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Positive mental health is critical to overall well-being during pregnancy and after childbirth. It includes a wide range of emotional and psychological issues which may be experienced during and after pregnancy, such as stress, anxiety, depression, and mood disorders.
The most common form of maternal mental health issue is postpartum depression, also known as PPD, which affects more than 1 in 10 new mothers. PPD is a condition which lasts longer than two weeks and can significantly impact the ability to function in day-to-day life as well as bonding with the newborn child, so early recognition is really important.
Is PDD the same as baby blues?
PPD and baby blues might share the postpartum phase, but they're distinct experiences. Baby blues are common, fleeting feelings of sadness, anxiety, or irritability that many new parents experience within the first two weeks after childbirth. These emotions often arise due to hormonal shifts, sleep deprivation, and the adjustment to parenthood. Symptoms include mood swings, weepiness, and trouble sleeping, yet they tend to fade on their own.
In contrast, PDD involves more intense and persistent feelings of sadness, hopelessness, or emptiness that can interfere with daily life and bonding with the baby. These symptoms endure beyond the initial two weeks and might exacerbate over time if left untreated.
Seeking help or treatment becomes crucial when these feelings persist for longer periods, impacting one's ability to function. Unlike baby blues, PDD often requires professional intervention, such as therapy or medication, to support the individual's mental health during this challenging postpartum period.
Postpartum depression symptoms
Postpartum depression (PDD) manifests differently for each individual, but certain symptoms are commonly observed, affecting mental, behavioral, and self-perception aspects:
Mental symptoms: PDD often triggers overwhelming feelings of sadness, despair, or emptiness that persist beyond the initial weeks after childbirth. Some experience severe mood swings, irritability, or constant crying without a clear cause. Anxiety, excessive worry, or feeling disconnected from the baby are prevalent. Thoughts of harming oneself or the baby may also occur, though these are serious and require immediate attention.
Everyday/behavioural symptoms: Individuals with PDD might struggle with sleep disturbances, either sleeping excessively or facing insomnia even when the baby is resting. Appetite changes, whether an increase or decrease in eating habits, are common. Difficulty concentrating or making decisions, along with a loss of interest in activities once enjoyed, can also be observed. Fatigue or a lack of energy, despite adequate rest, is pervasive.
Changes in self-perception or baby perception: PDD often leads to negative thoughts about oneself as a parent, feeling incompetent or unworthy. Some may experience a lack of attachment or bonding with the baby, despite efforts to connect, fostering guilt or shame.
It's essential to recognise that these symptoms might vary in intensity and duration for each person experiencing PDD, emphasising the importance of seeking professional help to address these challenges effectively.
Not only is good mental health essential for overall wellness, but it can also impact the child’s mental and emotional wellbeing.
For example, studies have shown that postpartum depression can negatively impact a child’s cognitive and social development if not treated promptly.
What causes postpartum depression?
We’re not exactly sure what causes PPD. It can happen to any woman after having a baby. Possible causes include hormonal changes, genetic predisposition, stress, lack of support, prior mental health issues, and the adjustment to new parenthood, all contributing to the complex onset of postpartum depression.
Hormonal changes: After childbirth, hormonal fluctuations occur as estrogen and progesterone levels, which surged during pregnancy, swiftly return to baseline within the initial 24 hours. This sudden decline in hormone levels post-birth is associated with the onset of postpartum depression (PPD), potentially impacting mood regulation and contributing to its development.
Genes: Genes, the body’s instructions for growth and function, can influence postpartum depression (PPD). When depression runs in the family—a family history of depression—there’s a higher likelihood of experiencing PPD due to inherited genetic predispositions passed from parents to children, making it more prevalent among those with familial depressive tendencies.
Lifestyle changes: Sleep deprivation post-childbirth can exacerbate postpartum depression (PDD). Women struggling to achieve restful sleep often experience physical symptoms like body pain and exhaustion, intensifying the risk of PDD.
Additionally, the loss of freedom and "me time" in the transition to parenthood can be challenging and contribute significantly to feelings of depression. Adjusting to this loss of personal time and independence might amplify the emotional strain and vulnerability to postpartum depression.
