Post natal depression
depression; harm; mental; health; illness; postnatal; depression; post natal depression; puerperal disorders; post; natal; cultural; multicultural; languages ;
Contents
Most women feel 'blue' and weepy a few days or so after they have a baby. This is due to all the changes in their bodies and lives and it goes away before long.
All women, after they have babies, have some bad days when they feel really down - due to tiredness, being constantly on call, not being able to keep their homes as well as they did, losing their old lifestyle and so on.
- This is normal. Women need extra help and support when they are caring for a new baby - this is the time to accept offers of help and ask for what you need.
Postnatal depression
For some women, however, it is more than just having a bad day or days. The bad feelings become so strong that they take over and make it very difficult for the woman to cope with the demands of her life - this is called postnatal depression. Post natal depression affects almost one in six women giving birth in Australia.
Postnatal depression can occur soon after birth or come several weeks or months down the track. It is very distressing and can make life very difficult for the woman and her family but it can be helped and it is important to get support and help as soon as possible.
Post natal depression is not your fault. It happens just like any other illness for a variety of reasons and it will get better.
ALERT!
Sometimes when depression is very severe there is a risk that the woman will harm herself or her baby. Emergency action is needed if a woman feels she will harm herself or her baby in the near future if she doesn't get help.
If this is you
- Ring a taxi and ask to be taken to a hospital that can help you (in South Australia this could be the Women's and Children's Hospital, Flinders Medical Centre, The Queen Elizabeth Hospital or Lyell McEwin Hospital or a local hospital if you are in the country).
- If you don't feel able to do that, ring anyone whom you know will help you to come and be with you and help you to get help. Tell the person how you are feeling.
If it is your friend or partner
- It is important not to leave her alone, and to take her to get help.
- If she is so depressed that you are unable to persuade her to go with you, stay with her and phone for help - in South Australia - ACIS (24 hour line for emergency psychiatric help on 13 14 65), her family doctor, or Crisis Care (13 16 11 after hours only).
- If she is able to she could speak to one of the above agencies on the phone or Helen Mayo House - 8303 1183.
Post natal depression can be helped. Getting proper support and treatment will help heal the pain.
There is often a mixture of causes which can include any of the following. It is not usually just due to one simple reason.
Biological/physical causes
- Sometimes a woman has had episodes of depression in the past - perhaps triggered by stressful experiences. She may have a tendency to get depressed when stressed.
- Sometimes there is depression in the family so the tendency for this kind of illness is inherited.
- It can be partly be caused by being worn out and lack of sleep.
- It can be caused by not enough thyroid hormone.
- Some women have bipolar disorder which can cause quite severe depression.
Psychological/emotional causes
- Sometimes low self esteem (not feeling good about yourself as a person) can contribute to depression.
- Some mothers are troubled by memories of their own parents and how they were parented.
- It may be that a woman has experienced trauma such as abuse.
- It sometimes happens to women who tend to be perfectionists, and want to do everything perfectly (no- one can do that with a new baby), and then blame themselves when they find they can't.
- Some women have a need to be in control (again not possible all the time with a new baby).
- It can come from grief, eg for previous loss of a child or a pregnancy.
Social reasons
There can also be social causes that contribute to post natal depression.
- Sometimes a mother is very alone much of the time - perhaps having moved from a previous home, or having no family or friends who are available for support.
- There could be relationship problems with your partner. The big adjustment of having a baby can be a time when partners lose the ability to understand and support each other - just when you need it most. Depression is also quite common in partners, due again to the big changes.
- Sometimes there are problems getting on with other family members.
Women who come from other countries to Australia may be isolated and even more at risk of postnatal depression. The Beyondblue website has information about postnatal depression in many different languages http://www.beyondblue.org.au/index.aspx?link_id=102.944
How do you know it is post natal depression?
These are some of the things that can be symptoms of postnatal depression.
How you feel and think
- Mood changes - feeling anxious, depressed, tearful for a lot of the time.
- Thought changes - having gloomy, hopeless thoughts in your head, or feeling guilty about feeling that you are not a good mother.
- Obsessional - always seem to be worried. Worrying about your feelings for the baby. Not being able to stop the worries going round and round in your mind.
- Behaviour changes - not being able to get going, sitting around all the time, not taking an interest in how you look or taking care of yourself.
- Problems with organising routines and activities.
- Physical changes - lacking energy, poor concentration, always tired (most new mothers might say this), sleep difficulty (lying awake after feeding the baby). Sometimes there can be excessive sleep, poor appetite or excessive eating for comfort. You don't feel like sex (many new mothers feel this at least for a time), crying a lot.
Getting on with others
- Your relationship with your partner can be very stressed.
- Every little thing makes you cross and irritable.
- Getting angry with people a lot (there may be other reasons for this such as changes in family life).
- Finding it hard to love the baby (many women feel this at first but with depression it hangs around - feeling you can't relate to the baby, then feeling guilty about it and so on).
- Feeling angry with other family members such as other children.
- Problems with friends.
