Having a baby is a big change in one’s life, and it can bring along many emotions. Almost half of new mothers develop “baby blues” within days of delivery, but the symptoms subside gradually within 10 days of delivery. “Baby blues” includes symptoms such as over-reacting to little things, irritability, easy bursting into tears, anxious and low mood at times.
However, postnatal depression (PND) is a mental illness that affects about 10-15 out of 100 women, and the symptoms are very similar to depression. Women who suffer PND may feel guilty for not experiencing the joy and excitement expected with the baby arrival.
PND may happen anytime between the last months of pregnancy and few months after delivery.
1. What does postnatal depression feel like?
- Depressed mood; crying, tearful, low mood
- Irritability, mostly at partner and baby
- Exhausted, lack of energy
- Insomnia, despite exhaustion and even when baby is sleeping, the mother with PND lies down worried and incapable of sleeping
- Appetite changes; either forgetting to eat or over-eating for comfort
- Inability to enjoy anything
- Lack of sexual desire
- Negative or guilty thoughts; thoughts of lack of coping, loss of confidence, being a bad mother and that the baby doesn’t love her; guilt for feeling this way
- Overwhelming anxiety that the baby is ill, crying too much or is too quiet, fear of not knowing how to deal with the baby; worry that she may harm the baby; worry that this anxiety will never go away
- Avoiding other people
- Suicidal thoughts
- Psychotic symptoms; in severe cases, the new mother may hear voices (no one else can hear them) and may have unusual beliefs. This is an emergency situation that requires immediate medical attention
Will mothers with PND hurt her baby?
Usually mothers with PND worry that they may harm their babies, but it is a very rare case when they actually do. If a mother feels like hitting or shaking the baby, she should express it to someone and ask for help with the baby.
2. Causes of PND
There is no single reason for postnatal depression. You are most likely to have PND if:
- You had depression before
- You had depression/ anxiety during pregnancy
- You do not have support from family/ friends
- You had recent stressful event, such as death of a relative, loss of a job, relationship problems
3. What are the treatment modalities at LWHCC for depression?
- Psychotherapy plays an important role in treating depression. It can help you relieve your chest, think clearly, develop new ways of thinking and behaving, and develop problem-solving skills.
Psychotherapy is a process that takes time. You may feel bad during the process because some unresolved issues from the past, but psychotherapy will help cope and overcome these feelings, and it will help you develop new helpful ways of thinking and behaving.
- Antidepressants, which are usually prescribed when patients have been suffering with symptoms and are interfering with daily activities. Use of antidepressants at right time is crucial to halt the progress of the depression and subsequent effect on the care of infant.
- You may start to sleep better and feel less anxious after a few days of starting antidepressants, but your mood will probably not improve before 2-4 weeks.
Neurotransmitters are tiny chemicals that help transfer messages between brain cells. In depression, two neurotransmitters are majorly affected, Serotonin and Noradrenaline. Antidepressants work by increasing the concentration of those two neurotransmitters.
Your psychiatrist and/ or mental health nurse will educate you about the expected side effects of the prescribed antidepressant, which include dry mouth, constipation, and sleepiness, increased appetite, weight gain, and insomnia. Usually those side effects wear off in a week or two. Your mental health provider will follow up on your side effects and work up a plan to relieve these side effects.
Which treatment modality is better for me?
At LWHCC, we will provide you with free triage service with a professional mental health nurse who will carry on a brief mental health assessment, either over the phone or during a face-to-face interview, and guide you to the appropriate service based on your mental health status and individual needs.
4. What can you do to help yourself?
- Do not be afraid of the diagnosis. It is treatable and common, and many women who get treated of PND get much better with time
- Talk to someone who can understand what is going on and provide support (spouse, friend, doctor…)
- Try to rest as much as you can; ask for help from your spouse or friends, or try to sleep whenever baby sleeps
- Try to find time to relax or do any activity; walk for example
- Try to eat healthy meals on a regular basis
- Try to enjoy some time with your partner
- Find local groups for new mothers and postnatal groups
- Do not blame yourself, your partner, or any friends or relatives
- Do not use alcohol and/ or drugs
5. What can you do to help a close one who has depression?
- Do not be shocked or disappointed at your relative/ spouse. PND is common and treatable
- Listen; even if you have to listen to the same thing over and over, and try not to give advice unless asked for
- It is helpful to spend time with this person and encourage her to talk; you may reassure her that she will get better
- Help her with practical activities; cooking, cleaning, shopping, caring for the baby
- Make sure that this person is eating and sleeping well as much as possible
- Help her stay away from alcohol/drugs
- If she starts talking about ideas of not wanting to live, take it seriously and make sure she tells her psychiatrist
- Encourage her to get help. Do not discourage psychotherapy or taking medication if it is prescribed. If you have worries or concerns about your close one’s treatment, do not hesitate to discuss them with her medical team.
Fathers also may get depressed after having a baby, especially if the mother has PND.
Contact us if you feel you may be depressed
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