This thread is Part 1 of 2 on today's topic of Postnatal Depression. In Part 1 below you will find information on what PND is, as well as factors that contribute to it.
In Part 2 you will find information on the Symptoms, Effects and Treatment of PND.
Postnatal Depression (PND)
PND describes the more severe or prolonged symptoms of depression (clinical depression) that last more than a week or two and interfere with the ability to function with normal routines on a daily basis, including caring for a baby. (Factsheet; Depression during pregnancy and the postnatal period, The Blackdog Institute) More than 15% of women and 10% of men develop postnatal depression. Many women do not know that postnatal depression can occur after delivery and typically blame themselves, their partners or their baby for the way they feel. Some try hard to “snap out of it” without understanding that women with postnatal depression have little control over the way they are feeling. It is very important for women and their partners to learn to recognise the signs and symptoms of postnatal depression so that they can ask for help as early as possible. (Factsheet: Postnatal Depression, PANDA)
Postnatal depression is difficult to identify
Society makes it difficult for a woman to acknowledge that she may be experiencing postnatal depression. She is constantly confronted by messages about joy and bliss but not about the challenges that come with motherhood. The media tends to reinforce the unrealistic expectations of motherhood, for example promoting celebrities who appear to be coping exceptionally well.’ Added to this is the stigma of depression, with postnatal depression often being portrayed in a negative and sensational way. Women will put on a brave face and go to extraordinary lengths to hide how they feel. A woman who is not coping can feel very alone and can find it hard to come to terms with her feelings. (Factsheet: Postnatal Depression, PANDA)
Contributing factors for PND
Some parents are more vulnerable to PND than others. Parents experiencing some of the known contributory factors should be encouraged to talk with their doctor and family. It is important to remember that it is the individual meaning and response to these factors that needs to be discussed and assessed.
- Genetic predisposition to depression
- Sudden changes in pregnancy hormones following delivery
- Nutritional deficiencies
- Difficult or highly medicalised pregnancy or childbirth experiences
- History of pre-menstrual tension
- Previous experience of PND
- Family/personal history of mental health conditions such as depression, bipolar disorder or schizophrenia
- Sleep deprivation
- Infertility and use of IVF for conception
- Difficult or traumatic birth (perhaps involving unexpected interventions such as an emergency caesarian)
- Traumatic or abusive childhood (particularly sexual abuse)
- Unrealistic expectations of motherhood and of herself
- Certain personality types (perfectionist or controlling)
- Limited social and emotional skills (difficulties in effective communication)
- Past unresolved issues of grief and loss such as previous miscarriage)
Effects of postnatal depression
- Lack of family and community support
- Problematic or unresolved relationships
- Difficult couple relationship
- Partner who is removed emotionally, works long hours or travels
- Intrusive or difficult family relationships
- Social isolation
- Financial hardship
- Lack of close friends, particularly families with children
- Moving house
- Lack of access to transport
- Being of younger or older age
- Stressful life events such as a death in the family or a job loss (Factsheet: Postnatal Depression, PANDA)
If postnatal depression is not identified or treated the toll it takes on the woman, her baby, partner, family and extended relationships increases. It does not usually resolve itself fully without treatment and she may experience future episodes of depression and mental illness. Many women with postnatal depression are very close to their babies despite how they feel. For others, if postnatal depression is ongoing they may struggle to connect with their baby. This can have an impact on the wellbeing of the baby. With early identification and intervention most women fully recover from postnatal depression and there are no long term effects. (Factsheet: Postnatal Depression, PANDA)
Effects on the woman
Effects on the mother-infant relationships
- There can be significant impact on the woman’s psysical wellbeing - -poor diet, lack of sleep, altered activity levels and exhaustion.
- Depression and anxiety may be expressed in physical symptoms such as pain, headaches, chest pain, difficulty breathing or feeling sick.
- Ongoing depression and high anxiety levels reduce the body’s immunity and ability to fight infection.
- Unresolved or future episodes of depression or complicated mental health problems.
- Suicide is a leading cause of maternal mortality in the UK and probably also in northern Europe.
Effects on the infant
- PND can interfere with behavioural and emotional mother and infant interactions.
- A woman with PND may be less sensitive to her infant’s needs and less appropriately responsive to his communications.
- There can be attachment difficulties between the mother and infant that effect her ability to parent.
- Severe PND has been claimed to contribute to child abuse and neglect.
Effects on the partner relationship
- Difficulties in mother-infant interaction may lead to increased fussiness or withdrawal and have an impact on the development of the infant’s brain pathways.
- PND can impact on the child’s future cognitive and language development as well as social competence and mental health.
- The child may go into adulthood with behavioural and mental health problems and experience difficulties parenting their own children.
Effects on family relationships
- Living with a woman experiencing PND is difficult. Her partner can be the target for much of her frustration and distress, her intense needs within the relationship and her partner’s struggles to know how to best provide support can result in conflict.
- Partners often feel confuse, lost and helpless and are at increased risk of developing depression and anxiety. They may manage this with increased use of alcohol, drugs, withdrawal or extended hours at work.
- They benefit from counselling, support from their family and friends and from other people with similar experiences such as men at PND support groups.
- Partners benefit from understanding more about what is happening to the woman. It is important that they are included by the health professionals who are treating women with PND. Partners tend to be more supportive if they understand what the problem is and what they can do to help.
Extended family members may worry about the new mother and become exhausted by providing practical and emotional support. (Factsheet: Postnatal Depression, and Guide to Postnatal Depression Support Groups, PANDA)
- Parent-child relationships may be damaged due to the woman’s withrawal or volatility with her children, parental conflict and inconsistent parenting, often at a time when they need her the most (toddlers and pre-schoolers)
- Extended family relationships may become strained due to a lack of understanding of PND and the family may be unhelpful and provide only conditional support.
Advice for Partner, Family and Friends
Please see separate thread/post about Advice for Partner, Family and Friends
PND and Breastfeeding
Please see separate thread/post about PND and breastfeeding
With thanks and gratitude to MuminMind, our Ambassador for PND, for compiling this information.