Postnatal depression

This content mentions abuse or violence, trauma, depression and anxiety, which some people may find triggering.

Summary

What is postnatal depression?
What causes postnatal depression?
Getting support
Ways you can help yourself
What is postnatal psychosis?
Useful resources

Having a baby is a huge life event. It’s normal to experience a range of powerful emotions while you’re pregnant and after giving birth: excitement, joy, and anxiety. You may also feel depressed. It’s not a sign of weakness or anything to feel guilty about. With support and treatment, you can get better.

While most people have heard of postnatal depression, it’s also possible to experience antenatal depression while you’re pregnant. Some people experience both. The term ‘perinatal depression’ covers depression at any time, from getting pregnant to around a year after giving birth.

We’ve used the term ‘postnatal depression’ on this page as it’s more well known, but the symptoms and treatment for antenatal or perinatal depression are the same.

What is postnatal depression?

The ‘baby blues’ is a brief period of feeling low, emotional and tearful after giving birth. It doesn’t last for more than two weeks after giving birth.

If your symptoms last longer or start later, you could have postnatal depression. It can start any time in the year after giving birth and may begin gradually or suddenly. It can range from mild to severe.

It might be difficult to talk about how you’re feeling. You may feel people expect you to be happy or worry you’re a bad parent if you tell someone you’re depressed. Remember that postnatal depression can happen to anyone and isn’t your fault. It’s never too early or late to get help.

What are the symptoms?

The symptoms of postnatal depression are similar to the symptoms of depression. They include:

feeling sad or low
being unable to enjoy things that normally bring you pleasure
tiredness or loss of energy
poor concentration or attention span
low self-esteem and self-confidence
disturbed sleep, even when your baby is asleep
changes in appetite

You may feel detached from your baby or partner. You may even have thoughts of hurting yourself or your baby. It can be very frightening to have thoughts of harming your baby but remember, this doesn’t mean you’re actually going to hurt them. The sooner you can talk to someone about your thoughts and feelings – a friend, relative, doctor or midwife, for instance – the sooner you can get the help you need.

Only people who have given birth in the last year can be formally diagnosed with postnatal depression, but evidence suggests partners can also experience anxiety or depression. This is a huge life change for them too, and dealing with a lack of sleep, extra household responsibilities and financial worries, for example, can be very difficult.

Help and support are available, either through their GP or specialist organisations such as the National Childbirth Trust, the Fatherhood Institute or PANDAS.

What causes postnatal depression?

There are many reasons why someone can develop postnatal depression. These include:

previous mental health problems
hormonal changes during and after pregnancy
your circumstances: for example, a lack of social support, stressful living conditions, losing your job, bereavement
childhood experiences such as abuse, neglect or trauma. These may make it hard for you to relate to others, including your baby, or doubt your parenting skills
domestic violence or other abuse
low self-esteem

For many people, a combination of factors causes postnatal depression.

If you’ve experienced mental health problems in the past, tell your GP, health visitor and/or midwife. They can support you during and after pregnancy.

Getting support

Being depressed doesn’t mean you’re a bad parent or that you’re going mad. Some people worry it will mean their baby will be taken away from them. Remember that asking for help means you’re doing the best for your baby: it’s good parenting. Healthcare professionals will want to support you so you can look after your baby. Children are only taken into care in very exceptional circumstances.

If you have symptoms of postnatal depression, speak to your GP, health visitor and/or midwife. It’s never too late to seek help: you can feel better even if you’ve had symptoms for a long time.

Different help is available depending on how severe your symptoms are.

Talking therapy

You could be offered a self-help course or talking therapy such as Cognitive Behavioural Therapy (CBT). You can refer yourself for talking therapy in England.

CBT can help you see how the ways you think and behave may be making you feel depressed. For example, you may have unrealistic expectations about being a parent and feel you should never make a mistake. CBT can help you see these thoughts are unhelpful and help you find a different way to think about parenthood.

Medication

Antidepressants can help if your depression is severe or if talking therapy hasn’t helped. If you’re breastfeeding, your GP can recommend one that’s safe to take.

Specialist services

Specialist services are available if you need more support. These include:

perinatal mental health services with specialist nurses and doctors who can help you get the right support
community mental health teams (CMHTs). They can help if there aren’t any perinatal mental health services in your area
mother and baby units (MBUs). These are psychiatric wards in hospitals that can give you treatment and support as well as help you care for your baby. You’ll have your own bedroom with a cot for your baby

Ways you can help yourself

Our page on depression has ideas on ways to look after yourself. As well as these, try to build a support network so you can meet friends and other new parents for a chat. Accept offers of help: don’t feel you have to do everything yourself.

Tommy’s has information about planning for after the birth with practical tips on some of the practical and emotional stresses you may experience.

What is postnatal psychosis?

Postnatal psychosis is a rare but serious illness. You may experience symptoms such as hearing or seeing things that aren’t there, believing things that aren’t true, mood swings, feeling confused and behaving in a way that is out of character. Symptoms usually start suddenly, often within hours or days of giving birth.

Postnatal psychosis (also known as postpartum psychosis) should be treated as a medical emergency. If you or your partner think you may have postnatal psychosis, seek medical help immediately from your GP, A&E or crisis team if you have one.

Useful resources

The Association for Postnatal Illness can connect you to someone who has recovered from postnatal mental illness
Family Action and Family Rights Group both offer a range of practical and emotional support for parents
National Childbirth Trust offers information and support during pregnancy and early parenthood, including antenatal courses and local meet-ups
PANDAS offers support to anyone experiencing perinatal mental health problems. They have a helpline, support groups and tips on self-care