Over one million people in Australia live with depression. You’re not alone.
To find out more, visit Beyond Blue, the Australian government national depression initiative
1300 224 636
Adjusting to life as a mother can be a difficult transition. Having a baby is the most significant life changing event that a woman will ever experience. Adjusting to this major life change, as well as having to cope with the everyday demands of a new baby, can make some women more vulnerable to experience depression during the post natal period, especially is they have experienced depression in the past.
HOW COMMON IS POSTNATAL DEPRESSION?
Postnatal depression affects around 16% of new mothers in Australia. Major depressive episodes after childbirth are referred to as postnatal depression. Postnatal depression must be distinguished from postnatal blues (baby blues), which is a common experience following birth in which new mothers experience lability of mood and tearfulness. This mild and self limiting condition typically disappears two weeks after giving birth. Postnatal depression is common as is depression in the general population. Depression affects one out of 5 females and one out of every 8 males. Around one million Australian adults and 160,000 young people are living with depression each year.
WHAT CAUSES POSTNATAL DEPRESSION?
Postnatal depression doesn’t have a definite cause, but is likely to result from a combination of factors which include:
* a past history of depression and/or anxiety
* a stressful pregnancy
* depression during your current pregnancy
* a family history of mental health disorders
* experiencing severe “baby blues”
* a prolonged labour and/or birthing complications
* problems with your baby’s health
* difficulty with breastfeeding
* a lack of practical, financial and/or emotional support
* past history of abuse
* difficulties in close relationships
* sleep deprivation
* being a single parent
* having to cope with an unsettled baby
* having unrealistic expectations about motherhood
* moving to a new house
* making work adjustments (stopping or restarting work)
It is also possible that a sudden fall in blood levels of oestrogen and progesterone (two hormones) may play a role in postnatal depression. Environmental conditions may also play a part. Women who have recently experienced stressful life conditions and have little social and/or family support, tend to have a higher incidence of postnatal depression.
HOW DO I KNOW IF I HAVE POSTNATAL DEPRESSION?
Postnatal depression has the same signs and symptoms as depression. Women with PND can experience a prolonged period of low mood, reduced interest in activities, tiredness and disturbances of sleep and appetite, with negative thoughts and feelings.
HOW DO I KNOW IF I’M DEPRESSED OR JUST SAD?
You may be depressed if for more than two weeks you have:
felt sad, down or miserable most of the time
lost interest or pleasure in most of your usual activities
experience a number of these symptoms:
* Stopped going out
* Not getting things done at work
* Withdrawing from close family and friends
* Relying on alcohol and sedatives
* No longer doing things you enjoy
* Unable to concentrate
* I’m a failure
* It’s my fault
* Nothing good ever happens to me
* I’m worthless
* Life’s not worth living
* Lack of confidence
* Tired all the time
* Unwell and feeling run down
* Headaches and muscle pain
* Churning gut
* Sleep difficulties
* Loss of appetite or a change in appetite
* Significant weight loss or weight gain
In most cases, depression will go on for weeks or months if left undiagnosed and untreated. If depression is not properly treated, it is very likely to recur.
THE EDINBURGH POSTNATAL DEPRESSION SCALE (EPDS)
The EPDS is a set of questions designed to assess if a new mother may have depression. The answeres to the questions will not provide a diagnosis, but screens for the possibility of depression. It will indicate if you have the symptoms that are common amongst women with PND.
To download a copy of the EPDS, go to http://www.BeyondBlue.org.au then click on the postnatal depression link, then click on download information and then click on Edinburgh Postnatal Depression Scale.
HOW IS POSTNATAL DEPRESSION TREATED?
There is a range of effective treatments for PND. Postnatal depression is a highly treatable condition. A variety of interventions, including psychotherapy plus or minus antidepressant medication can be used.
Often referred to as “talking therapy”, and has been found to be the most effective way of treating PND. Psychological treatment can help by:
* Changing negative thoughts and feelings
* Encouraging involvement in activities
* Speeding up the recovery process
* Preventing depression from getting serious again
COGNITIVE BEAHIOUR THERAPY (CBT)
Cognitive behaviour therapy refers to a group of therapies that include behaviour therapy, behaviour modification and cognitive therapy in various combinations. CBT is a short term, problem focused psychosocial intervention, and is the most researched form of short term psychotherapy. It teaches how to identify negative automatic thoughts which perpetuate the way a person feels; and helps to identify underlying beliefs and assumptions, and helps to develop a shared understanding of problems. Cognitive approaches emphasise how cognitions mediate feelings and behaviour, and explores the meanings that we attach to our experiences. Psychotherapies are based on both behavioural and cognitive theories. They are structured and prescriptive. They are focused on enabling the person to think and act differently. Treatment can either by group or individual, short or long term but around 8 – 24 weekly sessions would be an average.
Medication can play an important role in assisting people with depression to manage on a daily basis. Some people may worry about how antidepressant medicatiion will affect a baby who is breastfed. However, remaining on medication can be an important step in avoiding significant depression, which can have a negative impact for mother and baby.
If the mother is breastfeeding, specific types of medications can be prescribed which have been found to be least likely to cause any harm to infants. The decision to take medicatio is up to the individual and should be made in consultation with a doctor, after considering the risks and benefits to both mother and baby.
HOW TO HELP YOURSELF IF YOU HAVE PND
* Seek health professional assistance from a doctor
* Seek out friendships with other women, including other mums who have PND
* Organise childcare or ask friends or family to look after the baby and other children occasionally to allow you to have some me time
* Make sure you take time to do the things you enjoy to do
* Spend some time with your partner to nurture the relationship
* Develop a support sysmtem of friends, family and professionals and accept help when offered
* Restrict visitors when feeling unwell, overwhelmed or tired
* Take things one step at a time
* Don’t bottle up your feelings, discuss them with friends, family or your partner
* Eat a balanced diet
* Practise deep breathing and muscle relaxation techniques.
* Establish good sleeping patterns
* Learn all you can about PND
HOW TO HELP SOMEONE WITH POSTNATAL DEPRESSION
* Remember that PND is treatable
* Encourage the woman to see a health professional and offer to attend the session with her for support
* Learn about postnatal depression
* Spend time listening, without feeling the need to offer solutions
* Offer to spend time looking after the baby or older children or discuss other childcare options so the mother can have much needed time to herself
* Offer to help with housework
* Let the woman know how well she is doing when she makes small gain
* Encourage the woman to use self help strategies
* Try not to take what the person with PND says to you as a personal attack. Women with PND can be moody, irritable, volatile, teary and withdrawn
* Contact a doctor or hospital, if the woman becomes a threat to herself or others.
WHERE TO GET HELP
Visiting your family doctor is a good first step. You may then be referred to a mental health specialist such as a psychiatrist or a psychologist. Just remember, that you are not alone as many women develop postnantal depression and there is support out there for you.