Info Centre - Feeling down? Feelings after the birth of your baby

Feeling low after you have had a baby is not unusual. Women may experience:

Baby blues – a sad, sometimes weepy, feeling lasting a few hours or days (half of all mothers feel like this)
Postnatal depression – a state in which a mother feels tired and as though she is not coping; it is thought to affect some 10% of new mothers and is more common in women who have previously suffered from depression
Puerperal psychosis – a rare, serious mental illness often needing psychiatric treatment and possibly a hospital stay (affecting only one mother in 500).

In addition, there are some women who show symptoms of post-traumatic stress, such as distressing flashbacks, nightmares and intrusive images, and this usually seems to be linked to experiencing the birth as a traumatic event.

The baby-blues

‘My husband was late visiting and that was it. I felt abandoned. So I shouted at him and then burst into tears’.

A mother going through the baby-blues might feel very low and tearful in the first week or so after birth. She may feel irritable for no obvious reason and may get upset or cross.

The blues can last for a few hours or a few days but they are usually over by the end of the first two weeks or so.

There’s normally no treatment needed but anyone going through them will probably feel better for some tender, loving care from the people around her. Peace and quiet, with opportunities to sleep, are likely to help.

Postnatal depression

‘I wore the same jogging bottoms and T-shirt for weeks. I couldn’t cope with making my mind up about anything’.

Postnatal depression (or PND) can affect any mother and can start at any time in the first days, weeks or months after the birth. It often lasts for more than three months and sometimes as long as a year or more, especially if the mother doesn’t receive appropriate treatment.

You may have PND if you have some or all of the following symptoms:

You are often sad, and find it hard to see the funny side of things – some women feel so low they avoid meeting people, and some cry easily
You feel you are the only mother who can’t cope
You feel a failure, and guilty because of it
You feel anxious and irritable, maybe worried over world problems you can’t influence
You find coping with your baby’s crying very difficult
Either you can’t sleep even though you are exhausted, or you endlessly crave sleep
You feel as if you hardly ever have enough energy to do things
You feel you have lost your appetite
You find making decisions, even about simple things, is very hard.

It is not known what causes postnatal depression. Some research suggests that genes and hormones are important whereas other studies suggest that experiences during the birth can play an important role. Other research indicates that PND is related to the way a woman’s adjusts to a new role and a new situation. For example, a mother may feel angry that motherhood is so different from her expectations, and also ashamed that she is unable to conform to the social norm of being a contented mother. She may feel guilty for having these feelings or even fear that she is causing her baby developmental harm because of them. The kinds of feelings that becoming, and being, a mother can trigger can be made more intense by her circumstances, such as feeling isolated. Her own psychological history (women who have a history of depression, or other mental health condition, are more at risk of developing PND), including the way in which she was herself parented, can also have an effect.

Why it’s important to get help for someone suffering from PND

It is therefore important for PND to be diagnosed so that treatment can be offered. If you have had PND, another depressive illness or any other mental health problem before, it is important that you talk to your midwife, health visitor or family doctor during pregnancy; these health professionals are there to help. Equally, if you’ve had your baby and you think you may have postnatal depression, talk to your health visitor or family doctor as soon as possible.

Women experiencing depression may recover spontaneously but treatment usually shortens the time the depression lasts. Although some women feel very uncomfortable about having a label of depression, some feel relieved to be given a name for their feelings.

Help and support on offer

Some health visitors ask new mothers to complete a questionnaire about their feelings after having their baby. It helps them offer extra support to mothers who may already have PND or may be at risk of developing it. The extra time and support may be offered at home or in a support group run by health visitors.

Talking therapies

Many women find that some form of talking therapy, combined with practical support, really helps. You might be comfortable talking to your health visitor, doctor or a counsellor. Your doctor may also discuss referring you to a psychologist, psychiatrist, counsellor or community psychiatric nurse. Cognitive behavioural therapy, which focuses on coping strategies and challenging unhelpful beliefs, may be offered.

If you feel you can’t ask for help by yourself, you can ask someone to come with you to visit the doctor. Take this leaflet with you, to help you explain.

Talking to other mothers who have also experienced PND may be helpful to you and your local NCT branch may be able to put you in contact.

Drug treatments

For some women with PND, antidepressants have helped their unpleasant symptoms fade until they have gone completely. Women come off the antidepressants gradually, as they recover. A depressed mother who is breastfeeding needs to inform her doctor and speak to a pharmacist there are several different sorts of antidepressants and not all are safe to take while breastfeeding.

Some mothers’ treatment is a combination of a talking therapy and anti-depressant medication.

Ways you can help yourself

‘I’m doing some small new thing every day and the fog and the panic are gradually receding’.

You can do a lot to help yourself through postnatal depression. If you feel that you have postnatal depression, it is easier if you can accept that you cannot carry on as usual. It can also make a difference if you are able to ask for help.

Self-help suggestions:

Build time for yourself into every day
Take one day at a time. Set yourself small goals each day, such as phoning a friend
Eat well. Fast food doesn’t have to be junk food. Try a piece of fruit and cheese with wholemeal bread for lunch – it’s quick and easy
Rest if you can, and get help with the chores
Do the jobs you must do in the morning. PND is often worse as the day goes on.
Talk things through with people you trust
If you wake at night, you might feel like trying to relax by reading or listening to music
Try not to worry if you can’t sleep
Do only what you feel able to do. Don’t worry about what you think you ought to do. You will be able to do more as time goes on.
Reward yourself when you have done something successfully, however small.
Accept that there will still be bad days, even when you are on the way to recovering. It will take time.
Remember you will get better and will be able to enjoy things again.

Reflections

‘I didn’t know I had PND until one morning I woke up and thought: ‘Where have I been?’’

Many women do not know they have PND until it is over. They then realise that ‘part of myself has returned’, that ‘a grey cloud has lifted’ or that ‘the picture is now complete’. But recovery doesn’t erase the memory. Some women come to terms with the experience while others may go on feeling pain, embarrassment or confusion. Some women feel that because they have survived PND they can survive anything. Others feel that it has changed their priorities so they no longer need to achieve to feel valuable, they feel more self-contained, they feel they have grown up or they feel that they now have a new, more satisfying balance in their lives.

Resources

Feelings after Birth: The NCT Book of Postnatal Depression. Available from NCT Shop:
http://www.nctshop.co.uk/Feelings-after-birth/productinfo/2157/

The Birth Trauma Association
http://www.birthtraumaassociation.org.uk/

Women’s Aid
Women's Aid is the key national charity working to end domestic violence against women and children. It supports a network of over 500 domestic and sexual violence services across the UK.
http://www.womensaid.org.uk/

Page lasted updated 2009.