What is postnatal depression?

Many new parents feel tired or overwhelmed, but postnatal depression is different. In postnatal depression, you may have feelings of:

• sadness
• numbness
• hopelessness

These symptoms affect your ability to cope with and enjoy your daily life.

Postnatal depression is common, affecting about 1 in 7 women in the first year after having a baby. Up to 1 in 10 fathers also experience depression around this time.

If you have symptoms of depression, there's lots of support available to help you get back to enjoying life and your new baby. Getting help early is best for both you and your baby.

What are the symptoms of postnatal depression?

People experience postnatal depression differently, but many people will have similar symptoms or difficulties. Sometimes, signs of depression are missed or dismissed as a normal part of life with a new baby. So, it's a good idea to be aware of the common signs of postnatal depression.

Common symptoms of postnatal depression you might notice include:

• feeling low or numb
• feeling helpless, hopeless or worthless
• losing interest in others, including your new baby
• changes in your sleep or appetite
• having no interest or pleasure in things your normally enjoy
• tiredness or problems with concentration and making decisions
• thoughts of harming yourself or your baby

If you have postnatal depression, you are probably also having problems with your usual activities, including:

• looking after your baby
• socialising
• parenting any older children
• working

People who have depression may also have anxiety during this time.

It's important to see your doctor if you have any symptoms of depression or anxiety. Your doctor will also routinely check you for any symptoms of postnatal depression in the months after you give birth.

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

About 4 out of 5 new mums experience 'baby blues' in the first 3 to 5 days after having a baby. These feelings are usually due to the hormonal changes that happen during pregnancy and birth.

If you have 'baby blues', you may:

• feel tearful, sensitive, anxious or overwhelmed
• feel moody or irritable
• have trouble sleeping

These feelings can be challenging, but they usually pass on their own within 10 days.

In postnatal depression, your symptoms:

• last longer than 2 weeks
• may be more severe
• usually interfere with your ability to function normally

Unlike 'baby blues', postnatal depression doesn't usually go away on its own. This can be especially tough to cope with when you are recovering from birth and have a new baby to look after.

It can be hard to know if what you're feeling is normal or might be the start of something more serious. If you're not sure, it's a good idea to check in with your doctor or child health nurse.

What is the difference between postnatal anxiety and depression?

Both anxiety and depression are more common after the birth of a baby. Many people who have postnatal depression will have anxiety at the same time.

Some symptoms are similar, but anxiety and depression are different conditions that may need different treatments. Postnatal anxiety can cause feelings of worry or fear that are difficult to control. In both conditions, you may struggle to cope with your daily activities.

Am I at risk of postnatal depression?

There are some factors that can increase your chance of developing postnatal depression. These include:

• a history or family history of mental illness
• a lack of social support
• previous trauma or a history of physical, sexual or emotional abuse
• current or recent stressful life events
• previous pregnancy losses
• a difficult pregnancy or birth
• a baby who is unwell or difficult to settle

Having one or more of these risk factors does not necessarily mean that you will develop postnatal depression.

If you have any of these risk factors, make sure you have enough practical and psychological support during your pregnancy and after your baby's birth. This can help to reduce your chance of developing depression and help you to cope better if you do become unwell.

How is postnatal depression diagnosed?

If you notice symptoms of postnatal depression, talk to your:

• doctor
• midwife
• child health nurse

They may:

• ask about how you have been feeling
• give you a questionnaire to complete
• ask to speak with your partner, if you have one
• do a physical examination

Try to be as honest as you can. This will make it easier for the doctor or nurse to give you the treatment and support you need. Remember, postnatal anxiety and depression are extremely common. There's no need to feel ashamed.

Personal story — video

Elizabeth shares her experience with postnatal depression. Videos provided by Healthtalk Australia.

What is the Edinburgh Postnatal Depression Scale?

The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire used to help identify people who may have postnatal depression and/or anxiety.

It's a good idea to complete the EPDS together with your doctor or midwife, who can provide you with more information and support.

It's also important to remember that the EPDS cannot be used to diagnose postnatal depression by itself. Only a trained health professional can:

• fully assess your symptoms
• give you a diagnosis
• recommend the right treatment for you

How is postnatal depression treated?

There are several treatments for postnatal depression. Your treatment will depend on your symptoms and how severe they are.

Treatments include:

• psychological therapies
• antidepressant medicines
• self-care measures

Your doctor will discuss with you the benefits and disadvantages of any treatment. This includes the impact of any medicines on breastfeeding.

Psychological therapy

Psychological therapy or counselling can help in the treatment of depression. Therapy aims to give you support, education and information on how to understand and cope with depression.

Therapies may include:

• cognitive behavioural therapy (CBT)
• interpersonal psychotherapy (IPT)

Medicines

In some cases, your doctor may prescribe antidepressant medicines to help treat depression.

Self-care measures

You can help improve your symptoms by:

• getting practical help and emotional support from family and friends
• eating a healthy diet
• keeping active with physical activities you usually enjoy
• planning for regular, quality sleep
• using stress-management techniques, such as muscle relaxation and deep breathing

It can be difficult to establish and maintain a healthy lifestyle while recovering from birth and looking after your new baby. There is no shame in asking for and accepting help from family and friends.

Self-care is important to keep yourself physically and mentally healthy. Remember that looking after yourself benefits your whole family, especially your new baby.

Resources and support

If you or someone you know is showing signs of postnatal depression, see your doctor. It's important to seek help early.

PANDA (Perinatal Anxiety & Depression Australia) has information on mental health problems during and after pregnancy:

• Phone their National Helpline on 1300 726 306.
• Find support in different languages and support for Aboriginal and/or Torres Strait Islander people.

COPE (Centre of Perinatal Excellence) provides support for the emotional challenges of becoming a parent. They also have information in different languages.

Beyond Blue offers support online, or you can phone 1300 22 4636.

For advice and to get connected to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.