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What is postnatal depression?

Megan Holmes

Little is mentioned about postnatal depression in most antenatal classes – apart from a quick reference to the baby blues. The lack of discussion on subjects such as depression turns them into ‘taboo’ topics rather than conditions that need to be identified and treated at its earliest stages.

We’ve all been there, right? Shortly after the exhilaration of having a baby, we get those dreaded ‘baby blues’! Usually the blues resolve themselves after a few days but there are two types of depression that can occur after childbirth that may require the attention of a health professional.

Firstly, post natal depression (PND). This condition, which is much more serious than the baby blues, is in fact quite common. It occurs when the mother becomes seriously depressed in the first months following the baby’s birth. It is estimated that 10-40% of mothers will experience postnatal depression.

While PND may follow on from the baby blues, it is more likely to occur (but not exclusively) between the third and ninth month after the birth of the baby. Its effect is bewildering for women when they experience it, instead of the anticipated joy and fulfilment of motherhood.

PND is not a transitory condition and it may persist for 6 - 15 months or longer and occurs with varying degree of severity – mild, moderate and severe.

Then there is postnatal psychosis (sometimes called post partum psychosis). This form of depression is rare and involves symptoms of psychosis (being out of touch with reality) associated with changes in mood either a depressed or an extremely high mood. It usually begins in the first two weeks after the child is born.

So, what causes these forms of depression to occur?

Some of the risk factors pre pregnancy or birth include a past history of depression or other mental health problem, relationship difficulties, having little social contact, onset of depression during pregnancy and life stresses or difficulties such as money or housing problems.

Sometimes the depression is a result of problems that occur during the birth for example, birth complications such as an unwanted Caesarean delivery or the birth of a brain damaged or otherwise ill baby. Risk factors after birth include persisting postnatal ‘blues’, a fussy or colicky baby, feeling detached from the baby and a lack of sleep can also be considered triggers.

But how do you know you have postnatal depression and are not just feeling a bit down?

Postnatal mood symptoms include persistent low, sad or depressed moods, loss of interest and pleasure in usual activities and irritable moods. Physical symptoms include changes in sleeping patterns, change in appetite, decreased energy and physical slowing or agitation. Some cognitive symptoms include thoughts of worthlessness or guilt, thoughts of hopelessness and death, difficulty in thinking clearly, anxiety, panic and excessive concern about health and poor concentration.

There is no medical test that can diagnose depression or psychosis. A diagnosis is made when a woman has some or all of the typical symptoms. For this reason it is very important for the health professional to get a full understanding of the difficulties

Postnatal depression is treated through various means depending on the individual. These include counselling, antidepressant medication, and support groups/networks.

If you feel you need help then you can contact any of the following people:

  • Your GP (General Practitioner)
  • Your Midwife or LMC (Lead Maternity Carer)
  • Your Plunket Nurse
  • Your Community Mental Health Team via a referral from one of the above services

In NZ there should be more done to educate parents about PND. Like all mental health problems, these issues now need to be identified, brought out into the open, discussed and treated with the support of close family and friends.