What we know about Postnatal Depression
You might not know this, but it is very normal for a woman to experience emotional mood swings after having a baby. In fact, ‘baby blues’ affect around 60-80% of women in the first one to two weeks, and they often involve mood swings, stress, irritability and oversensitivity. However, for one in seven women, these postnatal stresses last longer than this buffing period, and the severity of these emotions is a telltale sign of postnatal depression (PND).
PND is a mental illness that impacts one’s ability to function on a daily basis, and interferes with the development of a relationship between a mother and her baby. Of the 25% of women who suffer from PND, 10-15% will require professional intervention and treatment. We spoke with Mary Williams, Manager of the Brisbane Centre for Postnatal Disorders, to learn a little more about the mood disorder.
WHAT CAUSES PND?
While we don’t yet understand what causes postnatal depression, we do know there are a variety of ‘triggers’ - biological, psychological, social and environmental - that contribute to our mental health.
Melancholic and psychotic types of depression are influenced more by genetic and biochemical processes than by psychological, social or environmental influences. So, a new mum is more likely to suffer from PND if she has a family or personal history of depression, postnatal depression or mental illness. That being said, it shouldn’t be assumed she’ll have PND - but being aware of the risk can help an individual, their family and GP to look out for the warning signs.
Non-melancholic types of PND are linked to the impact of psychological, social and environmental stressors on individuals. Those with non-melancholic depression tend to exhibit lowered self-esteem and heightened mood swings, as well as a change in appetite, fatigue or sleep disturbance.
And aside from these, any difficulties during and after birth can make women more vulnerable to depression. How the birth went can have a huge impact on the relationship between mum and bub, as can a mother’s adjustment to her changing body and environment. After giving birth, your body goes through massive hormonal shifts, and if you’re having issues with breastfeeding or irregular sleep or feeding patterns, this can trigger PND.
PND studies have found certain personality types are more likely to suffer from depression, though there is no hard and fast rule. The most common ‘risk personalities’ are:
- Individuals with high levels of internalised, ongoing anxiety
- Individuals who are highly irritable, with high levels of externalised, ongoing anxiety
- Individuals who avoid social situations or fell anxious around groups of people
- Individuals who are uncomfortable about sharing their feelings or opening up to others
- Individuals with low self-esteem and self-worth
- Individuals with self-imposed high standards and/or OCD-prone behaviour (perfectionists)
- Individuals who are sensitive to rejection and regard their own self-worth based on how they see other people react to them
- Individuals who are self-focused and put their needs before others
THE SYMPTOMS OF PND
The range of symptoms experienced may include:
- Low self-esteem and lack of confidence
- Feelings of inadequacy and guilt
- Negative thoughts and worrying (some women believe their baby would be better off without them or worry the baby doesn't love them or, in some cases, don't love the baby)
- Nonsensical thoughts and erratic behaviour
- Inability to cope or feeling overwhelmed
- Tearfulness and irritability
- Difficulty sleeping or change in sleeping patterns (though Mary says exhaustion and lack of sleep don't necessarily point to PND)
- Loss of appetite
- Anxiety, panic attacks or heart palpatations
- Difficulties concentrating or remembering things
HOW TO TREAT PND
Medication is the most obvious - and effective - form of treatment, along with supportive psychological therapy, such as Cognitive Behavioural Therapy (CBT). When it comes to medication, patients are treated on a case-by-case basis, but CBT is a prolific and integral part of the healing process. Dr Enno Taemets, PND specialist from the Brisbane Postnatal Disorders Centre at Belmont Private Hospital, says “contact is key. We listen to [the patients] in a ‘workshop’ format using CBT to uncover how they are feeling, and to get them to change their thought patterns, mood and behaviours. They need to recognise in themselves that their feelings, actions, behaviours and reactions need to change.” Without supportive psychotherapy, antidepressants won’t help patients to work through the problems they’re facing in the long run.
Antidepressants balance the chemicals in the brain, and Mary says the stigma about taking them needs to change, pointing out: “if there’s a problem with another organ, we’d treat it with medication, so why wouldn’t we do the same for our brain?”
Antidepressants raise serotonin levels, which in turn lifts your mood, encourage sleep and eases irritability and anxiety. So, many women with PND find antidepressants help with their symptoms.
If you’re struggling with PND or suffering from depression or anxiety, go online and take the The Edinburgh Postnatal Depression Scale (EPDS) test. This will help you to identify whether your symptoms are in line with depression and anxiety during pregnancy and in the year following the birth of a child. You should also speak to a professional GP, or contact Beyond Blue on 1300 224 636 or Lifeline on 13 14 11. The most important thing you can do is talk to someone, be it a family member, friend, Doctor or helpline. With help, things will get better.
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