We hear about members’ experiences and discuss the support that’s available if you think you might be experiencing antenatal or postnatal depression.
As an expectant or new mum it can sometimes feel like everyone else is coping perfectly with pregnancy and parenthood. But, actually, as many as one in three women report some level of anxiety or depression during or after pregnancy.
Rebecca Hall (pictured), mum to Elodie, two, and a member of NCT’s York branch, suffered with antenatal depression. She says: ‘My feelings about my pregnancy were negative from the start. Elodie was conceived after three miscarriages and I was convinced this pregnancy would go the same way, so I immediately started distancing myself.
I felt the first flutters of movement at 15 weeks and can remember being distinctly unimpressed. Again I felt no connection when I heard the baby’s heartbeat at the scan. I told my midwife I felt like I was a surrogate to someone else’s baby.’
What are the symptoms?
Antenatal depression can begin at any point during pregnancy and is characterised as having a higher than normal level of worry about the impending birth and parenthood.
Unfortunately, it can be very difficult to talk about because people expect mums-to-be to feel excited and overjoyed. Although antenatal depression is more likely to occur among women who have a history of depression, it is by no means inevitable.
Other factors that can contribute to antenatal depression are pregnancy sickness and tiredness, anxieties over coping with motherhood, and economic and relationship concerns. It can also be caused by a hormone imbalance during pregnancy.
It is important, however, that women with a history of mental health issues tell their midwife so they can discuss how this might affect their pregnancy and birth, and plan the right care and support.
The symptoms of PND can include low mood, anxiety, panic attacks, inability to look forward to anything, tearfulness, feeling unable to cope, extreme tiredness and difficulty sleeping.
And PND can occur any time after giving birth. It is sometimes confused with the baby blues, which are very common and can leave mums feeling emotional, tearful, irritable and anxious. Levels of hormones required during pregnancy drop quickly, while others that promote the bonding process and trigger the start of milk production rise. These rapid changes can leave mums feeling confused.
What are the baby blues?
Baby blues typically occur two to four days after the birth and usually clear up within a few days. If mums are still experiencing some of these feelings after that time, it’s worth speaking to a GP, midwife, health visitor, family or friends, as this could be more than the baby blues.
The six-week check with your GP is a good time to discuss emotional health and wellbeing, in addition to your physical recovery.
We don’t know for sure what specifically causes PND, but a number of factors can contribute to it, such as health problems after the birth, the pressure of looking after a newborn, sleep deprivation, hormonal changes and stressful circumstances, such as money worries, relationship problems, bereavement or domestic violence. A lack of social support can also be a key factor.
As with antenatal depression, it can be more common among women with a history of depression. It’s worth pointing out that around one third of cases of antenatal depression will lead onto PND.
There is also evidence that idealised views of motherhood can contribute to depression – so we want to encourage all mums to be kind to themselves and not judge themselves by impossible standards or feel that others are doing a better job.
Women shouldn’t feel that antenatal depression or PND is their fault either. No mum should ever blame herself and feel unable to ask for help as a result.
Felicity Green (pictured) is mum to Imogen, four, and Caitlin, 17 months, and she attended an NCT antenatal course in Ewell, Surrey. She suffered from PND after both of her pregnancies.
‘Lots of people knew I wasn’t well before I did myself, my mum and mother-in-law included. It was only when I became seriously unwell, having a breakdown about five months after my first daughter was born, that I realised I wasn’t weak but ill and I needed help.’
Felicity says: ‘I went along to the PND support group at my local children’s centre, which was amazing as I realised I wasn’t a failure as a mother and that other people were feeling as wretched as I was.
The group was run by an amazing woman who had experienced PND herself and runs a charity supporting people with the condition.’
After some initial misgivings, Felicity decided to have a second baby, and although she suffered a mild case of PND again, her experience was better and she felt more supported.
If a woman has had PND, there is a chance it can happen again with subsequent children, but many women like Felicity find that with plenty of support and preparation they’re able to get help much earlier and recover more quickly.
Having a child is hard work and can make everyone in the family feel that they’re not coping, so partners can definitely suffer from depression too. In fact, if one parent has depression it can increase the risk that their partner will also become depressed.
