Perinatal Depression

There’s a collective term now for prenatal depression before the baby’s born and postpartum/postnatal depression after the baby’s born — perinatal depression. This blog will discuss this in a bit more depth.

Normal pregnancy shares some symptoms and signs of depression. For instance, with either, you’re likely to be tired, have some insomnia, experience emotional changes, and gain weight. That means pregnancy can mask any symptoms of prenatal depression. To help recognise depression during pregnancy, it’s worth talking with your doctor about any of these symptoms:

• Frequent crying or weepiness

• Trouble sleeping not because of frequent urination

• Fatigue or low energy

• Changes in appetite

• Loss of enjoyment in once pleasurable activities

• Increased anxiety

• Trouble feeling connected to your developing baby (called poor fetal attachment)

• If you had depression before pregnancy, your symptoms may be more significant during it than they were before.

Pregnancy may be overwhelming enough on its own to cause depression. Or for women already feeling low for a combination of reasons, pregnancy may act as a trigger that brings on a more serious depression. Contributing factors can include hormone changes, morning sickness, anxieties over becoming a mother and worrying about how your relationship or finances will cope with your new arrival.

Postpartum depression (or postnatal depression) is a type of depression that many parents experience after having a baby. It is a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners. Postpartum depression does not have a single cause, but likely results from a combination of physical and emotional factors. After childbirth, the levels of hormones (oestrogen and progesterone) in a woman’s body quickly drops. This leads to chemical changes in her brain that may trigger mood swings. In addition, many mothers are unable to get the rest they need to fully recovery from giving birth. Constant sleep deprivation can lead to physical discomfort and exhaustion, which can contribute to the symptoms of postpartum depression. Some women are also at greater risk for developing postpartum depression because they have one or more risk factors, such as:

• Symptoms of depression during or after a previous pregnancy

• Previous experience with depression or bipolar disorder at another time in their life

• A family member who has been diagnosed with depression or other mental illness

• A stressful life event during pregnancy or shortly after giving birth

• Medical complications during childbirth

• Mixed feelings about the pregnancy

• A lack of strong emotional support

• Alcohol or drug problems

Many women often feel a bit down, tearful or anxious in the first week after giving birth. This is often referred to as the “baby blues” and it is so common that it’s considered normal. The “baby blues” will often start in the first week after giving birth and not last for more than two weeks after giving birth. If symptoms start later or last longer than this could be an indication of postpartum depression. The main symptoms for postpartum depression include:

• A persistent feeling of sadness and low mood

• Lack of enjoyment and loss of interest in the wider world

• Feeling agitated, irritable or very apathetic

• Feelings of guilt, hopelessness and self-blame

• Lack of energy and feeling tired all the time

• Feeling your unable to look after your baby

• Loss of appetite of an increased appetite

• Trouble sleeping at night and feeling sleepy in the day

• Difficulty bonding with your baby

• Withdrawing from contact with other people

• Problems concentrating and making decisions

• Frightening thoughts for example about hurting your baby.

• Thinking about suicide and self-harm

Many women do not realise they are experiencing postpartum depression as it often develops gradually however if you suspect you may be suffering from this then talk to your GP or health visitor as soon as possible so you can access the support you need. Don’t struggle on alone and hope things will just improve – postpartum depression can actually continue for months or years if it is not addressed.

There are also some signs for partners, family and friends to look out for in new parents. These include:

• Frequently crying for no obvious reason

• Having difficulty bonding with their baby

• Withdrawing from contact with others

• Speaking negatively

• Neglecting themselves

• Losing all sense of time

• Losing sense of humour

• Constantly worrying that something is wrong with their baby

If you think someone you know is depressed, encourage them to talk about their feelings to you, a friend, GP or health visitor. There are effective treatments for postpartum depression and treatment may include medication and/or therapy. Therapy seen as particularly effective is Cognitive Behavioural Therapy (CBT) and Interpersonal Therapy (IPT). Seeking treatment can be a frightening time for a new parent and a report published by the charity 4children in 2011 found that 49% of women with symptoms did not seek help despite believing they were suffering from postpartum depression. This percentage represents 35,000 mothers and their families suffering in silence. The two most common reasons for not seeking help were 60% not believing their symptoms were serious enough to warrant treatment and 33% saying they were too scared to tell anyone because they were afraid that admitting symptoms will constitute an admission of failure or have serious implications for their child. Rest assured movements have been made towards normalising attitudes to postpartum depression and removing the taboos that can hinder attempts to seek support. This is vital as ultimately the sooner a mother with postpartum depression gets help; the less damaging it is for her and her family. No one should have to suffer in silence.

Check out the 4children study