At least one in eight women are affected by postnatal depression. In fact the first six months after giving birth is the most likely time in a woman’s life when she will suffer depression. Like most depression, it often goes undetected in the early stages. Patients often interpret the symptoms of fatigue, poor concentration and irritability as understandable consequences of the sleep disturbance associated with a new baby. If it is the first time a woman has suffered depression, making sense of it, let alone accepting it, can be very difficult. It is a time when everyone expects to be overjoyed. This is often reinforced by the attitude of family and friends.
We tend to interpret negative feelings largely in terms of external factors e.g. relationship difficulties, work stress and adverse life events. We find it hard to conceptualise emotional vulnerability in terms of hormonal changes and the destabilizing effect they commonly have on neurotransmitters such as serotonin. Accepting what is happening can be difficult and often gets in the way of seeking treatment early.
Routine screening by health visitors using rating scales as well as patient education, form the cornerstone of greater acceptance of postnatal depression and a willingness to seek help. Self-help in the form of establishing good habits; sleep (where possible!), diet and exercise all help as does the support of family and friends. The correct diagnosis by the GP, or where appropriate, a psychiatrist will ensure the correct treatment plan (usually psychological therapy and occasionally medication) is started promptly and actively managed.
Postnatal depression might be very common and very disabling but it is also very treatable.
Dr Gary Bell FRCPsych