Thursday, November 05, 2009

All About Post Natal Depression



Thursday 5th November 2009

Statistics suggest that 1 in 10 mothers will develop post natal depression or PND, and I can be counted as one of those that have.

Having a baby is a very emotional experience and your mood can swing in all directions during and post pregnancy. Like me you may feel very unhappy, tearful and low, but there is help out there for all new mums and their families, and you can get over it.

There are three definite types of depression that can follow childbirth;

- 'Baby blues'. This is so common that it can be considered normal. Symptoms include being weepy, irritability, anxiety and feeling low. It usually starts around the 3rd day after giving birth, but usually goes by day 10. It does not usually require any medical treatment.

- Postnatal depression. As I have already said, this occurs in about 1 in 10 mothers. It usually develops within the first four weeks after childbirth. However, it can start several months or even up to one year following childbirth. Symptoms, including low mood, mood swings and anxiety. Severe symptoms may also include irrational thoughts and behaviours. The symptoms last much longer than baby blues. Treatment is advised.

- Postnatal (puerperal) psychosis. This is an uncommon, but severe form of postnatal depression. It develops in about 1 in 1000 mothers.

For today we are going to focus on Post Natal Depression.

The symptoms are similar to those that occur with depression at any other time. They usually include one or more of the following. In postnatal depression, symptoms are usually there on most days, for most of the time, for two weeks or more.
  • Low mood. Tends to be worse first thing in the morning, but not always.
  • Not really enjoying anything. Lack of interest in yourself and your baby.
  • Lack of motivation to do anything.
  • Often feeling tearful.
  • Feeling irritable a lot of the time.
  • Feelings of guilt, rejection, or inadequacy.
  • Poor concentration (like forgetting or losing things) or being unable to make a decision about things.
  • Feeling unable to cope with anything.

You may also get thoughts about harming your baby. Around half the women with postnatal depression get these thoughts. If things are very bad you may get ideas of harming or killing yourself. The reality is that only in very rare cases is anyone harmed. If you have such thoughts, you must seek some help.

In addition, you may also have: less energy, disturbed sleep, poor appetite, and a reduced sex drive. However, these are common and normal for a while after childbirth, and on their own do not necessarily mean that you are depressed.

What causes postnatal depression?

The exact cause is not clear. Common misconceptions are that it is just due to hormone changes after you give birth and that it will go away by itself. Any mother can develop postnatal depression. Some studies suggest that depression after childbirth is no more common than at other times (depression is common). However, it is thought that women are more prone to develop depression just after childbirth.

The main cause seems to be stressful events after childbirth such as feelings of isolation, worry, and responsibility about the new baby, etc. In addition, you may be at greater risk of developing postnatal depression if you have/have had:

  • Mental health problems in the past (including depression, previous postnatal depression, bipolar disorder or schizophrenia).
  • Previous treatment by a psychiatrist or mental health team.
  • Depression during your pregnancy.
  • Postnatal depression that runs in your family.
  • Marital or relationship problems.
  • No close friends or family around you.
  • Money troubles.
  • Physical health problems following the birth (such as anaemia, incontinence, etc).

However, in many cases, there is no apparent cause.

How is postnatal depression diagnosed?

A doctor, midwife or health visitor will usually check for depression in all women who have recently given birth. They may ask the following two questions when they see you (this may be during one of your postnatal checks or visits):

  • During the past month, have you often been bothered by feeling down, depressed, or hopeless?
  • During the past month, have you often been bothered by having little interest or pleasure in doing things?

If you answer yes to either of these questions, they may ask a third question:

  • Is this something you feel you need or want help with?

It is very important that you are truthful about how you are feeling. You should not think that having postnatal depression makes you a bad parent or will mean that your baby is taken away from you. This is extremely rare. Every aim when treating postnatal depression is to keep you with your baby wherever possible so that the bond between you can develop.

If the health care professional that you see suspects that you may have postnatal depression, they will usually refer you to your GP so that the diagnosis can be confirmed. The diagnosis of postnatal depression is usually made by your doctor based on what you, and those who know you, tell him or her. Tests are not usually needed but sometimes your doctor may do a blood test to make sure that there is not a physical reason for the symptoms such as an under active thyroid or anaemia.

You may not recognise that you are depressed. However, your partner or a family member or friend will probably have noticed that you are different, and may not understand why. Sometimes a friend or family member may suggest that you see a doctor because they are worried that you may have postnatal depression.

At the end of this post I will be putting a link to the official 'Edinburgh Test' in which you can asses yourself for the condition.

How is Post Natal Depression treated?

The type of treatment that is best for you can depend on various things including:

  • How severe your depression is and what symptoms you have.
  • The impact of your symptoms on your ability to function (to look after yourself and your baby).
  • Whether you have had depression or other mental health problems in the past.
  • The likely waiting time for any of the treatments.
  • Your current situation.
Together you and your doctor should be able to decide which is the right treatment for you. There are several options available to you and these range from professional counselling to anti depressant pills.


Some do's and don't when dealing with any form of depression.
  • Don't bottle things up and 'go it alone'. Try and tell people who are close to you how you feel. It is not weak to cry or admit that you are struggling.
  • Don't despair. Most people with depression recover. It is important to remember this.
  • Do try and distract yourself by doing other things. Try doing things that do not need much concentration but can be distracting such as watching TV. Radio or TV is useful late at night if sleeping is a problem.
  • Do eat regularly, even if you do not feel like eating.
  • Don't drink too much alcohol. Drinking alcohol is tempting to some people with depression as the immediate effect may seem to relieve the symptoms. However, drinking heavily is likely to make your situation worse in the long run.
  • Don't make any major decisions whilst you are depressed. If possible, delay any major decisions about relationships, jobs, or money until you are well again.
  • Do tell your doctor if you feel that you are getting worse, particularly if suicidal thoughts are troubling you.

Will it happen again?

If you have an episode of postnatal depression you have a greater than average chance of it happening again if you have another baby. About 3 in 10 mothers who have postnatal depression have another episode of depression if they have another baby. However, you and your doctor are more likely to be aware of the possibility in future pregnancies. This means that you are more likely to be diagnosed and treated promptly should it recur.

So, What happened to me?

Well, my post natal depression reared it's ugly head after the birth of my second baby just 18 months ago. All the symptoms listed here are exactly what I experienced, including the more severe symptoms. For me PND was a never ending cycle of guilty feeling. I couldn't help the way I was feeling, the way I felt about my new baby or wanting to end my life, nor could I understand it, and that made me feel guilty...and so the cycle continued.

I am living proof that you can get over this. With professional help, time and understanding you, or a loved one, will get over it too.

As promised, here is a link to the official Edinburgh Test that is used by professionals to diagnose Post Natal Depression. It consist of ten questions, answer them as honestly as you possibly can. You then get a total score and a suggestion of what you should do next.

Commonly a score above 10 means you need to seek medical help, please do so.

That concludes my post for today.

See you tomorrow.



1 comments:

Fay on 5 January 2010 at 22:09 said...

Hi,

I'm glad you are enjoying the blog and that you felt enough about it to leave your comment.

I hope you feel motivated by my posts to leave comments in the future.

 

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