What is Post Natal Depression?
Post-natal depression is a mood disorder or form of depression that occurs after childbirth. Its acronym, which is used by the vast majority, is PND. It affects both sexes but it is more prevalent amongst women and it affects at least one in every eight new Mums. This may result in the Mother being unable to look at herself or to take charge over simple menial tasks, for either her and her baby. It mostly affects mum within the first few weeks but it can come at anytime within the first year after giving birth. Sometimes, Mum’s life with her new born baby will start off taking shape, but after a while the ailment may gradually catch up with the new Mother.
1. What are the symptoms of Post Natal Depression?
Some of the symptoms include low moods and a general lack of joy in one’s life. Irritability is also a major symptom. The Mother becomes very thin skinned and can feel very over-sensitive. The affected Mum can also have a tendency of feeling lethargic and visibly tired, coupled with a feeling of desperation and also anxiety.
Her anxiety could be based on a couple of factors, such as her worry that her baby may not be healthy enough and is possibly not hitting the intended or desired scale of weight based on how old baby is. The anxiety could also stem from the fact that the Mother feels like she could possibly never improve or get better, hence worrying that she is not coping with taking care of her baby.
Sleeplessness is also another issue. The affected Mum may feel like an insomniac with a tendency to wake up at night despite feeling tired. Some women also lose their appetite and find that they are only eating only for survival, whereas others overeat as they seek refuge or comfort in food. Ultimately, they end up feeling bad about their subsequent weight gain.
The Mother could also lose her interest in sex due to the resulting pain after child birth or caused by a general lack of desire. There can also be an influx of negative energy and thoughts and a complete dip in confidence. She may also feel like the love she tries to show to her baby is not reciprocated, which may leave her feeling unloved.
All these symptoms can be experienced singularly or simultaneously. Suicidal thoughts can also be a factor, even including psychotic tendencies, such as hearing voices. Naturally this is frightening for the woman affected, which can trigger a desire to seek safety. A lack of focus and concentration can be other symptoms experienced by women suffering from post-natal depression. Depending on the severity of the condition, women may feel one or more of these symptoms at a given time.
2. What causes post-natal depression?
It is still not crystal clear as to some women suffer from post-natal depession, and others don’t. Its causes are most likely due to a combination of several factors. These elements can include a pre-existing cause for depression, which can be related to some aspects of the Mother’s lifestyle. For example, post-natal depression can be more prevalent in women who may be experiencing social difficulties, perhaps in some of their important relationships, or financial issues. However there are many other possible factors.
Also it is not unusual for an expectant Mother, to have big expectations of how her newborn baby is going to change her life, but of course, the day to day reality of coping with motherhood may come as a shock, possibly triggering post-natal depression.
Some women could be more susceptible and prone than others based on various factors. This includes whether one has previously experienced mental health issues before, whether the baby was born healthy and if her baby is thriving and developing well, or not. Additionally, the woman’s support system is very important. Like other major life changes, it becomes clear at a time like this, how a person’s support system is. While some women may be disappointed and shocked to observe that their support system is weak, others may be nurtured by a strong, loving support system. Without a good support system, people often lack the positive feedback that they require to thrive, so this factor can easily shift the balance if a woman is already feeling vulnerable.
3. Will others realise if I have post-natal depression?
These days there is a better degree of openess about mental health issues of all types, yet depending on your circle of friends, family and acquaintances, there can still be some stigma surrounding post-natal depression, or any form of depression. As a woman going through this, it can be almost automatic to desire to conceal your post-natal depression to others, especially as you already feel very sensitive and possibly ashamed of your situation and/or mothering abilities. Although it may seem hard to digest, particularly when you are feeling low, there is nothing at all to be ashamed of, or feel the need to hide. In fact, the sooner you can seek support, the better, both for you, baby, your partner and others close to you.
For women who are more open about what they are experiencing, it will be likely that those who care about you, will realise that you are suffering from some form of depression. This is better than hiding how you are feeling, as you then have the chance to seek understanding and help
4. Can any steps be taken to prevent and subsequently overcome postnatal depression?
Although a number of medical studies have been carried out around this topic, as yet there is no concrete evidence about methods to prevent post-natal depression. Especially if you have been prone to mental health issues previously, or there is a family history of depression or mental health issues, then special attention should be focused on having a very healthy and positive lifestyle. This should include a healthy diet, sleeping patterns and having a strong support network. If you are hoping to become pregnant or already pregnant, all of these aspects of life should be analysed and planned to ensure you have the best outcome.
