Postnatal depression - Symptoms of postnatal depression

Postnatal depression can affect women in different ways.

Symptoms can start soon after giving birth and last for months or, in severe cases, they can persist for more than a year.

The main symptoms of postnatal depression are:

• a persistent feeling of sadness and low mood
• loss of interest in the world around you and no longer enjoying things that used to give pleasure
• lack of energy and feeling tired all the time (fatigue)

Other symptoms can include:

• disturbed sleep, such as having trouble sleeping during the night and then being sleepy during the day
• difficulties with concentration and making decisions
• low self-confidence
• poor appetite or an increase in appetite ("comfort eating")
• feeling very agitated or, alternatively, very apathetic (you can’t be bothered)
• feelings of guilt and self-blame
• thinking about suicide and self-harming

Postnatal depression can interfere with your day-to-day life and can be associated with increased anxiety. Some women feel they're unable to look after their baby, or they feel too anxious to leave the house or keep in touch with friends.

Frightening thoughts

Some women who have postnatal depression get thoughts about harming their baby. These thoughts, known as obsessional ruminations, are very rarely acted upon.

Harmful thoughts are believed to be extremely common. However, it's difficult to know exactly how common they are because many mothers feel too ashamed to admit to having such thoughts and think it might encourage the involvement of social services.

If you're troubled by thoughts of harming your baby or yourself, it's best you discuss it with your GP who may refer you for specialist help.

Treatment will benefit both your health and the healthy development of your baby, as well as your relationship with your partner, family and friends. Seeking help for postnatal depression doesn't mean you're a bad mother or unable to cope.

Spotting the signs in others

Many mothers don't recognise they have postnatal depression and don't talk to family and friends about their true feelings.

It's therefore important for partners, family members and friends to recognise the signs of postnatal depression at an early stage.

Warning signs in new mothers include:

• frequently crying for no obvious reason
• having difficulty bonding with their baby
• neglecting themselves – for example, not washing or changing their clothes
• losing all sense of time – for example, being unaware whether 10 minutes or two hours have passed.
• losing all sense of humour and not being able to see the funny side of anything
• worrying that something is wrong with their baby, regardless of reassurance

If you think someone you know has postnatal depression, encourage them to open up and talk about their feelings to you, a friend, GP or health visitor.

Postnatal depression needs to be properly treated and isn't something you can just snap out of.

Postnatal psychosis

Postnatal psychosis is a rarer and more serious mental health condition that can develop after giving birth. It's thought to affect around one in 1,000 women.

Symptoms of postnatal psychosis include:

• bipolar-like symptoms – feeling depressed one moment and very happy the next
• believing things that are obviously untrue and illogical (delusions) – often relating to the baby, such as thinking the baby is dying or that either you or the baby have magical powers
• seeing and hearing things that aren't really there (hallucination) – this is often hearing voices telling you to harm the baby

Postnatal psychosis is regarded as a medical emergency.

Contact your GP immediately if you think someone you know may have developed postnatal psychosis. If this isn't possible, call NHS 111 or your local out-of-hours service.

If you think there's a danger of imminent harm to you, your partner or your baby, call your local A&E services and ask to speak to the duty psychiatrist.  

Postnatal OCD

Some women develop a mental health condition called obsessive compulsive disorder (OCD) after giving birth.

An obsession is an unwanted, unpleasant thought, image or urge that repeatedly enters a person's mind, causing them anxiety. A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to prevent an obsession coming true.

For example, someone who is obsessively scared they will catch a disease may feel the need to have a shower every time they use a toilet.

OCD can often be treated with behavioural therapy or medication.

You can read more about prenatal and postnatal OCD on the Maternal OCD and OCD-UK websites.