleepless, even though you are tired, you can’t fall asleep. You may lie awake worrying about things. You wake during the night even when your baby is asleep. You may wake very early, before your baby wakes up. You may worry that something will happen to your baby if you fall asleep and nothing anyone says to you can persuade you otherwise.
Appetite changes, you may lose your appetite and forget to eat. Some women eat for comfort and then feel bad about gaining weight.
Lethargy & Low Mood,are you unable to enjoy anything? You find that you can’t enjoy or be interested in anything. You may not enjoy being with your baby, having company, being alone, listening to music, reading etc. Even taking baby out for a walk to the shops or a mums n tots group may fill you with dread.
Loss of interest in sex, there are several reasons why you lose interest in sex after having a baby. It may be painful or you may be too tired. PND can take away any desire. Your partner may not understand this and feel rejected.
Negative and guilty thoughts. Depression changes your thinking. Examples of negative thoughts are; you might think that you are not a good mother or that your baby doesn’t love you, you may feel guilty for feeling like this or that this is your fault, you may lose your confidence, you might think you can’t cope with ‘normal’ things.
Postnatal Anxiety (Part of the PND spectrum of illnesses)
Most new mothers worry about their babies’ health. If you have PND, the anxiety can be overwhelming. You may worry that: your baby is very ill, your baby is not putting on enough weight, your baby is crying too much and you can’t settle him/her, your baby is too quiet and might have stopped breathing, you might harm your baby, you have a physical illness or your PND will never get better. You may be so worried that you are afraid to be left alone with your baby and will seek constant company or alternatively you may wish to be left alone with your baby so that no-one else can visit or hold your baby. This is Postnatal Anxiety. When you feel anxious, you may have some of the following:
fear that you may have a heart attack or collapse.
You may avoid situations, such as crowded shops, because you are afraid of having panic symptoms.
You may avoid other people
You may not want to see friends and family. You might find it hard to go to postnatal support groups.
You may feel hopeless. You may feel that things will never get better. You may think that life is not worth living. You may even wonder whether your family would be better off without you.
Thoughts of suicide. If you have thoughts about harming yourself, you should speak to a supportive adult as soon as possible. If you have a strong urge to harm yourself, please seek urgent help (see below).
Postnatal (Pueperal) Psychosis
This is the most severe type of mental illness that happens after having a baby. It affects less than 1 in 1000 women and starts within days or weeks of childbirth. It can develop in a few hours and can be life-threatening, so needs urgent treatment.
There are many symptoms that may occur. Your mood may be high or low and there are often rapid mood swings. Women often experience psychotic symptoms. They may believe things that are not true (delusions) or see or hear things that are not there (hallucinations).
This illness always needs medical help and support. You may have to go into hospital. Ideally, this should be to a specialist mother and baby unit where your baby can go with you and you can continue to bond & care for your child as you would like to.
Women who have had previous episodes of severe mental illness, particularly bipolar disorder are at a high risk of postnatal (puerperal) psychosis. Women, who have had a severe episode of illness following a previous delivery, are also at very high risk. Let your doctor or midwife know about this. You can discuss with them ways to increase the chances of you staying well.
Although puerperal psychosis is a serious condition, the vast majority of women make a full recovery. You won’t have to suffer with it forever and help is available.
Can postnatal depression be prevented? Self Help
The following suggestions seem sensible and may help to keep you well.
Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired.
Plan a ‘Babymoon’ and outline the support you require.
Do talk to your partner, family &friends. Ensure they know your needs & requirements. Ask for help.
Do find someone you can talk to if not family & friends. If you don’t have a close friend you can turn to, try the NCT (National Childbirth Trust), local VBAC (Vaginal Birth After C-section), Homebirth Support Group or a specialist counsellor.
Do make friends with other women who are pregnant or have just had a baby. It may be more difficult to make new friends if you get PND.
Dogo to antenatal classes or gather friends together to make your own. If you have a partner, take them with you. If not take a friend or relative. BabyCalm, NCT, NHS etc all offer different antenatal classes. Also contact doulas or independant midwives as often they will run an antenatal or birth awareness course. As do yoga teachers in some areas. There are so many to choose from!
And again……Do accept offers of help from friends and family.
Don’t be frightened by the diagnosis. Many women have postnatal depression and you will get better in time. Your partner, friends or family can be more helpful and understanding if they know what the problem is.
Dotell someone about how you feel. It can be a huge relief to talk to someone understanding. This may be your partner, a relative or friend.
Dotake every opportunity to get some sleep or rest during the day or night. If you have a helpful partner, relative or friend, ask them to feed the baby at night sometimes. You can use your own expressed breast milk, or ask your partner to help latch your baby on whilst you continue sleeping. If you are on your own, try and rest when the baby sleeps.
Do try to eat regularly, even if you don’t feel like eating. Eat healthy food.
Dofind time to do things you enjoy or help you relax – e.g. go for a walk, read a magazine, listen to music, laugh at daft tv or dvds.
If you have a partner, do try to enjoy your time together as a family with baby. If you are a single mother, try to do something enjoyable with a friend or family member.
Do let others help you with housework, shopping and looking after other children. Sit back & relax. Its not being lazy, its enjoying your post-baby holiday (‘babymoon’).
Do some exercise. Ask your health visitor if there are any mother and baby exercise classes in your area. Walking with your baby in the pram is good exercise. Regular exercise can boost your mood.
Don’t blame yourself. Ask for help. Insist on help.
Don’t use alcohol or drugs. You may feel that they make you feel better for a short time, but it doesn’t last and only supresses the emotions. Alcohol and drugs can make depression worse. They are also bad for your physical health.
How to help if your partner, friend or relative has PND.
Don’t be shocked or disappointed if your partner, friend or relative says she has postnatal depression. It is common and you can be effectively help them.
Make sure that you understand what postnatal depression is. Research it.
It’s helpful just to spend time with someone who is depressed. It is important to listen and to offer encouragement and support. Reassure her that she will get better & that you will support her no matter what.
Take your partner, relative or friend seriously if she talks about not wanting to live or about harming herself. Make sure she seeks help urgently.
Do all you can to help with the practical things. This includes feeding and changing the baby, shopping, cooking or housework.
If you are the mother’s partner, make sure that you have some support yourself.
If this is a first baby, you may feel pushed to one side, both by the baby and by your partner’s needs. Try not to feel resentful. Your partner needs your help and support.
Fathers can also get depressed after the birth of a baby. This may be more likely if the mother also has postnatal depression. If you are a father and think you may have depression you can call me too. It is important for you and your family that you get the help you need.
Why is support important?
Most women will get better within 3 to 6 months. 1 in 4 mothers with PND are still depressed when their child is one-year-old. However, this can mean a lot of suffering. PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner. You may not look after your baby, or yourself, as well as you would when you are well.
Please do call if you require help. You can leave PND behind with support.