The first step for dads is realising that PND is not just a ‘woman’s illness’ and to try to open up about the way they’re feeling to friends, family and their GP.
Treatment is available for both antenatal depression and PND and these can range from simply talking things through to antidepressants, as we discuss below…
Postpartum psychosis
Sadly, some mums suffer from postpartum psychosis, which is a serious illness that affects around one in every 1,000 women. The symptoms include hallucinations, delusional thinking and disruption of perception, emotions and behavior. Medical help should be sought as a matter of urgency if this is suspected.
Many people find that talking to other mums and dads can be helpful and reassuring as they realise they’re not alone and that other parents are sharing the same anxieties and frustrations.
Rosey Wren, mum to Kimberley, seven, Connor, five, and Harvey, two, runs PNDandMe, a weekly online support group on Twitter. It’s held at 8pm every Wednesday and supports between 30 and 60 women each week (see #PNDChat and #PNDHour).
She says: ‘As social media can be accessed at any time, people can see PNDandMe during a night feed at 2am, for example. These are times that can feel especially isolating. In fact, many have called the service a lifeline to them during bad days.
Speaking to someone who has been through what you’re going through and who has recovered allows mums to see they can get better.’
Taking time out for yourself can be hugely beneficial, as can getting rest and sleep. Of course this can be difficult with a baby to care for, but it’s worth thinking about people who could help with childcare, even if it’s just for a few hours.
There is evidence that exercise can have a positive effect on mood and wellbeing, so think about getting out and about when you can.
Simple and nutritious food can also help mums feel better, while skipping meals or eating unhealthily can contribute to tiredness and irritability.
As a result of a difficult labour or birth, some women may suffer from post-traumatic stress disorder (PTSD), which is different to PND.
If you or your partner are suffering from trauma following childbirth (symptoms include flashbacks, nightmares, anxiety and avoiding things which remind you of what happened), it’s important to seek help.
If the symptoms persist for more than four weeks, you may have developed PTSD. This can be treated with various forms of talking therapy. If left untreated, it can have a negative impact on people’s lives and relationships for many years, so do seek help.
In addition to the above self-help strategies, there are also talking treatments, such as counselling and psychotherapy. These offer the opportunity to look at the underlying factors that have contributed to the depression, as well as helping women to change the way they feel. If a friend or someone you know recommends a therapist, this can be a great way to find someone.
Some women may be prescribed antidepressants and they might be reluctant to take them, perhaps because of a fear of becoming dependent or because of worries about the effects on their pregnancy or breastfeeding.
Dr Lisa Linsky (pictured), GP and member of Woking NCT branch, says: ‘The antidepressants we prescribe for antenatal depression and PND now are considerably better than they were years ago and actually have very few side effects in most people. Some can even be taken while breastfeeding. They work best alongside counselling for these conditions, which can be obtained through a GP or health visitor.’
Discuss potential medications with your GP and also remember to check they’re right for you and particularly to find out if they’re suitable during pregnancy or while breastfeeding.
Also remember antidepressants are prescribed for at least six months, often longer, and it may take several weeks for them to become fully effective.
Rebecca tried several antidepressants that made no difference, before being prescribed one that made her feel like a new person after a couple of weeks.
‘My bond with Elodie changed drastically and she became more loving and affectionate as a result. I still had blips in the road, but overall my recovery was steady.’
Experiencing depression can feel isolating and confusing. But you’re not alone. Try to talk about how you’re feeling and be positive about seeking help: it’s the best thing you can do. With the right help and support, particularly early on, things can get better.
It can be difficult for women to judge if they think they’re experiencing antenatal depression or PND, so for peace of mind, raise any issues or concerns with GPs, midwives, health visitors, family or friends.
And don’t be put off if you feel you’re not being taken seriously or if your voice isn’t heard the first time.
Lisa says: ‘Make sure you see your GP if you feel like you are slipping lower and further from who you are, if you cannot remember the last time you felt happy, if your friends and family are concerned about you and things are becoming unmanageable.’
NCT Helpline 0300 330 0770
You’ll find more information about antenatal depression, the baby blues and postnatal depression on our website.
