What to do if you think you have postnatal depression

Postnatal depression, baby blues, a bad day… it goes without saying that having a baby can flip your mood on its head. Many women are unsure what changes in mood are considered within the ‘normal range’ and when it may be time to seek support. 

Let’s start with the statistics – 1 in 7 women will experience postnatal depression.

Look around your mothers groups, your mum friends, your colleagues and family, ladies – odds are, there is a significant number of women around you that have had or are going through a very challenging time. 

It is important to clear up some of the confusing information around mood disturbance in pregnancy and the postnatal period as we know that the earlier help and treatment is sought, the easier the recovery.

Did you know?

> 80% of women experience baby blues, which presents as low mood and irritability accompanied by lots of tears generally lasting from day three postpartum until about two weeks postpartum. This is caused by a huge shift in hormones post delivery.

> 50% of women who experience mood disturbance after the birth of their baby actually had clinical mental health symptoms during the pregnancy.  

> Whilst postnatal depression is generally more talked about, many postpartum women experience a mixture of depression and anxiety symptoms.

> Postnatal depression can begin in the weeks after delivery but very commonly may have a delayed onset of up to six months.

Postnatal depression is a group of problems and can present differently depending on the individual. Postnatal distress is a spectrum, so what are some of the signs and symptoms to watch out for?

> Feelings of sadness or noticeable mood swings

> Lots of tears (yours, not the baby’s)

> A lack of energy and need to push yourself to get tasks done

> Withdrawal from people, commitments and responsibilities

> Changes in appetite (eating more or less than usual)

> Difficulty sleeping (problems falling asleep or sleeping too much)

> Reduced interest and pleasure in activities you used to enjoy

> Intense irritability or irrational anger

> Feelings of hopelessness, shame, guilt, or inadequacy

> Brain ‘fog’ (difficulty in thinking clearly, concentrating or making decisions)

>Thoughts of harming yourself or your baby

> Thoughts of death or suicide e.g. “I want this to stop” or “my family would be better off without me”

Why changes are as important as the symptoms themselves

Beyond what to look for, it’s important to attend to changes in your mood as compared to what is normal for you. It can be helpful to think of “what’s the DIFF?”:

Duration – clinically, psychologists consider symptoms sustained for most of the day over every day of a two-week period.

Intensity – keep track of your symptoms using a simple 0-10 ranking (10 being most extreme and 0 being not noticeable). The more high-ranking numbers can highlight the biggest areas of concern.

Frequency– how often are your noticing issues with your mood – is it just in the morning, all day, in the middle of the night, every day, all week?

Function – what is the change in your capacity to go about your daily responsibilities like getting out of bed, eating, attending to your baby and leaving the house?

Knowing your fingerprint for your own wellbeing will best help you to track how you are travelling. 

And so what do you do if you think you have postnatal depression?

Starting a conversation about your mood as early as during pregnancy can ensure that those around you can be best positioned to help you get the help you need.

If you are noticing changes within yourself, reach out to those around you who you feel can help – that may be your parent, partner or friend. You can use words like “this has been a hard day, in fact a hard few weeks. I’m finding that…(recount your symptoms and experiences)… and I think I need some support”. Sometimes writing this down in a text or email can be easier than saying it out loud. 

It can be also helpful to think about some of the things that you feel you need – be it extra hands to hold the baby, more quality and connective time, domestic support etc. Sometimes people just don’t know how to offer help even when they want to, so even giving those around you words that help them check in on you such as “what is going to be the best way I can help right now?”can have a big impact for you!

It is always best to reach out to a trusted GP. An outside perspective can help you better understand the distress you are experiencing. They can also help refer you to suitable support be it a lactation or sleep consultant, a specialised perinatal psychologist or offer suitable medication (at times in collaboration with a psychiatrist). 

Importantly, postnatal depression is a treatable condition. Early identification and intervention can help to prevent unnecessary impacts to you, your baby and family. There are always good days and bad days as a mother and the aim is to help shift the balance to the positive side of the spectrum and enable you to function and even flourish in your life as a mum.

Additional resources:

Beyond Blue

PANDA – Perinatal Anxiety & Depression Australia

COPE (Centre of Perinatal Excellence) eCope Directory

Expert author: Belinda Williams

Belinda Williams is a Psychologist and co-founder of The Bumpy Road. She specialises in supporting wellbeing in the journey into and through motherhood.

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