Awareness Days, International Women's Day, Mental Health, Women's Health

International Women’s Day – Postnatal Depression

Continuing our theme for International Women’s Day, our next topic is postnatal depression (PND).

Before we get started, we would like to say that we acknowledge men can also suffer from PND and this article is in no way diminishing the role of men in parenthood or the struggles that come with it. Despite this being published in accordance with IWD, much of the information can be applied to men and non-parents.

An interesting statistic is that at 3 and 12 months post-partum, 9.3% and 4.4% of mothers and 3.4% and 4.0% of fathers were newly diagnosed with depression in a study by Escribà-Agüir and Artazcoz (2011). We will explore this in the future because we believe that men’s mental health deserves it’s own post to highlight the need for increased awareness and further action! Keep an eye out for our 6 part series on men’s health awareness scheduled for International Men’s Day.

What Is Post-natal Depression?

The NHS define it as a type of depression that many parents experience after having a baby. They describe it as a common problem, affecting more than 1 in every 10 women within a year of giving birth.

If It Is So Common, Why Do So Many Suffer In Silence?

There may be several possible reasons, including fear of people thinking you are a bad parent, fear of not being taken seriously or being dismissed and not knowing where to go for help. However the responsibility doesn’t just rely on the person struggling to ask for help, it is also the responsibility of their support system to keep an eye on your new-parent friends. This is where the awareness of the signs and symptoms come in.

How To Recognise PND

Postnatal depression doesn’t necessarily start immediately after birth, it can start any time in the first year..

Here are the signs to look out for that may indicate you or someone you know might be depressed:

  • a persistent feeling of sadness and low mood
  • difficulty bonding with your baby
  • lack of enjoyment and loss of interest in the wider world
  • lack of energy and feeling tired all the time
  • trouble sleeping at night and feeling sleepy during the day
  • problems concentrating and making decisions
  • withdrawing from contact with other people
  • frightening thoughts – for example, about hurting your baby

PND can develop gradually so many parents don’t realise they are depressed until it has become more severe. It can be hard to notice when you’re already over-tired from lack of sleep looking after a newborn.

Other things to look out for when you speak to your parent friends are phrases such as:

  • “I’m exhausted, I can barely manage to leave the house.” – May mean they’re just up with a crying baby, or it might not.
  • “Being a parent is more lonely than I thought.” – Having a baby is a big change and sometimes parents can feel unsupported and alone when their partners go back to work and the initial excitement from friends lessens.
  • “Me”, “myself” and “I” – not because they are selfish but because depression can cause a lot more inward thoughts, often negative ones.
  • “I should” – there is a lot of pressure felt by most parents to be perfect and pressure to do something that isn’t possible can lead to misplaced feelings of guilt, inadequacy and depression.
  • Repeated use of the words “down” or “stressed” – we all use these words occasionally (unless you’re an osteopathy student, then it’s just your life for 4-5 yrs!) but the trick is to spot a pattern of consistent use.
  • “It’s all my fault” – feelings of guilt and self-blame can quickly lead to feeling like a burden and how everyone would be better off if they weren’t there.

How Is PND Treated?

The first step is always talking about it, sharing heavy negative emotions with another trusted person whether that is a friend, relative or medical professional can reduce the burden significantly. Osteopaths are great listeners and everything you say is confidential unless they believe you may be a danger to yourself or others. They can always show you where to get more help if needed. Alternatively your GP or health visitor are equally good choices.

Other self-help measures such as going for a walk, resting where possible and paying close attention to eating a healthy balanced diet can be beneficial.

Talking therapies such as counselling or Cognitive Behavioural Therapy (CBT) are often recommended. The GP is able to refer you, but in most counties there is an NHS self-referral form online for talking therapy assessment. Search for ” NHS talking therapies [insert county]” and it should bring your local self-referral service up on Google.

Lastly, antidepressants may be recommended if the depression is more severe or other treatments have not helped; your doctor will be able to prescribe a medicine that’s safe to take while breastfeeding.

More information can be found  Association for Post Natal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS)

Why We Need To Ditch The Term “Baby Blues”

“Baby blues” is an old fashioned way of referring to postnatal depression. It has since evolved to refer to the 2 weeks postpartum where a woman may feel down, tearful and anxious, which is normal because looking after a baby is hard and hormones are flying. However the use of this phrase is still used by many to refer to PND.

It trivialises and diminishes the impact both that those initial feelings and depression can have on a persons wellbeing. It can perpetuate the idea that it is normal to feel “a bit down” for a few months after the arrival of a new baby when it is not; and in those first two weeks it can feel like a dismissal of difficult feelings when support is required.

The take away from this piece is: check in with your parent friends, your non-parent friends, your relatives; offer help where you can and believe them if they tell you they are struggling.

Photo by Ömürden Cengiz on Unsplash

Escribà-Agüir V, Artazcoz L. Gender differences in postpartum depression: a longitudinal cohort study. Journal of Epidemiology & Community Health 2011;65:320-326.