Postnatal depression (PND)

What is the difference between postnatal depression and the baby blues?

Having the ‘baby blues’ after giving birth is very common. It usually starts 2 or 3 days after you’ve given birth and stops by the time your baby is 5-10 days old. 

Postnatal depression is when you have feelings of sadness, hopelessness, guilt or self-blame most of the time for weeks or months after you’ve had a baby. 

Watch one mum's experience of postnatal depression in the video below.

Depression is a mental health condition. It is not a sign of weakness or something that you can, or should, ‘just snap out of’. The good news is that postnatal depression can be treated with the right care and support and most people will make a full recovery. 

Trust yourself. You are the best judge of whether your feelings are normal for you. Talk to your midwife or GP if you think you have any symptoms of depression and they last for more than 2 weeks.

"It was a difficult birth and although I loved her because she was my child, I felt there was something missing. There’s so much pressure and expectation on new mothers - and I wondered what was wrong with me.” 

Caroline, mum of 1

Some women and birthing people have depression when they are pregnant. This is called antenatal depression. 

What are the symptoms of postnatal depression?

You may have postnatal depression if you have: 

• feelings of sadness and low mood that won’t go away
• lost interest in life and you’re not enjoying the things you used to
• problems sleeping, such as having trouble getting back to sleep after caring for your baby at night, even when your baby is asleep and you’re feeling exhausted
• difficulty concentrating and making decisions
• been feeling anxious
• been avoiding other people
• feelings of guilt and self-blame
• been finding it difficult to care for yourself and your baby
• been thinking about, and even planning, suicide.

If you’re feeling like you want to die, it’s important to tell someone. This could be a family member, friend, your GP or midwife. You can also call the Samaritans on 116 123.

You may not have all these symptoms and they may come on gradually or you may suddenly start to feel very low. 

"I came home on day 3 or 4 and the moment I walked into the house I burst into tears. I got the same anxiety feeling, the feeling I wasn't going to be able to cope with this."  

Stephanie, mum of 2. 

How common is postnatal depression?

Very common. More than 1 in every 10 women and birthing people get postnatal depression within a year of giving birth. New fathers and partners can get postnatal depression too.

What causes postnatal depression?

We do not know exactly what causes postnatal depression. But childbirth and the stress of looking after a new baby may trigger depression in some people.

You may be more likely to get postnatal depression if you have:

• had mental health problems before, particularly depression
• had mental health problems during your pregnancy
• no close friends or family to support you
• a poor relationship with your partner
• had a lot of stress in your life recently, such as a bereavement
• had the baby blues.

I think I may have postnatal depression. What should I do?

Tell your midwife, health visitor or doctor how you feel. They understand that depression is a mental health condition and will not judge you. They will focus on helping you find the right treatment and support so you can take care of yourself and your baby.  

If you find it difficult to talk about your thoughts and feelings, you could write down what you want to say first, or you may want to have someone with you. The important thing is to let someone know so that you can get the right help as soon as possible. 

“I knew something wasn’t right but I didn’t want to admit it. I thought I would be a failure if I admitted that I was struggling with being a mum. One day I went out for a walk and nearly didn’t go home. I thought my husband and son would be better off without me. I knew then it was time to ask for help.” 

Ruth

What is the treatment for depression?

The good news is that postnatal depression can be treated - it is a temporary illness that you can recover from. The treatment is likely to depend on how much your depression affects your life.

“It’s difficult trying to find out what’s wrong with you. Is it just being a new mum? Is it you’re anxious because you can’t settle the baby? Is it postnatal depression? There are so many things that overlap.” 

Emily, mum of 1. Read more...

If you have mild depression, the doctor may recommend an exercise programme and/or guided self-help.  Your doctor may offer you medication if you have had severe depression in the past.

If you have moderate or severe depression, your doctor may offer you:

• a talking (psychological) therapy, such as cognitive behavioural therapy (CBT)
• antidepressants
• a combination of talking therapies and anti-depressants.

You can also refer yourself for talking therapies.

Your doctor will discuss your treatment options with you, depending on what is appropriate for you and your symptoms.

It’s important to tell your doctor if you are planning to breastfeed your baby. Some antidepressants can pass into breastmilk so your doctor will help you find one that is safe for you and your baby. 

Find out more about medication and breastfeeding.

"I was on medication...and I was under close review because things were bad... But by about four months things started to lift. I've always described it like layers of cling-film coming off." 

Stephanie, mum of 2

How can I help myself?

It’s important to tell the midwife or doctor if you have had depression in the past because you may be more likely to get depression in this pregnancy or after you give birth. They can then give you the best support to reduce the chances of you getting depression again.  

It also helps to know what the symptoms of postnatal depression are so you can ask for help if you get them. Make sure those close to you know what to look for, too, so that they can help you get support if they feel you need it.

Depression can make you want to hide away from the world and you may feel like you want to do anything at all. But it is important to take care of yourself. Start with small activities, take things at your own pace and most importantly, ask for help if you need it.

Here are a few ideas.

• Talk to someone you trust about your feelings, such as your partner, family or a friend.
• Go to antenatal classes or try to meet other new parents.
• Try not to feel guilty, ashamed or embarrassed. These feelings are not your fault.
• Get some exercise every day – keeping active will release some feel-good hormones.
• Eat regularly and healthily even if you don’t have much appetite.
• Avoid alcohol and smoking – they can harm your baby and make you feel worse.

Read about planning ahead for emotional wellbeing after birth.

"It was really only a week after she was born and things started to go right downhill again. I just couldn't get up. I couldn't get out of bed. It wasn't even about bonding with her. I just didn't want to exist anymore." 

Abby, mum of one

More information and support

PANDAS provides telephone support, online information and local support groups for pregnancy depression and postnatal depression. You can call their helpline on 0808 1961 776.

The Association for Postnatal Illness (APNI) provides telephone support and online information on postnatal depression on 0207 386 0868. 

MIND is a mental health charity providing information, support, local groups and an online chatroom. The helpline is 0300 123 3393.