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Antenatal & 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.
Click to the right to watch a video from Best Beginnings with Dr Alain Gregoire on depression in the antenatal & postnatal period.

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 - check out common symptoms in the bullet points below. 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 own development. Around 10-15% 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.

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

  • 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

  • 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

Note: - some of these experienced - like lack of concentration, disturbed sleep 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.

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 urgent referral to a specialist mental health team.

We know that talking about how your 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 are able to support you and your family. There will be a range of treatment options open to you -

Self-help:

There are lots of different types of self-help available to you for mild to moderate depression so you should be able to find an approach that suits you. One example can be seen by clicking here. This provides you with the option of exploring how you might be feeling through a workbook approach. There are also a number of online self-help information pages such as this one.

You may also find the Baby Buddy app useful. It contains masses of useful information about your physical and mental health in pregnancy and after the baby has arrived.

Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing.

You can also look at online Cognitive Behavioural Therapy (CBTS) programmes as well as self-help guides from the NHS here.

Talking therapy is a NICE recognised therapy delivered by a therapist either face to face, over the telephone or in groups. The therapy is available wherever you live via the NHS and is completely free. Women in the perinatal period (antenatal and up to 1 year post-birth) will be prioritised for talking therapy treatment. There are many different types of therapy available including Cognitive Behavioural Therapy (CBT), which has proved very effective for depression. You should receive your treatment within 6 weeks of the initial referral (NICE 2014).

Medication - You will need to seek the advice of your GP. For mild to moderate depression, talking therapy is the first choice of treatment and medication won't usually be considered until you have undertaken some therapy. The medications for treating depression are called antidepressants and there are lots of different ones to choose from. If you are pregnant or breastfeeding there are still antidepressants that you can take, but you need to discuss this with your GP. Please see further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

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

Useful services & resources:

  • PANDAS Foundation
  • Baby Buddy is the multi-award winning free app that guides you through pregnancy, birth, parenting and beyond. You can explore the we.b version of Baby Buddy or download the full version of the app for free on the App Store and Google Play. There is a lot of information including videos about your physical and mental health.

Further reading:

Resources:

Content adapted from MIND.