You've just had a beautiful baby, and you had expected to be filled with joy during this time. Instead, you are overwhelmed by feelings of dread, self-doubt, sadness, and confusion. Feeling overwhelmed – particularly in those first few months – can be totally normal: You have a new family member, you’re not sleeping much, and you have a lot on your plate. But if your feelings seem to be something else, something perhaps a little more severe, it may be that you have postnatal depression, or PND. This condition is not a flaw or a sign of weakness — instead, it can be considered a complication of childbirth. Read on to find out what postnatal depression is, learn some of the signs and symptoms, and find some coping mechanisms that may help you manage your symptoms in conjunction with your GP or health visitor’s plan.

What Is Postnatal Depression?

Postnatal depression is a medical condition that causes a new mum to feel severe and long-lasting negative emotions or thoughts in the months after giving birth. Some of the main signs and symptoms of PND are listed below. Postnatal depression can occur after any delivery — not necessarily the first one. It usually starts between two and eight weeks after the baby is born, but for some women, it may begin several months later, or even up to a year after birth.

How common is postnatal depression? It’s more common than you might think. More than 1 in 10 women who've given birth experience this condition within a year of giving birth. Around a third of women diagnosed with PND may start to have symptoms during pregnancy. So if you do feel like you have the symptoms of PND or you have been recently diagnosed, know that you are not alone, and in time you will start to feel better once more.

Postnatal depression should not be confused with the ‘baby blues’. This is when you have less severe symptoms of feeling sad, irritable and touchy, crying, or having anxiety. These milder symptoms typically begin in the first week after you give birth, and usually go away after a couple of weeks. While having the baby blues can really get you feeling down, rest assured those feelings will soon pass. PND should also not be confused with a rare mood disorder called postpartum psychosis, which involves more severe symptoms, such as hallucinations.

Postnatal Depression Signs and Symptoms

The first step is to recognise whether you may have PND. The signs of postnatal depression include:

  • Depressed mood

  • Excessive crying

  • Difficulty bonding with your baby

  • Withdrawing from loved ones

  • Loss of appetite

  • Eating much more than usual

  • Inability to sleep (insomnia)

  • Feeling sleepy during the day

  • Overwhelming fatigue or loss of energy

  • Reduced interest and pleasure in activities you used to enjoy

  • Intense irritability and anger

  • Fear that you're not a good mother

  • Feelings of worthlessness, shame, guilt, or inadequacy

  • Diminished ability to focus

  • Decreased ability to handle everyday tasks

  • Severe anxiety and panic attacks

  • Thoughts of harming yourself or your baby

  • Recurrent thoughts of death or suicide.

Only after speaking to your GP or your health visitor will you be able to answer the question: Do I have postnatal depression? But you may want to ask yourself (and then tell your doctor) whether you are experiencing any of the symptoms listed above, and whether:

  • Any of these symptoms has lasted longer than two weeks

  • Your symptoms are getting worse, not better

  • You're finding it hard to care for your baby

  • You're finding it challenging to complete everyday tasks.

Causes and Risk Factors

It’s not known exactly what causes postnatal depression, but it is likely triggered by a combination of physical and emotional factors, which may include:

  • Hormonal changes. A sharp drop in pregnancy hormones, like progesterone, after you give birth to your baby may contribute to the baby blues, which can lead to depression. In addition, levels of other hormones produced by your thyroid gland may also drop, making you feel tired, sluggish, and depressed.

  • Stressful life events. If you’ve had a recent stressful event like the death of someone close to you, losing a job, or a relationship ending, this can trigger PND.

  • A history of mental health issues. If you have had a mental health problem, such as depression, earlier in life or during pregnancy, you may be at an increased risk of postnatal depression.

Risk factors for postnatal depression include if you have:

  • Had postnatal depression after a previous pregnancy or mental health problems while pregnant

  • Family members who've had depression or other mood problems

  • Experienced major stressors during the past year (even those unrelated to pregnancy)

  • Had twins or multiple babies, which can put you under extra pressure and lead to postnatal depression

  • Problems in your relationship with your partner

  • A weak support system

  • Financial worries.

If you have had postnatal depression before, tell your GP as soon as you find out you are pregnant. Your doctor may take any of the following steps:

  • Monitoring you closely for any signs and symptoms of depression

  • Giving you a depression-screening questionnaire during your pregnancy and after delivery

  • Suggesting you attend support groups, counselling, or other therapies to help you handle any mild depression

  • Recommending antidepressants — even during pregnancy

  • Recommending psychotherapy immediately after delivery.

How to Cope With Postnatal Depression

Know that there is postnatal depression help available through your GP who will talk to you about the different types of treatment available.

Although PND isn’t generally something you can treat on your own, these ideas may help set a solid foundation for your medical treatment plan, and could help speed recovery:

  • Maintain a healthy lifestyle. Add gentle exercise into your daily routine. For example, take a walk with your baby. Try to get adequate rest, and eat healthily.

  • Have realistic expectations. You’re adjusting to having a new baby, so don't put pressure on yourself for everything to be perfect.

  • Make time for yourself. Organise someone to care for your baby, and have some me-time. Leave the house, and do something relaxing that you enjoy.

  • Connect with others. Feeling isolated can be a problem for some new mums. Talk to your loved ones about how you're feeling, and speak to other mums about their experiences.

  • Share the load. Your loved ones will often be happy to help out. Sometimes all it takes is just to ask! This time off will give you a chance to have some much-needed breathing room.

  • Keep going. Follow your GP or health visitor’s advice, but don’t stop treatment simply because you ‘feel better’, as this may lead to a relapse.

How to Support a Loved One Who Has Postnatal Depression

People with PND may not be able to tell that they're depressed; they may not know the signs and symptoms. If you suspect a loved one has postnatal depression, help her seek medical advice right away. Keep in mind that as a partner, friend, or family member, you can’t ‘fix’ postnatal depression, but you can be there for the new mum. Here are some practical things you can try:

  • Reassure her that she will get better

  • Listen to and accept her feelings; understand that she cannot control any negative feelings

  • Offer to take care of the baby so she has space to do relaxing things like go for a walk or get a massage, guilt-free

  • Arrange for a family member, friend, or babysitter to care for the baby for a few hours, so she has a chance to sleep

  • Help out by doing basic errands, chores, or day-to-day tasks to take some of the responsibility off her plate.

If you are the other parent of the newborn, keep in mind that there is such a thing as paternal and male postnatal depression. If your partner is depressed, it can also affect you, as your risk of depression is already higher during this time. If you find yourself feeling depressed, try the above-mentioned tools, and speak to your GP.

Postnatal depression is not your fault. Unfortunately, many women feel guilty or ashamed because they can't find any reason to explain why they feel so unhappy. Some may even experience having their feelings dismissed or criticised by others. Remember, this is a medical condition that requires treatment, and it’s important not to suffer alone. There is support out there, and once the fog clears, you’ll be able to enjoy this time with your baby.