Postnatal depression

Postnatal depression (PND) – also known as postpartum depression – is a type of depression some women experience after having a baby.

Between 10 and 30 percent of all new mothers reportedly suffer from postnatal depression. A woman is vulnerable when she has recently given birth and the combination of too many stress factors at this time causes some women to develop PND.

A combination of risk factors can contribute to the condition:

  • After childbirth, a dramatic drop in hormones (oestrogen and progesterone) in your body may contribute to PND
  • Feeling unable to cope with demanding circumstances
  • Lack of support from partner and family
  • A traumatic birth
  • Financial and other stress
  • Loneliness and an unhappy relationship with the baby’s father
  • Previous experience of depression.

It can also occur in men. An estimated 10% of new fathers can develop paternal postpartum depression, according to the American Academy of Pediatrics.

What are its symptoms?

Postnatal depression can affect women and men in different ways. Symptoms can start soon after giving birth and last for months or even longer than a year.

The key symptoms of postnatal depression are:

  • A persistent feeling of sadness
  • Loss of interest in the world around you
  • Lack of energy and fatigue

Other signs can include:

  • Disturbed sleep
  • Difficulty concentrating and making decisions
  • Poor self-confidence
  • Poor appetite or an increase in appetite
  • Feeling agitated or apathetic
  • Feelings of guilt and self-blame
  • Suicidal thoughts
  • Lack of libido

How is it diagnosed?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, PND is considered a subtype of major depression. For PND to be diagnosed, signs and symptoms of major depression must develop within four weeks of giving birth.

Consult your doctor if you have any signs of PND. He/she may ask you to complete a depression-screening questionnaire. Your doctor may also perform blood tests to determine whether an underactive thyroid is contributing to your symptoms.

If you have three of the above symptoms, it’s likely you have mild depression. If you have five or six symptoms, it's likely you have moderate depression. People with moderate depression will have great difficulty carrying out normal activities.

What are your treatment options?

The sooner treatment starts the better. The condition is unlikely to get better by itself and it could impact on the care of your baby.

The Post Natal Depression Support Association recommends three things in the treatment of PND: medication, psychotherapy and individual or group support.

  • Antidepressants: Antidepressants are a proven treatment option. Your doctor will advise you of the potential risks and benefits of specific antidepressants.
  • Hormone therapy: Oestrogen replacement may help counteract the rapid drop in oestrogen that accompanies childbirth, which may ease the symptoms of PND in some women.
  • Therapy: It helps to talk through your concerns with a psychiatrist, psychologist or counsellor. You will find ways to cope with your feelings, solve problems and set goals.

Can it be prevented?

Although you cannot prevent the hormone changes that cause PND, you can take steps towards the prevention of ongoing postnatal depression. This includes:

  • Keeping your body and mind strong and healthy
  • Following a good diet and exercising regularly
  • Asking for help and support from others so you can get as much sleep as possible
  • Staying away from alcohol, caffeine, and other drugs or medicines unless recommended by your doctor.

Women whose risk is higher for the reasons listed below should take extra steps to prevent PND. This includes:

  • A history of depression
  • A history of PND
  • Domestic violence.

For more info
The South African Depression & Anxiety Group 

Post Natal Depression Support Association South Africa

Perinatal Mental Health Project

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2015