3 months after giving birth is considered the riskiest time to develop symptoms of Postnatal Depression, although women may develop symptoms during pregnancy or within the first 2-4 weeks after giving birth.
Several factors increase the risk of a mum to develop Postnatal Depression, such as:
- If you have a past history depression, the pressures of a new baby can make the depression symptoms flare-up again;
- If you are having a rough time in your relationship and are not very supported;
- If you are experiencing other concomitant stressful life events e.g. moving home, death of a loved one, work problems etc;
- Being a teenage mum.
Making the diagnosis
All healthcare professionals involved in the care of newly born babies, children and young mums should be aware of the possibility of a mum developing Postnatal Depression.
Doctors check for symptoms of Postnatal Depression during all routine postnatal consultations and some doctors use validated questionnaires as a screening tool. One of such tools is the Edinburgh Postnatal Depression Scale used as a screening questionnaire at various appointments after birth. A score of over 9 (out of 30) indicates possible depression so I recommend you see your doctor or Health Visitor shortly. A score of above 12 indicates probable post-natal depression so I recommend you see your doctor urgently.
If you are feeling low, you find yourself being irritable, crying easily, you feel frustrated and inadequate you should not delay it and discuss your symptoms with your doctor. It may be that you suffer with Postnatal Depression but sometimes it may be that your symptoms are due to hormonal abnormalities such as in the thyroid function.
Treatments
Postnatal Depression can be lonely, distressing and frightening, but there are many treatments available. As long as it’s recognised and treated, Postnatal Depression is a temporary condition you can recover from.
- Psychological Therapy. This is the first treatment that should be offered once a diagnosis of Postnatal Depression has been made. Talking therapies such as Cognitive Behavioural Therapy or Interpersonal Psychotherapy are available. Cognitive Behavioural Therapy (CBT) is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle, so it aims to help you crack this cycle. Interpersonal Psychotherapy (IPT) aims to identify whether your relationships with others may be contributing towards feelings of depression. Both therapy courses last around 6 weeks.
- Medication treatment. The mainstay is starting a selective serotonin re-uptake inhibitor (or SSRI) once a day. If you are breast feeding, then the doctor’s aim would be to allow you to continue so they may seek specialist advice on the best medication for you. In general most patients need antidepressants for approximately 6 months. The SSRIs are not addictive like the older anti-depressants.
- Exercise. Exercise has been proven to help depression and your doctor may be able to refer you to a qualified fitness trainer who will be able to provide you with a suitable exercise programme.
- Self-help reading. Overcoming Postnatal Depression: A Five Areas Approach, by Drs. Christopher Williams, Roch Cantwell and Ms. Karen Robertson. ISBN number to buy it online: 0340972343. You need to be motivated to read this though so it is not for all.
The future – recurrence and prevention
Let your GP or midwife know as soon as you are pregnant if you have suffered from depression or post-natal depression before, so they can be extra-vigilant in the new pregnancy.
To prevent developing Postnatal Depression with your new baby, here are few things you may follow:
- Try and get as much rest and relaxation as possible,
- Take regular gentle exercise,
- Don’t go for long periods without food as low blood sugar levels can make you feel much worse,
- Don’t drink alcohol because this is a natural depressant and will make you feel worse,
- And finally, try and eat a healthy, balanced diet.
The doctors at ROC Clinic will be very happy to consult you, assess you and support you through out your pregnancy and after giving birth.
