Having a baby is one of the most exciting moments in life. It is also one of the most daunting and brings with it a huge amount of change. The realisation hits that you are wholly responsible for keeping a tiny completely vulnerable little human alive. Along with this, you are weathering a hormonal storm, sleep deprivation, a string of visitors, body changes and feeding issues (sore nipples/low supply/undersupply and engorgement, formula guilt…) – all whilst drowning under a mountain of washing.
80% of new mums suffer from the “baby blues”
It is no wonder about 80% of new mums suffer from the baby blues. This tendency to be teary, irritable, anxious and moody just after having a baby normally lasts only two or three days. If these symptoms are more pervasive and lasting longer, you may be suffering from postnatal depression or anxiety.
Postnatal depression affects about 1/7 women in the year after having a baby. It is common but under-recognised. Symptoms will often be put down to “being tired” and “normal in the circumstances”. It is however, important to detect and is very treatable.
Signs that you (or your partner/friend) may notice include:
-Low mood -Feeling like a bad mother -Guilt, blaming your self unnecessarily -Exhausted -Teary and sad -Worthless or hopeless -Excessive worry about your baby -Not being able to laugh -Feeling you are not enjoying life/your new baby -Feeling detached/not bonding -Fear of being alone or being scared of leaving the house
Some of these symptoms could be perceived as normal in the context of new parenthood. Everyone will have days where they feel a bit overwhelmed, tired or not feel like going out. However if these symptoms are persistent, affecting your quality of life/bonding with your baby/ability to cope and you are feeling sad or anxious then you need to seek help because it is not “normal”. The Edinburg Post Natal Depression Scale is a good quick questionnaire that can be done online. If you score >10, then it would be a good idea to see your GP to discuss your symptoms.
Another condition to mention is postnatal psychosis. This is rare (only 1-2 per 1000 mothers) but very serious (it is a medical emergency). It usually presents in the first days to two weeks after delivery but may present up to 3 months later. Symptoms of this include significant changes in behaviour such as feeling over-energetic, restless or irritable, inability to sleep, having strange beliefs, hallucinations, difficulty concentrating or thoughts of harming yourself or your baby. There is serious risk to both the mother’s and baby’s wellbeing and potentially life, so this requires URGENT assessment and treatment.
Treatment for PND/Anxiety
Treatment for postnatal depression/anxiety may include putting into place family and/or community supports, seeing a psychologist, support groups, group treatment, relaxation, meditation, mindfulness, exercise, and medication (antidepressants).
Psychology really is a valuable tool in treating postnatal depression that I recommend wherever possible. If you have a diagnosis of post natal depression or anxiety, keep in mind that your GP could prepare a “Mental Health Plan” for you, that would entitle you to a Medicare rebate for up to 10 sessions per calendar year with a psychologist. Depending on your local services, this may mean bulk billed sessions are available or you will have a substantially reduced gap payment for your sessions.
Antidepressant medication may be required in more severe cases, or where you are not responding to psychological treatment. The risks of untreated depression for the mother and baby, particularly where there are issues with bonding and attachment are very real. The risks associated with (appropriately chosen) antidepressants, of which only a tiny dose is secreted in the breast milk are extremely low/negligible. It is not necessary to stop breastfeeding if you are on antidepressants, in fact continuing it is likely to help enhance your bonding experience.
So if you (or someone you know) may be suffering from postnatal depression or anxiety, the message is: seek help and allow people to help you. It is a disease, not a “weakness” and nor is it “normal” to feel that way. It is also very treatable once detected. GPs and child health nurses see it frequently, so please bring it up, even if you are unsure.
Some good resources include:
-Your GP or child health nurse
-Beyond Blue – 1300 224 636 (https://healthyfamilies.beyondblue.org.au/pregnancy-and-new-parents)
I'm a GP on the Sunshine Coast with an interest in paediatrics and women's health. One of the absolute highlights of my job is looking after women throughout their pregnancies, seeing their newborns and watching them grow up/adding to their families over time. I am currently waiting for my 2nd baby to arrive whilst tackling the sleep problems/tantrums/toilet training (or not)/general hyperactive behaviour of my crazy but wonderful 2 year old boy.