Preparation with prevention in mind is undoubtedly the best strategy. For example, this medical study, which had the objective of, “evaluating the effectiveness of continuous midwifery care in reducing the rates of postnatal depression in women with histories of depression,” concluded that, “While continuous midwifery care had no impact on psychiatric outcome, it was highly successful at engaging women in treatment and therefore has an important contribution to make in the care of child-bearing women with mental health problems.”
5. What treatments are available for postnatal depression?
Treatments for post-natal depression are normally based on the severity of the case. The main treatments are medication, self-help and psychological. Each treatment modality has its own pros and cons, but when you speak to your doctor, you can make an educated decision together. When possible, psychological treatments are the first choice.
a. Medication: Anti-depressants
In cases of moderate to severe post natal depression, medication may be the choice recommended by your doctor. An improvement can be experienced within a week or two of receiving treatment, which often includes improved sleeping patterns and improved moods. Never choose medication without consulting a medical professional, especially as some anti-depressants are unsafe to take when you are breastfeeding.
Anti-depressants work by balancing the brain’s mood-altering chemicals. The brain has various types of hormones such as serotonin whose levels, if altered, significantly change the moods of the individual affected. Research clearly illustrates that Tricyclic antidepressants are the best option for breastfeeding mothers. The other antidepressants are selective serotonin re-uptake inhibitors such as Seroxat and Prozac.
Your doctor should explain that antidepressants can have side effects, such as feeling shaky, agitated, dizziness, constipation, a dry mouth or blurred vision.
Breastfeeding helps improve the bond between the mother and the child. This can be helpful to overcome postnatal depression, due to the increased proximity and closeness to your new baby, when breastfeeding. It can also help improve your self-esteem at this time.
Being a Mum, especially for the first time, can be challenging and stressful. Or in some cases, it may be that a subsequent pregnancy was more difficult, or you experienced more stress in your personal life, so you became prone to suffering from post-natal depression. Self-help can be a good option in some cases of post-natal depression.
1. If this is the case, you should seek support by taking to your family, partner and friends, without feeling ashamed or embarrassed.
2. Also be sure to find time for yourself, which should include some relaxing activities, which can be as simple as a lovely, soothing bath or a walk in nature. Reach out and accept help, to ensure you don’t feel worse than you already do. Remember not to try to be some kind of Super-Mum.
3. Sleep is so very important. Be sure to involve your partner or family in helping out with routine tasks that may be too much for you at this time, to ensure that when you go to bed, that your mind is sufficiently relaxed, that you can fall asleep.
4. Focus on a healthy lifestyle, eating regularly and ensuring that your diet is fresh and nutritious. Drink plenty of water, and avoid alcohol and drugs, as they can exacerbate the situation.
5. Seek out a local support group, so that you don’t feel alone at this time. It will be very helpful to meet other women who are going through the same as you. At the end of this feature, we have links to some of the Dublin support organisations.
c. Psychological treatments post-natal depression
Cognitive behavioural therapy
CBT – cognitive behavioural therapy is based on the concept that when we think unrealistically or unhelpfully, this can trigger negative behaviour. The therapy is set up to help you to find ways to break this cycle and think more positively. A therapist can either work with you on-to-one or in a group setting. A common issue that may be affecting you at this time can be an unrealistic perspective on motherhood. In this instance, the therapist will work with you to begin to recognise these thought cycles, especially how they are unhelpful to you. Using CBT you will be able to shift your thought patterns to being more realistic and more positive.
Guided self-help is a therapeutic option, which can be carried out either with a therapist or by yourself, using an online course or book. The material used is specially focused on issues that are challenging for you at this time, and typically a course runs over a period of nine to twelve weeks. During this time, you will receive practical advice about dealing with these issues in a healthy way.
IPT – interpersonal therapy is when you work with a therapist, specifically to deal with the issues that are challenging you, at this time. Therefore, this type of therapy helps you through whatever is personally affecting you, be it new motherhood, partner issues, family problems or any other issue, which is causing your depression. Typically IPT will be carried out for around three to four months.
6. Support Groups
Regardless of what type of therapy route you and your doctor decide on for you, undoubtedly a support group is a wonderful anchor for you, at this time.
Here are some of the organisations that run support groups in the Dublin area:
Although this association is not Dublin based, their website is very supportive.
All articles on the blog and website are intended as information only. Please do not consider any of the information provided here as a substitute for medical advice. At all times seek medical advice directly with your own doctor and medical team.