What is Post-Natal Depression (PND) or Postpartum Depression (PPD)?

By Dr Vasilios Silivistris

Depression experienced by a mother following childbirth typically arises from hormonal changes, psychological adjustment to motherhood, and fatigue. About one in ten mothers develops postnatal depression. Support and understanding from family and friends can help mothers recover from the challenges of motherhood. Other treatment options include counselling and antidepressants.

Having a baby is a very emotional experience. You may feel tearful and your mood may be low; however, there are three main causes of low mood after childbirth:

Baby blues: This is very common and almost considered a normal occurrence. Symptoms include being weepy, irritability, anxiety and feeling low. It usually starts around the third day but typically resolves by the tenth day after childbirth.

Postnatal depression: It usually develops within the first four weeks after childbirth; however, it can begin several months postpartum. Treatment is advised.

Postnatal (puerperal) psychosis: This is uncommon, but a severe form of depression can develop in about one in a thousand mothers. Fathers may also experience postnatal depression.

The symptoms of post-natal depression are similar to those of depression at any other time and usually include one or more of the following: low mood; ack of motivation; tearfulness; irritability; feelings of guilt, rejection, or inadequacy; poor concentration; feeling unable to cope.

Mothers may also have thoughts of harming their babies. Around half of mothers with PND experience these thoughts. If the condition is very severe, mothers may have suicidal thoughts; however, this is rare.

Additionally, mothers may experience lower energy levels, disturbed sleep, poor appetite and low libido. These symptoms are common and normal for a while after childbirth and do not necessarily indicate depression on their own.

What to do

If you do nothing about the depression, you might recover within six to nine months; some may take longer. Nevertheless, there are several reasons to seek help:

– admitting you are depressed is not a sign of weakness.

– feeling depressed can cause problems in your relationships, job, and overall life.

– if you are depressed, your relationship with your baby may suffer. You might not give your baby as much attention as you would like, potentially delaying their development and causing lasting developmental issues.

Causes

The exact cause is unclear. Any mother can develop PND, but new mothers are more vulnerable soon after childbirth. The main causes seem to include stressful events after birth, such as feelings of isolation, worry, and responsibility for the new baby.

Diagnosis

Usually, a doctor or midwife will check for depression in all women who have recently given birth. They may ask these two questions:

– during the past month, have you often been bothered by feeling down, depressed, hopeless, or helpless?

– in the past month, have you often been troubled by having little interest or pleasure in doing things?

If you answer yes to either, they might ask a third question:

– is this something you feel you need or want help with?

Therapy

Some studies suggest that counselling over several weeks can help ease PND. Antidepressants are sometimes prescribed, and when combined with counselling, they work very well. Most mothers find this mode of treatment very effective.

Dr Vasilios Silivistris (Vasos) is a psychotherapist, counselling practitioner psychotherapycounselling.uk