Antenatal and postnatal depression

Perinatal depression is depression experienced during pregnancy (known as ante or prenatal depression) or after childbirth (known as postnatal depression). Many people are aware of postnatal depression (PND) but it's less commonly known that you can experience it during pregnancy as well.

Watch a video from Best Beginnings with Dr. Alain Gregoire on depression in the antenatal and postnatal period (to the right of this page).

Becoming a parent brings a wide range of emotions, ranging from joy to excitement to stress and apprehension. The physical changes you go through can also affect your mood and feelings, and it's common to experience more ups and downs than usual. But depression is more than just a low mood - it's a serious condition that affects your physical and mental health. Untreated, it can affect not only you but also the people around you, your loved ones, and even the baby's development.

Around 10 to 15 percent of new mothers will experience postnatal depression. It can range from being relatively mild to very severe but it is also a very treatable illness if you get the right help.

Some common symptoms to look for in ante and postnatal depression might include (but are not limited to):

What are the symptoms?
  • Feeling sad, low, or down the majority of the time
  • Regularly feeling tearful
  • A loss of pleasure in doing the things that used to bring enjoyment· Feeling unusually sleepy during the day or an inability to get out of bed
  • Intrusive thoughts
  • Struggling with concentration
  • Becoming unusually indecisive
  • Irritability, short-tempered and rageful outbursts
  • Becoming isolated and avoiding social situations
  • Feeling restless, short-tempered or agitated
  • A loss of self-confidence and feelings of worthlessness
  • A sense of overwhelming guilt
  • Thoughts of self-harm or suicide
  • Struggling to bond with your baby
  • Struggling with everyday parenting or daily routine tasks
  • Over or under-eating.

If you are experiencing ante or postnatal depression you may feel:

  • Sad and low
  • Tearful for no apparent reason
  • Worthless
  • Hopeless about the future
  • Tired
  • Unable to cope
  • Irritable and angry
  • Guilty
  • Hostile or indifferent to your husband or partner
  • Hostile or indifferent to your baby.

Early recognition, support, and treatment can be a huge benefit to the health and well-being of the whole family, so it is important to seek professional help/guidance from a GP, midwife, or health visitor as soon as you think that you or someone you know might be affected by any of these symptoms.

If you are experiencing ante or postnatal depression you may find that you:

  • Have lost concentration
  • Have disturbed sleep
  • Find it hard to sleep - even when you have the opportunity
  • Have a reduced appetite
  • Lack of interest in sex
  • Have thoughts about death.

Some of these experiences, like lack of concentration, disturbed sleep,p and lack of interest in sex, are all common after becoming a parent, but it's still important to mention them to your doctor if you're concerned you might have postnatal depression.

Early recognition, support, and treatment can be a huge benefit to the health and well-being of the whole family, so it is important to seek professional help/guidance from a GP, midwife, or health visitor as soon as you think that you or someone you know might be affected by any of these symptoms.

If you experience any of the following symptoms (known as "red flag symptoms"):

  • New thoughts of violent self-harm
  • Sudden onset or rapidly worsening symptoms
  • Persistent feelings of estrangement from your baby.

Then you need an urgent referral to a specialist mental health team.

We know that talking about how you are feeling can often be very difficult. However, there is help out there. You do not have to feel like this.

We hear that women often worry that they will be judged or seen to be 'not coping' - this is a common misconception. Health professionals are aware of how common depression can be during the perinatal period and can support you and your family. There will be a range of treatment options open to you including:

Self-help

  • Self-care/making time for yourself; healthy eating; increasing exercise; becoming more socially active; attending mother and baby groups/activities; practising mindfulness; developing self-help coping strategies; journaling; arts/crafting; peer-to-peer support and talking to friends and family to build your support network around you.

More information on self-help tips and support can be found on the NHS website. 

  • You may also find the Baby Buddy app useful. It contains masses of useful information about your physical and mental health during pregnancy and after the baby has arrived.
  • Reading well books are available from most libraries, they promote the benefits of reading for health and well-being.

Talking therapy

Different types of talking therapies can be effective in treating perinatal mental ill health.

The most commonly offered are:

Cognitive Behavioural Therapy (CBT); Guided self-help; Eye movement desensitisation and reprocessing (EMDR); counselling; psychotherapy.

(Anyone with a child under one will be prioritised. Parents should be triaged within four weeks and seen within 16 weeks in line with NICE Guidance CG192)

Further information on talking therapies and how to self-refer to your local service can be found here.

Medication

There are a variety of medications that can support your recovery. Please speak to your GP or midwife and they can help you to find the best one for you.

Bumps is a safe and useful website for researching medications during and after pregnancy.

Specialist perinatal mental health services:

Specialist perinatal mental health services are available for any woman/birthing person who has a diagnosis of a mental health condition, during pregnancy or up to a year after the birth of their baby.

More information on perinatal mental health services and referral processes can be found here on the Royal College of Psychiatrists website. 

For psychosis and severe mental ill health

If you are concerned for your or your partner’s safety, contact emergency care immediately, where rapid support and treatment will be offered.

More information on how to get urgent help can be found here.

Help offered could be support from the local mental health crisis intervention team, a place in a mother and baby unit, and/or antipsychotic medication.

Further information on mother and baby units can be found here.

Here are some of the different ways you can access support locally

*Content adapted from MIND.

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