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Postnatal depression (PND)

Summary

Postnatal depression (PND) affects some mothers in the days, weeks or months after giving birth. Symptoms may include lack of confidence, negative thoughts, feelings of being unable to cope or that life is meaningless, anxiety, difficulty sleeping and loss of appetite. Depression during pregnancy is called antenatal depression. Treatment may include support, therapy and medication.

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After having a baby, up to 80 per cent of women may develop the ‘baby blues’ between day three and day ten after the birth. This feeling passes in a day or two and is different from postnatal depression (PND). However, around one in seven to ten mothers develop PND.

PND is a depression that comes on within 12 months of having a baby, usually during the first few weeks or months. It can start slowly or suddenly, and can range from very mild and transient, to severe and lingering. For most women, it passes quickly, but others will need professional help.

PND is most common after a woman’s first pregnancy. Some women experience depression during their pregnancy (this is called antenatal depression).

The symptoms of antenatal and postnatal depression depend on the severity of the depression, but may include low self-esteem, feelings of inadequacy and guilt, tearfulness, sleeping difficulties and panic attacks. Fathers can also develop depression before and after the birth of a child.

Partners, family and friends can all have an important role in a woman’s recovery from PND. Having a baby and PND both place great stress on relationships. A woman with postnatal depression may withdraw from everyone, including her baby and partner. The support of family members, especially her partner, is crucial in helping her recover.

Symptoms of postnatal depression (PND)


The range of symptoms experienced depends on the severity of the depression, and may include:
  • Low self-esteem and lack of confidence
  • Feelings of inadequacy and guilt
  • Negative thoughts
  • Feeling that life is meaningless
  • Feeling unable to cope
  • Tearfulness and irritability
  • Difficulty sleeping or changes in sleeping patterns
  • Low sex drive
  • Anxiety, panic attacks or heart palpitations
  • Loss of appetite
  • Difficulty concentrating or remembering things.

Factors contributing to postnatal depression


The exact causes of PND are still not known. Some contributing factors might include:
  • Physical changes – even a relatively easy birth is an overwhelming experience for a woman’s body. In addition, the sudden drop in pregnancy hormones affects brain chemicals (neurotransmitters). Broken sleep and exhaustion can also contribute to depression
  • Emotional changes – adapting to parenthood is daunting. A new mother has to deal with the constant demands of her baby, a different dynamic in her relationship with her partner and the loss of her own independence. Such changes would be hard at the best of times, but are even more overwhelming when a woman is still physically recovering from childbirth and coping with broken sleep
  • Social changes – society puts lots of demands and expectations on a new mother, which a woman may feel she needs to live up to. She may find herself less able to keep up contact with her friends and workmates. Adapting to living on one wage may also be difficult.

A mother’s relationship with her baby during postnatal depression


A woman with PND tends to withdraw from everyone, including her baby. This is a symptom of the disorder and doesn’t mean that she is a ‘bad’ mother. Some people think that bonding between the mother and child has to happen within the first few days or weeks of birth, or else it won’t happen at all. This is not true.

The relationship between a mother and her baby is an ongoing process. Once the depression lifts, the mother will be able to once again feel her full range of emotions and start to enjoy her baby. In the meantime, she might need some extra help from family and friends.

Postnatal depression and the family


A woman with PND may also withdraw from her partner. The support of family members is very important. In particular, her partner can play a pivotal role in her recovery.

Relationship stress and postnatal depression


Postnatal depression can put an enormous strain on any relationship, even when the partner is patient, loving and supportive. Many couples battling PND think that their relationship has soured beyond repair. Generally, this is not the case, since most relationships return to normal once the depression lifts. It is a good idea to postpone any major life decisions while in the grip of PND.

Other suggestions for a couple dealing with PND include:
  • Find out as much information as you can about PND.
  • Try to recognise that PND may be causing relationship problems, not the other way around.
  • Keep the lines of communication open.
  • Try not to take each other’s moods or criticisms too personally.
  • Seek out useful stress management techniques, such as exercise or meditation.
  • To prevent arguments and resentments, talk about sharing the household duties and who is supposed to do what.
  • Try to arrange at least an occasional night out together, away from the baby.
  • Seek professional help.

