Postnatal Depression

What is Postnatal Depression?

This is different to the “baby blues” that many women experience in the first few days after having a baby, and which resolves quickly. Many women, especially new mums, will experience some of these symptoms for a day or two, but if these symptoms are present most days for a couple of weeks, you need to speak to your midwife, child health nurse or GP. If this feels too hard, talk to a close friend, partner or family member. Symptoms to watch out for include:

• Feeling low or sad, tearful, negative
• Not enjoying things
• Struggling to bond with your new baby, or worrying about the baby
• Extreme tiredness and lack of motivation
• Hopelessness, worthlessness or a sense of inadequacy
• Anxiety and panic attacks
• Suicidal thoughts

“Depression alone affects up to one in ten women during pregnancy. In the first year after birth, it affects up to one in five women. Perinatal depression in dads or partners is not as well-researched. Evidence to date estimates about one in ten new dads are affected at some point from pregnancy through to the first year after birth. This rises to I in 5 if the mother is depressed. Dads’ roles have evolved in recent decades and men can find this transition to parenthood tricky”. The Gidget Foundation

The usual assessment tool health professionals use to help diagnose Postnatal Depression is the Edinburgh Postnatal Depression Score (EDPS) https://www.cope.org.au/wp-content/uploads/2018/02/EPDS-Questionnaire.pdf

What happens if I am experiencing these symptoms and don’t want to say anything?

• It is nothing to be ashamed of, it doesn’t make you a bad mother, and no one will judge you. But it is not something that you can “snap out of”, and you will likely need some support to get through it. Many women I see with postnatal depression take several months to come forward, and once on the road to recovery look back and say “I wish I’d sought help sooner”. So please, speak out, speak to someone you trust, and get the help you need and deserve.

What can I do to help myself?

• Build a support network, meet other mums for a chat, reach out through Central West Mums to fellow mums who may be in a similar position
• Accept offers of help
• Make time for some exercise, even if just putting baby in the pram and going out for a walk
• Focus on healthy and regular meals, and make sure you drink enough water. Reduce alcohol and caffeine
• Get up, showered and dressed, even if you don’t plan on leaving the house, having that routine can really help your mental health
• Keep a mood diary – it helps you notice changes in your mood, and how people, places and situations around you affect your mood
• Mindfulness – this doesn’t have to be time consuming; you can even practice it whilst your baby is feeding. There are multiple apps available to help with this.

I’m worried about being prescribed antidepressants as I’m breast feeding

• Not all women with postnatal depression need antidepressants. Many can be helped through their condition with simple strategies such as resting, exercise, getting some time out for yourself, extra support at home or with your new baby.
• For those women with more severe symptoms, counselling or psychological therapy can provide many therapeutic benefits
• For those women who require antidepressants, your GP will ensure you are prescribed one which is safe with breast feeding. Please don’t let this fear get in the way of seeking help.

I think I need psychological support but am worried about costs

• Your GP may be able to provide you with a Mental Health Care Plan, which allows you to access the Medicare rebate on psychological therapy. There is likely to be an out of pocket cost, but the psychology practice you are referred to will go through these costs with you. Generally, the majority of the cost is covered by the Medicare rebate.

I had postnatal depression in a previous pregnancy. Will I get it again with this pregnancy?

• There are things you can do during your pregnancy to help yourself be as strong as possible before your baby arrives. Ensuring adequate rest (not always easy if you have other children at home), reducing stress levels, accepting help and support from those around you can all contribute to improving your mental health antenatally, and potentially reduce the chances of developing postnatal depression with this pregnancy.
• Tell your midwife, obstetrician or GP about your history – they can work with you to make a plan for after delivery. The good news is that if you’ve had it before, you are likely to recognise the signs and seek help sooner.
• It is thought that approximately 20% of women who have experienced postnatal depression previously, will develop it in a subsequent pregnancy.

I’m worried about my partner – is it possible for him to have postnatal depression?

• Yes definitely, in fact about 1 in 10 dads develop postnatal depression in the first 12 months after their baby is born. And 50% of partners of mothers with postnatal depression, will experience similar symptoms. As with maternal postnatal depression, it often goes undiagnosed.
• Symptoms in men can be different, and include withdrawal from family, work or social situations, frustration and irritability, alcohol and drug use, indecisiveness, insomnia.
• If you have concerns about your partner’s mental health, please contact your GP, speak to him, or to friends or family for support.

If this article raises any issues or concerns, please call Lifeline on 13 11 14 (24 hours / 7 days)

If you’re concerned about your own or someone else’s mental health, you can call the NSW  Mental Health Line 1800 011 511 for advice.

If you or someone else is in immediate danger, call  000 or go to your nearest hospital emergency department.

PANDA, the national Perinatal Anxiety and Depression Association also has a helpline 1300 726 306 (Mon-Fri 9am – 7.30pm). More information about PANDA is available at www.panda.org.au

MumSpace is an online support resource for new Mums at every step.

References:

Cope (Centre of Perinatal Excellence)

Black Dog Institute

Postpartum Depression statistics