The act of giving birth is one of the most celebrated in human society. We all know parents who gush about this phenomenal experience and detail the elation they felt in the hours and days following. Popular culture and film are also awash with moving scenes of childhood as couples transition to parenthood against a backdrop of sentimental music and family joy.
What is less often depicted is that once the post-partum dust has settled, the early stages of parenthood can be truly difficult.
Whilst many women suffer the “baby blues” and may be anxious or tearful for short periods of time (usually around one to two weeks) following birth, this can sometimes develop into something more serious.
If symptoms last much longer, or start later into motherhood, postnatal depression is a possibility. Postnatal depression (sometimes also referred to as postpartum depression) is a mood disorder associated with childbirth. It is estimated that approximately 13% of women experience postnatal depression.
Symptoms that you or a loved one may be suffering from postnatal depression include:
What causes postnatal depression?
Unfortunately the answer to this isn’t entirely clear but it is believed to be caused by a combination of factors.
On a physiological level, pregnancy and birth bring with it a whole host of hormonal changes, which may lead to changes in mood. Hormones affect some women to a greater extent than others.
Parents who have suffered from depression prior to childbirth, are much more likely to develop postnatal depression. A family history of mental illness is also a risk factor.
That said, a history of depression does not automatically mean that you will go on to develop depression postpartum. It may be helpful to be aware that you are at risk, so that you can look out for the signs mentioned above.
Aside from this, there are factors relating to the birth process itself that may trigger postnatal depression. These include:
Your home-life may also be influential. Unsuitable housing or money issues may naturally make the transition to parenthood more stressful. Worries relating to work can also hamper your ability to relax and settle into the changes you face.
A strong support network and supportive partner may provide a protective effect against postnatal depression. It is not helpful to spend too much time alone without adult company so if you are feeling isolated it may be helpful to reach out to other parents in the community.
Can men experience postnatal depression?
Although men may not experience the hormonal storm of pregnancy, they may still be subject to its emotional effects. A recent study conducted in Sweden found that 28% of men demonstrated mild levels of depression. Women are routinely screened for postnatal depression while paternal mental health is often overlooked.
The research team added a series of questions to the most commonly used postnatal depression screen, in order to capture the unique symptoms that may be displayed by men. These included working longer hours, irritability and excessive alcohol consumption.
It is not entirely clear whether depression in fathers is a newer phenomenon, or just something which we have only recently begun to explore and detect. Many new fathers face challenges such as trying to balance their work life with their family life as well as decreased sleep and changes in their relationship.
Naturally, depression makes it harder for a new father to invest time in the newborn. Fathers experiencing difficulties should consider that they may have paternal postnatal depression.
How can postnatal depression be treated?
The first step is to speak to your general practitioner. With prevalence rates estimated to lie at about 13%, it is much more common than you think, and health services are trained to recognise the signs and give you the support that you need.
Self-care: It is also crucial at this stage to be kind to yourself. Take care of your primary needs such as getting enough sleep, eating well and doing things that you enjoy. It may feel like you do not have time for this with a young child on your hands, but don’t be afraid to ask others for help.
Talk therapy: As with many psychological difficulties and types of depression, cognitive behavioural therapy (CBT) may be useful. Most experienced therapists will be able to provide a course of CBT and tailor it to the specific difficulties you may be having. Many new parents struggle to live up to the ideal of “perfect parent” and may not have anticipated the difficulties associated with parenthood. CBT can help new parents find a way to think about the difficulties they face and learn better coping mechanisms.
Antidepressants: Antidepressants may also be useful, particularly if the depression is more severe. Some women worry about taking antidepressants whilst breastfeeding but your doctor will be able to provide you with ones that are safe.
One of the worst things about postnatal depression can be feeling alone or unusual in the feelings you are having. This couldn’t be further from the truth and it can help to reach out to national organisations. These can not only provide information and advice but also networks of other parents to talk to.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British journal of psychiatry, 150(6), 782-786.
NHS, Unknown. “Postnatal Depression.” NHS Choices, NHS, 11 Feb. 2016, www.nhs.uk/conditions/post-natal-depression/treatment/.
Psouni, E., Agebjörn, J., & Linder, H. (2017). Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool. Scandinavian journal of psychology.