Postnatal Depression

What is Postnatal Depression?

Postnatal depression (PND) is a term used to describe the development of depression during the first year after giving birth. It is different from the baby blues – which due to hormonal changes can come on around day 3 after giving birth. The Baby blues typically lasts 1-2 days and then you begin to feel better. Postnatal depression however is different – it may build and develop slowly. OR it can come on quite quickly. It can also vary – from mild to severe and debilitating.

Who can get PND and when?

If you have a previous history of depression, or depression during your pregnancy – studies have shown that you have an increased chance on developing PND. Approx 7 in 10 women who have the baby blues will go on to develop PND. And it’s not just Women as 1 in 10 men will also develop PND.

PND – can occur at any time within 12 months of having a baby – in general it generally occurs within the first 6-8 weeks, or earlier months after giving birth.

PND can cause the mother or father to withdraw from the relationship with the child. Parents with PND may seem emotionally withdrawn, their speech and responses to questions or their babies needs may be more slower and they may have difficulty responding to their babies needs. This can affect the parental bond between baby and the parent.

What is Perinatal Depression/anxiety?

Perinatal depression and anxiety refer to changes in mood that may occur during pregnancy and/or the postnatal period. Approximately 15–20 per cent of women in Australia are affected by perinatal depression or anxiety.

What causes it?

While the mechanism of postnatal depression is not fully understood, having a history of previous depression, hormonal changes, social changes (incl isolation, being away from family), sleep deprivation and trauma in childbirth can all combine together leading to psychological, emotional and physical effects on the body – which cumulate in postnatal depression.
Currently In Australia 1 in 6 women develop PND.

What are the symptoms of postnatal depression?

The range of symptoms experienced depends on the severity of the depression, and may include:

• depressed or sad mood
• tearfulness
• low self-esteem and lack of confidence
• feelings of inadequacy and guilt
• negative thoughts
• feeling that life is meaningless
• feeling unable to cope
• tearfulness and irritability
• difficulty sleeping or changes in sleeping patterns
• low sex drive
• anxiety, panic attacks or heart palpitations
• loss of appetite
• difficulty concentrating or remembering things
• loss of interest in usual activities

Baby Blues or PND?

While some of these may also sound like the baby blues – if you are experiencing any of the above symptoms for longer than 10 days at a time, chances are you may have PND. PND can vary – from very mild to extremely severe – affecting both mother and baby. If is important to reach out to others and talk about how you are feeling, whether this is with a friend or family member your partner / husband / wife, a mums group or a maternal health nurse.

Risk Factors for PND

Although it’s not certain exactly what causes PND some factors include:

1. Physical changes. Giving birth is difficult and is a huge strain on the body. If you have also had a traumatic birth, this can also effect your body. The changes in hormones and brain chemicals (neurotransmitters) can lead to chemical changes causing depression. A lack of sleep, broken sleep and exhaustion may also contribute to depression.
2. Social changes. Having a new baby can be very demanding. You may also feel isolated and trapped at home during the initial weeks as you try to establish a routine and bond with your baby. Society places unrealistic expectations on new mothers and many women feel like they fail when they are not able to live up to societies expectations.
3. Relationship changes between partners may also change and may leave you feeling alone and isolated. Relationship changes between friends who don’t have children may also affect friendships.
4. Emotional changes. Adapting to being a new parent is extremely hard – broken sleep, adjusting to being the main person(s) to meet a new babies needs, a loss of independence and a sense of loss for yourself as a person may occur. Broken sleep also affects our energy – and our brain chemistry as well as impacting our emotions. You may also feel a sense of loss around your previous lifestyle.

Other events may also trigger depression during the first 12 months such as death in the family, relationship issues or financial issues, may also contribute to the development of depression.

How can we assist PND?

For all new parents – its important that they try and practice self-care:

• Prioritize sleep. Try and get sleep as much as you can.
• Exercise. Any exercise is great, especially outside if it’s a sunny day. Vit D helps to boost your mood as well as aiding with sleep and building up the immune system.
• Ask for help from friends & family. Seek out support groups. See if you can hire a postnatal doula to help with cooking, cleaning, minding baby so you can have some sleep, go for a walk, meet a friend.
• Eat. New parents often forget to eat or eat nutritionally empty food. Fresh fruit and veggies are a must, make sure you take a multivitamin as well. Meals such as soup, bolognaise sauce, bone broth soup, frozen veggies can all save time and provide you with nutrients. If breast feeding make sure you are drinking enough and having protein and fat with every meal.
• Self-care. Make sure you get care for you. Acupuncture, Osteo, Massage, reflexology, soaking your feet in Epsom salts, asking for time away from the baby, prioritize exercise, sleep, time to rest and eating.
• Acupuncture and Chinese herbal Medicine provide a natural and effective way to assist with PND. Both can help to restore and rebalance the body back to your normal physiologically state. Acupuncture works on the brain’s chemistry by releasing oxytocin and dopamine into the body. This reduces stress and aids to relax the body. Chinese herbal medicine also helps to rebalance the imbalance in the body. You can use Acupuncture and Chinese herbal medicine together or separately.

Where to get help for PND?

If you are worried about a friend or partner – speak to them. The best help that you can give them is to listen and be supportive of them and their feelings. Be gentle with them, don’t judge them, give them some space, try and get them out a little if they are isolated.

Other services include:

• GP (doctor)
• Professional counsellor e.g. psychologist, psychotherapist
• Referral to a perinatal psychiatrist
• Your maternity or local hospital – many offer support for women (and their families) affected by PND
• Maternal and child health nurse in your local council
• Maternal and Child Health Line (24 hours) Tel. 13 22 29
• PANDA (Perinatal Anxiety and Depression Australia) helpline Tel. 1300 726 306
• Lifeline Tel. 13 11 14
• Beyond Blue Tel. 1300 224 636
• Gidget Foundation
• Suicide Call Back Service
• Your MumSafe trainer will also provide links to any of the above as well.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561681/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083254/
https://www.betterhealth.vic.gov.au/health/healthyliving/postnatal-depression-pnd#bhc-content
https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/postnatal-depression/