Post Natal Depression

It is a known fact that mothers who have had a premature baby are more likely to experience Post Natal Depression. It is difficult for a person to accept that they may be suffering from Post Natal Depression but it is necessary to accept it in order to be treated. It is important to remember that with the right help you will get over it.

10 to 15 percent of all women develop some form of post-natal depression lasting more than two weeks
More than half of these women develop severe depression where treatment is considered necessary
Most serious depressions are apparent in the first month after childbirth, but they can also arise later
Without the right treatment, postnatal depression can last months

Postnatal depression

WHAT IS IT?

Most patients and doctors feel they know what postnatal depression is – feeling depressed after having a baby. Actually distinguishing it from ordinary clinical depression has taken an international effort, and even then the two chief world authorities on classifying illness do not quite agree. One defines it as “major depression occurring in the first four weeks after delivery”, the other stipulates the first six weeks. In actual practice, many doctors use a time limit of three to six months after delivery.

SYMPTOMS AND SIGNS

The symptoms of postnatal depression are the same as ordinary clinical depression. It differs only in its timing, and this makes it a special illness because of the very damaging effects it has on the family at a critical time.

The major symptoms are, for most of the time, for two weeks or more:
• low mood and unprovoked tearfulness
• unexplained mood swings
• irrational sense of guilt
• loss of concentration and poor short-term memory
• loss of pleasure in the usual enjoyable activities
• loss of sex drive
• low self-esteem and worthlessness
• unexplained appetite increase or decrease
• unexplained weight gain or loss
• sleep disturbance unrelated to the new baby: taking a long time to get off to sleep, frequent waking and waking up unusually early
• recurrent thoughts about death
• recurrent thoughts of self-harm or suicide
• feeling of unreality and not being one’s usual self
• emotional detachment from loved ones, and especially the new baby.

It can be difficult to tell if you have postnatal depression. The very symptoms of the illness can make it hard to see what is happening, and harder still to get help. It is different from the “baby blues” (low mood, generally worst on day four or five after delivery, and lifting within a day or two), and full-blown puerperal psychosis. This is rare, affecting only 2 per 1,000 women.

COULD IT HAPPEN TO ME?

The risk of becoming depressed within five weeks of delivery is three times greater than the risk of depression in the general population. It can happen to any woman who has had a baby, and certain things are known to make it more likely:

• a difficult, traumatic delivery
• difficult home relationships
• lack of social support
• adverse life events
• a past history of depression or postnatal depression

HOW CAN I HELP MYSELF?

The single most important thing to do is to talk to someone if you have any of the symptoms, or think you might. Speak to your partner, a close relative or friend. The worst thing you can do is to hide the symptoms – very tempting, as the guilt and low self-esteem will tend to encourage that.

WHERE CAN I GET HELP?

In the early days after delivery, a community midwife can help by monitoring the situation and providing reassurance if it is the baby blues. Later on, a health visitor, who will have lot of experience of seeing women in the early weeks and months, can also help.

If there is any doubt, see your GP, who can help decide if major depression is present and should be treated.

TREATMENT

Antidepressants have been used for some time, and a recent important review reports that fluoxetine, the first of the “SSRI” family of antidepressants, is effective in treating postnatal depression. A non-drug therapy, Cognitive Behaviour Therapy, has also been shown to be effective, and it is especially suitable for breast-feeding mothers who do not want to stop breast-feeding to go on antidepressants.

Hormone therapy has also been tried as a treatment – the logic behind this is that the concentration of progesterone in the blood falls by a factor of about 1,000 in the days after childbirth. The level of oestrogen also falls, but less so. It is thought that these changes may affect mood. However, progesterone has been found to actually worsen postnatal depression, although oestrogen is possibly helpful in the later stages of postnatal depression. The bottom line is that hormone therapy is not recommended.

BABY BLUES BEFORE BIRTH (3.8.01)

Women are more likely to be depressed during their pregnancy than
after the child is born, according to a new report. Experts had
believed that pregnancy can protect against depression and less
attention had been paid to ante-natal depression. Now a study,
published in the British Medical Journal, shows that depression
reaches its peak when women are 32 weeks pregnant.
The team, from the University of Bristol, said that the incidence of
depression during pregnancy has been largely neglected. They call for
more research into the potential benefits of screening pregnant women
for depression. From the study of 9000 women, 11.8 per cent suffered
with probable depression at 18 weeks and 13.5 per cent at 32 weeks.
The incidence of depression actually fell after childbirth, from 9.1
to 8.1 per cent.

Leader of the research, Jonathan Evans, said that urgent research was
needed into the consequences of and treatment of ante-natal
depression. He said: 'The consequences of ante-natal depression are
not well understood. Our results show depression during pregnancy is
more common than post-natal depression. Offering treatment may be
important for both the mother and the future well being of the child
and family.' affects between 10 and 15 per cent of new mothers. (The
Times, The Daily Telegraph, The Independent)

Men get post-natal depression too
New dads can find it very hard to share their fears and insecurities, and often will suffer in silence rather than admit they're having trouble

New research from the NHS has shown that between 10 and 15% of men suffer post-natal depression. Obviously a new baby has a big impact on any couple, but male post-natal depression is not just a case of your partner resenting this disruption. This is a serious problem and while the rosy picture is of a couple playing happy families, as many as 20% of couples actually separate within a year of having a baby (source: UK Men's Movement).

Organisations

Association for Post-Natal Illness
25 Jerdan Place,
London
SW6 1BE
Tel: 020 7386 0868
Fax: 020 7386 8885
E-mail: info@apni.org
Web address: www.apni.org

Runs a network of volunteers to support sufferers throughout the UK.
Also offers advice and information.

Meet-a-Mum Association
26 Avenue Road,
London
SE25 4DX
Tel: 020 8771 5595
Helpline: 020 8768 0123
(Mon-Fri 7-10pm)
Fax: 020 8239 1153
E-mail: Meet-A-Mum.assoc@cableinet.co.uk

Supports mothers and mothers-to-be by putting them in touch with other mothers living nearby.
Provides one-to-one support for mothers suffering from post-natal depression and a helpline service
for women and their families. Provides family activities, social events and outings, individual and group
support and workshops.

Mothers for Mothers Support Group

A Post Natal Depression Support Group

PO Box 1292
Bristol
UK
BS99 2FP

Tel 0117 975 6006
Office Hours 9.30am to 12.30 pm
Crisis Line 2.30pm to 9.00pm