Are some mothers more at risk of postpartum depression?
There are many risk factors for postpartum depression, such as a history of mental health issues, lack of social support, unforeseen circumstances during pregnancy, and complications during childbirth. However, it can also appear without any obvious risk factors.
Increased risk factors for postpartum depression include:
Prior or during pregnancy depression
Family history of depression
Childhood abuse or adversity
Challenging or traumatic childbirth
Previous pregnancy/birth complications
Limited support from family, friends, or partners
Current or past experience of domestic violence
Relationship issues, financial stress, or significant life stressors
Being under 20 years old
Difficulty breastfeeding
Premature birth or a baby with special health needs
Unplanned pregnancy
Certain factors, from past experiences to current circumstances, may heighten the likelihood of postpartum depression.
Can men have PPD?
Recent studies reveal that postpartum depression affects nearly 1 in 10 fathers, a largely overlooked phenomenon. A comprehensive study delved into this under-recognised issue, outlining factors influencing its manifestation in men.
Similar to women, men experience comparable symptoms of postpartum depression. However, these signs might be less conspicuous, given men's tendency to mask their emotions.
Remember, seeking help is crucial regardless of gender, and openness about these feelings can lead to effective support and treatment.
Treatment for postpartum depression
Fortunately, several effective treatments are available for PPD. The choice of treatment, considering symptom severity, personal preferences, and various factors, offers hope for recovery.
Remember, never let worrying or shameful thoughts deter you from seeking the support and care you deserve during this challenging time.
Some treatment options for PPD include:
Psychotherapy
One of the most effective treatments for PPD is psychotherapy, also known as talk therapy. A therapist can help to explore feelings and concerns and provide tools to better cope with the challenges of parenting. Cognitive-behavioural therapy (CBT) is a particular type of psychotherapy that has been shown to be effective for PPD.
Medication
Antidepressants can also be helpful in treating PPD. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that is often prescribed for PPD. These drugs can take several weeks to start working and may cause side effects such as nausea, dizziness, and changes in sexual function. However, they have been shown to be effective in improving mood and reducing symptoms of PPD.
Self-care
Engaging in self-care activities such as exercise, yoga, and meditation can also help alleviate symptoms of PPD. Women with PPD should aim to get enough sleep, eat a healthy diet, and make time for themselves. A supportive network of family and friends can also be beneficial during this time.
Support groups
Participating in a support group for women with PPD can help reduce feelings of isolation and provide a supportive environment for women to share their experiences. These groups can be found through healthcare providers, community centres, or online.
Find help for postpartum depression in London
It’s important to seek treatment for PPD as soon as possible, as symptoms can become more severe if left untreated. Women with PPD can talk to their healthcare provider about their options for treatment, who will work with them to find the best approach for their individual needs.
At Schoen Clinic Chelsea we’re committed to providing highly specialised treatment for a range of mental health problems. We also offer a variety of helpful group therapies which may be beneficial to those experiencing PPD.
If you’re experiencing depression or another mental health problem and need support, please feel free to get in touch with our team.
Can you prevent postpartum depression?
Supporting mental wellbeing during pregnancy involves various proactive steps, including maintaining a healthy lifestyle, nurturing a robust support network for open conversations, attending antenatal classes to connect with peers, and seeking guidance from healthcare professionals.
However, despite these efforts, developing postpartum depression (PDD) isn't indicative of failure. PDD can arise irrespective of preventive measures. It's crucial not to perceive it as a personal shortcoming. Factors contributing to PDD are multifaceted and can't always be prevented, even with diligent preparation. Instead, view seeking help and support as a proactive step toward managing PDD should it occur.
Prioritising mental health throughout pregnancy is commendable. Remember, seeking advice and guidance from specialists in the area, particularly if there's a history of depression or mental health issues, is a responsible approach. Acknowledging that PDD can occur despite efforts empowers individuals to focus on effective coping strategies and seek assistance without self-blame.
References
This page was reviewed by Dr James Woolley, Senior Consultant Psychiatrist at Schoen Clinic Chelsea on 4th May 2023.