Postnatal depression (PND) may be common, but that doesn’t make it any easier for the women going through it. We regularly read about it in the media, we might know someone with it, or have at least followed a celebrity’s battle with it. However, despite the prevalence and awareness of postnatal depression, the reality is that women who are actually experiencing it, feel very, very alone.
It is estimated that PND affects around one in 10 mothers in the UK. PND usually develops in the first four to six weeks after childbirth, although in some cases it can develop several months later.
Having a baby is a huge adjustment for any woman, but can be more so if she is used to working full time. The majority of first time mothers are used to going out to work, and many find themselves feeling isolated or trapped at home with their baby, missing the social interaction and mental stimulation of work.
Despite missing work, returning to the workplace can trigger or exacerbate postnatal depression. Having a baby is hard, and trying to juggle a newborn with paid employment is even more stressful.
If untreated, the mother’s depression can have significant effects not only on her own mental health, but on the relationship with the baby, the baby’s own development, as well as affecting the partner and wider family.
It is important to differentiate from the ‘baby blues’ or postnatal ‘blues’, which is common , affecting 60-70 per cent of women and usually occurs in the first few days following birth and usually resolves after a few days.
Dr Trudi Seneviratne is a consultant psychiatrist at the Mother and Baby Unit at the South London and Maudsley NHS Foundation Trust (SLaM). Part of SLaM’s Perinatal Service, the unit offers specialised care and treatment for women from across the UK, who have developed postnatal depression (PND) following the birth of their baby.
“It is very important for new mothers struggling with depression to understand that having PND does not mean they do not love or care for their baby,†Dr Seneviratne stressed.
“Most women aren’t aware when they are experiencing PND, which means it is extremely important for partners, family and friends, along with healthcare professionals, to recognise the signs of PND as early as possible, and recommend treatment. Women often feel guilty about expressing their feelings as having a new child should be a ‘happy’ timeâ€
“PND can be a lonely and scary experience for new mothers, but it is not a permanent condition. With time and treatment, you will recover,†Dr Seneviratne said.
Mothers struggling to combine work and motherhood should look into all the options available to them, including maternity leave, holiday entitlement and unpaid parental leave. Working mothers experiencing postnatal depression are also entitled to sick leave, although this will require a doctors certificate.
Time off work will help, but it is important to find a long-term solution. Talking to a GP or health visitor is the first step in getting help. If a new mother has been feeling down, depressed and hopeless, and is unable to take an interest in normal activites and pleasures, they are most likely to be suffering from PND. They may not enjoy their baby and struggle with societal cultural pressures like maintaining breast feeding. A GP should ask questions and look for common symptoms of PND, then offer the most appropriate form of treatment.
Psychological interventions or therapy are often recommended, although the most important step is simply recognising the problem and talking it through with family and friends and helpful professionals. Medication, like antidepressants, can be used to treat PND. It is important that the mother is adequately supported and that any treatment plan is tailored to her wishes.
Long-term, it is important to balance your new role as a mother with work. Explore options for ongoing flexible working hours. Giving up work, either temporarily through extended maternity leave, or permanently, is not a decision to be taken lightly. It is important to remember that postnatal depression is treatable, and over time it becomes easier to adjust to the life changes new motherhood brings.
There is no single cause for PND, and it can be triggered by a number of things like social factors including relationship worries, money problems or having limited support from family and friends. Indeed, having a baby itself is a life-changing event that can be extremely exhausting and stressful. For working mothers, juggling a new baby with returning for work adds further stress. Other new mothers may struggle to adjust to leaving the office behind while on maternity leave.
“Some women feel unable to look after their baby, or maintain their relationship with their partner. They may feel anxious about leaving the house, juggling work and home, or that they simply cannot cope,†Dr Seneviratne explained.
The most common symptoms of postnatal depression include low mood, overwhelming guilt, feeling unable to cope and difficulty sleeping. While most mothers will experience some form of exhaustion and possibly mild depression, prolonged low moods are an indication of a more serious problem.
Symptoms of postnatal depression
The symptoms of postnatal depression usually include one or more of the following:
• Low mood for long periods of time (a week or more)
• Feeling irritable for a lot of the time
• Tearfulness
• Panic attacks or feeling trapped in your life
• Difficulty concentrating
• Lack of motivation
• Lack of interest in yourself and your new baby
• Feeling lonely
• Felling guilty, rejected or inadequate
• Feeling overwhelmed
• Feeling unable to cope
• Difficulty sleeping and feeling constantly tired
• Physical signs of tension, such as headaches, stomach pains or blurred vision
• Lack of appetite
• Reduced sex drive