A few weeks ago I was asked to do a phone-in about postnatal depression (PND) on ITV’s This Morning. I was dismayed to find mental health in pregnancy is getting no higher a priority than when I first wrote about it 40 years ago.
We have a generation of women who, when they get pregnant, don’t know anything about PND and have never heard of AND (antenatal
depression). And if either of these conditions hit them, they do not know where to turn for help.
“Baby blues”, the feeling of bewilderment, tearfulness and anxiety that usually starts 3-5 days after the birth and lasts no more than 10-14 days, is a relatively benign form of depression.
But make no mistake about it – if depression extends beyond then, a woman could be suffering full-blown PND, and 10% of mothers do.
It’s a psychiatric condition that needs specialist help. Both baby blues and PND are due to the cataclysmic fall in pregnancy hormones after birth. Oestrogen levels plummet 200 times lower, and progesterone 20 times. These sudden changes wreak havoc with a woman’s mental wellbeing, making them moody and emotional.
Birth tends to accentuate underlying problems. Unresolved issues come to the fore. Most women feel confused and anxious about their ability to look after their baby. They’re frustrated because it seems a long time to establish a routine.
Meanwhile, many fathers are feeling unwanted making it difficult to bridge the gap and talk. PND must be shared. It’s not just a woman’s illness; it’s a family illness. And, yes, a lot falls on the shoulders of fathers. We know the greatest preventive of PND and the most powerful cure is a supportive partner.
Doctors can and should provide antidepressants. The earlier a woman takes them the sooner the PND passes. They should be continued well after she’s recovered and stopped only by reducing the dose slowly under medical supervision.
There are many things a woman with PND can do for herself – never ignore your feelings, don’t overdo it and if you’re tired, STOP.
Be kind to yourself – rest all you can, eat little and often, and get out of the house as much as possible. Think only of the baby and yourself. Go to the Well Baby Clinic twice a week to meet other mums and compare notes.
You’re not alone.
Best of all contact Cocoon Family Support Services on 07946165515 and get the Royal College of General Practitioners Tool Kit for details of your local support groups at rcgp.org.uk/clinical-and-research/toolkits/perinatal-mental-health-toolkit.aspx.