If you have post natal depression these things are not your fault, you can't just 'pull yourself out of it'. You need help.
How you know when more help is needed?
- If you feel bad enough to ask for help - but often mothers can feel really bad and not ask for help so don't rely on this.
- If the problems have been there without improving for at least two weeks.
- If you have thoughts of hurting yourself or your baby.
- If you don't feel able to love the baby and it isn't getting better (it often takes a bit of time at the start).
- If there are ongoing problems with getting to sleep, or waking up early or wanting to sleep most of the time.
- If you are not able to do the everyday things that make your home work - get dressed, bath yourself and the baby, get meals etc.
- Problems with your relationship with your partner, friends or family starting or getting worse.
- You have had depressive illness before.
- You or others are really worried about what is happening.
What you can do
- Talk it over right now with someone supportive, e.g. your partner, mother, sister, other relation, girlfriend.
- Talk it over as soon as possible with your family doctor, obstetrician, child health nurse, pastor or other trusted person.
- In South Australia call the Child and Youth Health Parent Helpline 1300 364 100.
- In South Australia contact Helen Mayo House staff (see Resources below).
Counselling
Support from a professional who is experienced in working with mothers who have postnatal depression can be very useful. Your doctor may be able to refer you to a psychologist, social worker or other counsellor, or you could find out if there is someone at a community health centre who could help you.
Some women benefit a lot from talking with a psychiatrist or psychiatric nurse.
- Your partner is likely to feel reluctant to get help - you may need to give her a lot of encouragement to do this.
- Postnatal depression is not something your partner can help, and her being angry and irritable with you is part of the illness. Try to let it pass by you rather than reacting. Avoid responding to anger with anger.
- Postnatal depression takes a long time to heal - don't expect too much too soon.
- Try to understand your partner's feelings. Even though it may not seem reasonable to you, it is real for her at the time.
- Spend time with your baby.
- Making a close relationship with your baby and doing lots of caring for him or her will help your baby to be able to relate to your partner when she is better and help your baby to not miss out while she is not well.
- At the same time reassure your partner that you are wanting to support her, not take her place. This can be tricky.
- When women are depressed and tired sexual intercourse may seem like just another demand and they may well reject your approaches. With patience and understanding things will get better.
- Things that won't help your partner are:
- telling her to pull herself together
- telling her to be grateful that she has a lovely baby
- telling her she will get through it, everyone feels bad sometimes
- telling her to relax and she will feel better.
- Take care of yourself. Make sure you have some breaks because you will probably be your partner's best support and you need to ensure you can stay in there for the long haul.
- Let your family and friends know what is happening. Support from those close to you will be a big help at this time.
- Don't be too proud to accept help. Everyone needs help sometimes.
It can be very hard for partners to keep coming home to an unhappy house but it is important to hang in there - getting better takes a long time.
- Most women with PND will eventually feel better and more able to do things they enjoy but that can take many months and sometimes years.
- Anti depressant medication may speed up this recovery time and help mothers to manage, especially to sleep better.
- Some medications can be used safely while breastfeeding, but occasionally breastfeeding needs to stop.
- Talk to your doctor about medication. Depression, like other illnesses, often needs specific treatment, not only 'support.'
Resources
South Australia
CYH Parent Helpline 1300 364 100.
Helen Mayo House - telephone 8303 1183
- runs inpatient and day patient services
- telephone helpline
- sends out reading material
- advises about other available services eg postnatal depression groups in the community
Click here
Your family doctor.
Women's Healthline 1300 882 880
Lifeline 13 11 14
beyondblue info line 1300 224 636
Rural Mental Health Information and Referral Line 1800 13 11 14
Australia
Black Dog Institute - Fact sheet Depression in pregnancy and in the postnatal period
Postnatal depression: a systematic review of published scientific literature to 1999 (Republished 2006).
http://www.nhmrc.gov.au/publications/synopses/wh29syn.htm
Beyondblue, the national depression initiative (Australia).
http://www.beyondblue.org.au/
Blue Pages. Centre for Mental Health Research at the Australian National University.
http://bluepages.anu.edu.au/
Clinical Research Unit for Anxiety and Depression. WHO collaborating centre, University of New South Wales. CRUFAD
http://www.crufad.unsw.edu.au/
Help for people and their families to understand depression and its treatment
http://www.depnet.com.au/
Life is for everyone - suicide prevention in Australia
http://www.livingisforeveryone.com.au/
Key Centre for Women's Mental Health 'Factsheet: Maternal mental health'
Books for children
Louis, Andrea, "Robby Rose and Monkey".
Sved Williams, Anne, "Jake's Dinosaurs".
Both available from Helen Mayo House for $15.00 each. Phone: 8303 1183.
Ellis P M & Smith D A R, "Treating depression: The beyondblue guidelines for treating depression in primary care." Medical Journal of Australia 2002 www.mja.com.au/public/issues/176_10_200502/ell10082_fm.html
Brockington I, ''Postpartum psychiatric disorders'' The Lancet Vol 363, January 24 2004, p303-310
www.thelancet.com
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.