Post-Natal Depression or Anxiety
Overview
Postnatal Depression (PND) or Postpartum Anxiety (PPA) are mental health conditions that occur after childbirth, impacting not just new mothers but also fathers and non-birthing parents. PND and PPA are often under-recognised and under-treated, despite being fairly common occurrences in the postnatal period.
PND is characterised by a prolonged period of emotional disturbance, occurring at any time within the first year after childbirth. It often includes feelings of sadness, low energy, changes in sleeping and eating patterns, reduced desire for sex, crying episodes, anxiety, and irritability. In severe cases, it may also involve thoughts of self-harm or harm to the baby.
PPA, on the other hand, involves excessive worrying, often about the baby's health and wellbeing, restlessness, and a feeling of being on edge. Like PND, it can occur at any time within the first year after childbirth.
Both these conditions go beyond the 'baby blues,' which is a brief period of mood swings, tearfulness, and feeling overwhelmed, usually resolving within two weeks after delivery. According to the DSM-5, the defining factor for PND and PPA is the duration and impact on daily functioning, typically lasting for at least two weeks and causing significant distress or functional impairment.
The World Health Organisation (WHO) and the International Classification of Diseases (ICD-11) also recognise these conditions, emphasising their impact on global health.
Key Features
Postnatal Depression (PND):
Persistent Sadness: PND often involves a persistent feeling of sadness or low mood that lasts for more than two weeks.
Loss of Interest or Pleasure: Anhedonia, or a loss of interest or pleasure in activities that were once enjoyable, is common.
Fatigue: Feelings of fatigue or loss of energy, even after rest, are typical.
Changes in Appetite: Significant changes in appetite, such as overeating or loss of appetite, can occur.
Sleep Disturbances: Difficulties with sleep, including insomnia or excessive sleep, are common.
Feelings of Worthlessness or Guilt: PND may involve feelings of worthlessness, guilt, or self-blame.
Difficulty Bonding with the Baby: Mothers may experience difficulty bonding with their baby or feeling disconnected from them.
Irritability or Agitation: Increased irritability, agitation, or restlessness may be present.
Difficulty Concentrating: Problems with concentration, decision-making, or memory are common.
Thoughts of Self-Harm or Suicide: In severe cases, thoughts of self-harm or suicide may occur.
Postpartum Anxiety (PPA):
Excessive Worry: Postpartum anxiety often involves excessive worry or fear, particularly about the health and well-being of the baby.
Physical Symptoms: Physical symptoms such as rapid heartbeat, sweating, trembling, or dizziness may accompany feelings of anxiety.
Panic Attacks: Some individuals with postpartum anxiety may experience panic attacks characterized by sudden onset of intense fear or discomfort.
Restlessness: Feelings of restlessness or being on edge are common.
Irrational Fears: Postpartum anxiety may involve irrational fears or phobias, such as fear of leaving the baby alone or fear of something happening to the baby.
Difficulty Relaxing: Difficulty relaxing or feeling tense most of the time is typical.
Sleep Disturbances: Like PND, sleep disturbances such as difficulty falling asleep or staying asleep may occur.
Physical Symptoms: Physical symptoms such as headaches, muscle tension, or gastrointestinal discomfort may be present.
Hypervigilance: Mothers with postpartum anxiety may be hypervigilant, constantly monitoring the baby for signs of illness or distress.
How We Can Help
Psychologists play a crucial role in the treatment of PND and PPA. Cognitive Behavioural therapy (CBT) and interpersonal therapy (IPT) are well-validated treatments for these conditions.
CBT involves identifying and modifying unhelpful thought patterns and behaviors, while IPT focuses on improving interpersonal relationships and social support networks, critical areas often impacted in the postnatal period.
Additionally, psychoeducation is a vital component of treatment. Understanding that PND and PPA are not failures but treatable health conditions can alleviate guilt and promote recovery.
Group therapy can also be beneficial, offering a space to connect with others experiencing similar challenges, reducing feelings of isolation. For severe cases, psychologists can work in tandem with psychiatrists, who can assess the need for and oversee pharmacological treatment.
Overall, our role as psychologists is to offer a safe, supportive, and non-judgmental space to explore your feelings, fears, and hopes, and to work collaboratively towards improved wellbeing.
If you, or a loved one, are feeling overwhelmed, anxious, or unusually low after the arrival of a new baby, it's important to remember that you're not alone, and help is available. Our team of empathetic and experienced psychologists are here to support you through this challenging time. Reach out to us today. It's the first step towards a happier, healthier you and a brighter future for your family.