Understanding Postnatal Depression

Postnatal depression is a real mental health condition that can affect any person after they give birth. It is not a sign of weakness or a flaw as a person. Having postnatal depression does not mean that you do not love your child or that people will think you do not love your child. There are many factors out of your control that can initiate postnatal depression, including the reality that your body has recently gone through significant physical, emotional, and hormonal changes. Giving birth is a major life event, and it can take time to heal the various systems of the body that have adapted to growing a new life form for the past nine months.

Below, we’ll explore postnatal depression, common symptoms, and treatments for this condition.

Postnatal depression

Many parents feel confused or upset when they have depression and symptoms of mental illness after their child is born. They think this is supposed to be a happy time and wonder why they feel depressed. It can take time to adjust to a change, even with the emotional support of family and friends.

Causes of postnatal depression

Once you’ve undergone the process of giving birth or otherwise bringing a new child into the world, your hormones may be out of balance. Aside from welcoming a new person to your home, you’re likely losing sleep and experiencing a disruption in your routine. All of that can be a lot to balance for anyone, let alone someone whose body is recovering from childbirth.

While the cause of postnatal depression is not entirely clear, experts believe that it is the result of hormonal changes that occur during pregnancy and after the baby is born. There are also several factors that may determine whether parents are more susceptible to developing antenatal or postnatal depression, such as the following:

• A history of depression or other mental health conditions, such as bipolar disorder or panic disorder
• A history of mental health conditions during prior pregnancies
• A lack of a strong support network, including an unsupportive partner
• A stressful life event, like the loss of a job or the death of a loved one
• Health problems with your baby or problems breastfeeding
• Financial difficulties

Research shows that approximately 50% of all new parents experience a mild form of depression called the baby blues. Symptoms may include:

• Unexplainable bouts of crying
• Irritability
• Anxiety
• Fatigue or difficulty sleeping
• Mood changes
• Difficulty concentrating

Symptoms of postnatal depression

Over time, your symptoms may lessen, but without treatment, postpartum depression can sometimes last for months or longer. 

The possible symptoms of postnatal depression include:

• Overwhelming feelings of sorrow, guilt, or worthlessness
• Intense irritability
• Thoughts of hurting yourself or your baby and difficulty bonding with your baby
• Lack of appetite
• Fatigue or lack of energy, combined with trouble sleeping
• Withdrawal from friends and family

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

You may also want to seek emergency health care or contact a crisis lifeline if you’re experiencing psychotic symptoms associated with postpartum depression. Individuals with severe postnatal depression symptoms can develop postpartum psychosis, a serious mental health condition that involves symptoms like hallucinations, delusions, and disorganized thinking.

Because the symptoms of postpartum depression can vary widely, it is recommended that a person who experiences any of these symptoms speak with a doctor regarding treatment, as other people in their life might not understand what they’re going through. Treatment typically includes therapy and sometimes medication, such as antidepressants, to help manage the condition. A doctor can ensure any medication you take is safe in case you’re breastfeeding.

Antenatal depression

According to the Mayo Clinic, sometimes perinatal depression (a broad term that includes depression during and after pregnancy) can begin before birth. In these cases, it is called antenatal depression. The symptoms tend to be the same as those of postnatal depression, but the difference is that it manifests during pregnancy.

As with all other forms of depression, it is recommended that a person with antenatal depression be seen by a physician if the signs are present. 

Experts believe that between between 10% and 20% of women experience perinatal depression before or after birth. Some believe that what they're going through is a normal part of the pregnancy process, but this and other forms of depression are considered more than just the baby blues. 

For this reason, it’s recommended that you call a physician as soon as the symptoms present themselves. Your OB/GYN is likely to ask you questions about how you are feeling and how long you’ve had symptoms. You can be honest with them and let them guide you as to what is to be expected as a part of pregnancy and what is not, as it can be confusing to determine on your own.

Forms of treatment

If you're experiencing any of the symptoms mentioned above, it may help to seek assistance sooner rather than later. Below are some possible treatments that your doctor may recommend, and they don’t all require leaving the house, which can be challenging for new parents.

Therapy

Your doctor may recommend therapy, whether in person or online, to help you through postnatal depression. There are many licensed therapists with experience treating depression both during and after pregnancy. One of the approaches they may use is cognitive behavioral therapy (CBT), which is an evidence-based approach that has been proven to help with a variety of mental health conditions, including anxiety and depression. 

Medication

Sometimes medication may be necessary to manage postnatal depression. Your doctor may suggest medication in conjunction with the therapy so that you can remedy the problem from multiple angles. Your doctor may prescribe medication to help you feel less anxious or less sad. If you're breastfeeding and worried about taking something that you can pass to the baby in your milk, your doctor can recommend a medication that is considered safe to take during this time.

Self-care

In addition to following the treatment guidelines of your physician, you may benefit from some self-care strategies. You might try discussing what's bothering you with your partner, a family, or a friend and let them know what they can do to help you, including affording you some time to take a bath, watch a movie, or do whatever it is you need to get back on track and feel refreshed. 

Rest

You might try to prioritize rest whenever you can, which may mean sleeping, or at least lying down, whenever your baby sleeps. It will likely be a little while before your baby has a "normal" sleeping schedule, and they may sleep a lot during the day and less at night. For this reason, it may help to rest whenever you can so you are able to be awake when your baby is without being sleep deprived.

Nutrition

It may also help to prioritize eating nutritious foods with enough calories, especially if you’re breastfeeding. Even if you have to make something quick in those early days of infancy, consider having healthy snacks nearby so that you’re getting all the nutrients you need to feel well.

Exercise

It may be difficult to find the time, but research shows that exercise may help with depression. If the weather is nice, your baby may enjoy resting in a stroller while you walk around the neighborhood. You might also consider doing some gentle yoga while your baby naps. 

Seek support from loved ones

Reaching out to family and friends can be an effective way to find support. You may find that you have friends and family who have also experienced postnatal depression, and they may be able to offer you support during this time.

Dispelled myths about postnatal depression

Postnatal depression can be just as serious as other forms of depression. Some people may falsely believe that it is something that a person can just “shake off.” You might be experiencing a variety of symptoms that affect you in different ways, such as isolation, new intrusive feelings of sadness, or low energy.

While much research has been done on postnatal depression, there is no evidence to suggest that you can control whether you develop this condition. During pregnancy, you can aim to eat well, exercise, and maintain a healthy lifestyle (no smoking, no drugs, no alcohol, etc.), which can lower a person’s risk. However, these strategies may not eliminate cases of postnatal depression altogether.

Online therapy for postnatal depression

New parents in particular may benefit from getting online therapy for postpartum depression. With platforms like BetterHelp, you can connect to a licensed therapist from the comfort of your own bedroom or any location with a reliable internet connection. You can also schedule your appointments at times that work for your schedule, like when you know your baby is going to lie down for a nap. There’s no need to change your outfit, take a shower, get in the car, and pay for a babysitter to get the help you need. You can obtain professional and empathetic care, often at a reduced cost when compared to in-person therapy.

Online therapy has shown strong efficacy in supporting parents going through post-natal depression. In a recent study, 24 participants who were experiencing symptoms of post-partum depression completed a therapy-assisted Internet cognitive behavioral therapy (iCBT) intervention, and most reported that the program granted them flexibility, availability, and convenience. They also overwhelmingly valued their relationship with their internet therapist.

In a separate systematic literature review, researchers examined the effectiveness of various telehealth interventions in reducing symptoms of depression and anxiety in people with post-partum depression and established that internet-based interventions could effectively reduce these symptoms.