Help from a partner during postnatal depression


If you are the partner of a woman with postnatal depression, suggestions include:
  • Be patient.
  • Encourage your partner to talk about her feelings.
  • Accept that her feelings are genuine and don’t trivialise them by telling her to ‘snap out of it’ or ‘get over it’.
  • Try to understand her point of view.
  • Don’t take her negative feelings or criticisms personally.
  • Tactfully limit visitors if she doesn’t feel like socialising.
  • Enlist the aid of other family members to help around the house, if and when they can, including with babysitting.
  • Tell her often that you love her.
  • Show her you love her with cuddles, baby care and housework.
  • Don’t try to turn every cuddle into sexual intercourse.
  • Don’t criticise her post-pregnancy body or demand she lose weight, as she may already feel low about her appearance.
  • Telephone her from work, or drop in for lunch occasionally if you work close to home.
  • Care for the baby after work to promote your parent–child relationship, while giving your partner a much-needed break.
  • If you are worried, encourage her to see a doctor.
  • Go to the doctor yourself for information and advice, if your partner initially refuses to go.
  • Reassure her that, with appropriate help and support, she will recover from PND.

Fathers can also develop PND


A recent British study found that around three per cent of new fathers are prone to PND, particularly if their partner or wife is depressed. In families where one of the parents already has a child or children from a previous relationship, the rate of PND in fathers rises to around seven per cent.

Other risk factors for PND in fathers include:
  • Older age
  • First-time parent
  • Small circle of friends
  • Limited social interaction and support
  • Limited education
  • Concurrent stressful life events
  • Quality of the relationship with wife or partner.

Self-help for fathers and postnatal depression


As a new father, you need to look after your own physical and emotional wellbeing. Suggestions include:
  • Make sure you have some time to yourself, apart from work and family.
  • Try to keep up important hobbies and interests as much as possible.
  • Talk to close friends about your feelings and concerns.

Suggestions for family and friends


Ways you can help a loved one who has PND include:
  • Find out as much information as you can about PND.
  • Be patient and understanding.
  • Ask the couple how you can help.
  • Offer to babysit.
  • Offer to help around the house.
  • Let the mother know you are there for her, even if she doesn’t feel like talking.
  • Appreciate that the father may also be emotionally affected by the demands and challenges of new parenthood.

Help and support for postnatal depression


Support and patience from family and friends are perhaps the most important factor in a woman’s recovery. Talking about her feelings, particularly with other women in support groups or to a professional counsellor, can be helpful. In more severe cases, anti-depressants and other medications might be used to bring about a change in mood. It’s important to remember that PND is a temporary condition that will improve with time.

Where to get help

  • Your doctor
  • Professional counsellor
  • Your local hospital – many offer support for women (and their families) affected by PND
  • Maternal and child health nurse
  • Maternal and Child Health Line (24 hours) Tel. 132 229
  • PANDA (Post and Antenatal Depression Association) helpline Tel. 1300 726 306 (Monday to Friday, 9 am to 7 pm AEST)
  • The Royal Women’s Hospital Tel. (03) 8345 2000
  • Lifeline Tel. 13 11 14

Things to remember

  • A new mother can develop postnatal depression (PND) within a few days or weeks of giving birth.
  • Around one in seven to ten mothers develop postnatal depression.
  • PND can range from a mild feeling of sadness to a paralysing depression.
  • We do not know the exact causes of PND, but the enormous physical, emotional and social changes involved in becoming a parent seem to play a significant role.
  • Partners can play a big role in helping a woman to recover from PND.
  • New fathers can also develop PND, particularly if their partner or wife is depressed.

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This page has been produced in consultation with and approved by:

Royal Women's Hospital

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Royal Women's Hospital

Fact sheet currently being reviewed.
Last reviewed: December 2011

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Postnatal depression (PND) affects some mothers in the days, weeks or months after giving birth. Symptoms may include lack of confidence, negative thoughts, feelings of being unable to cope or that life is meaningless, anxiety, difficulty sleeping and loss of appetite. Depression during pregnancy is called antenatal depression. Treatment may include support, therapy and medication.



Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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