Treating postnatal depression

Having a baby can be an exciting time, but it can also be an emotional time whilst you get used to adjusting to new routines and responsibilities. If you are feeling low, anxious or very tearful this can sometimes lead to postnatal depression, you may need to get help from your GP.

You can also talk to your health visiting team who can identify, support and help you to manage low to moderate mood.  With the right support and treatment, the majority of people make a full recovery from postnatal depression over time.

Treatment takes three main forms:

• Self help
• Therapy
• Medication

Self help

There are a number of things you can try yourself if you are experiencing low mood.  Many parents say these things have made a difference and improved their symptoms.

• Talk to your partner, to friends and to family members you are happy to confide in – try to help them understand how you’re feeling and what they can do to support you
• Don’t try to do it all alone – it’s fine to say yes to help from others when it’s offered. Ask someone to help with tasks such as housework, cooking and shopping
• Make time for yourself – try to do activities that you find relaxing and enjoyable, such as going for a walk, listening to music, reading a book or having a warm bath
• Try relaxation techniques, breathing exercises and mindfulness. Take a look at these resources from the NHS.
• Rest when you can – although it can be difficult when you’re looking after a baby, try to sleep whenever you get the chance, follow good sleeping habits and, if possible, ask your partner to help with the night-time feeds
• Eat regular, healthy meals and don’t go for long periods without eating. If you are breastfeeding, we’ve got some great healthy eating tips
• Exercise regularly, even something as simple as going for a walk can help boost mood in people with mild depression
• Your health visiting team can point you in the direction of useful books or online resources for more information
• You may benefit from a referral to an agency such as Home Start. Talk to your health visiting team for more information

Therapies

If or when self help is not enough, then talking therapy may beneficial. For more severe cases of depression, talking therapy may be combined with medication.  Talk to your GP and Health Visitor who can make a referral for you. You might be able to self-refer to talking therapies in your area.

Talking

Talking about your feelings can be helpful, however low you are. Sometimes, it’s hard to express your feelings to someone close to you. Talking to a trained counsellor or therapist can be easier. A therapist can also help you to understand and make sense of your feelings.

Health visitors are also trained to offer support to mums and birthing partners who may be struggling with postnatal illness. When you have contact from a health visiting team, they will talk to you about how you’re feeling emotionally. They will ask you three questions:

1. During the last month have you often been bothered by feeling down, depressed or hopeless?
2. During the past month have you often been bothered by having little interest or pleasure in doing things?
3.  Is this something you feel or want help with?

If you answer yes to any of these questions, they may support you to complete a further screening questionnaire. This helps them to assess how you’re feeling and help you to talk through any issues. They will talk to you about the best way to get help and will refer you for specialist help if you need it.

Cognitive Behavioural Therapy (CBT)

CBT is a specialised psychological treatment.

It can help you to see how some of your ways of thinking and behaving may be making you depressed. You can learn to change these thoughts, leading to an improvement in your other symptoms. Find out more about what to expect from CBT sessions from the charity Mind.

Find your local services here.

Counselling and psychotherapies

Other psychotherapies can help you to explore your depression by looking at your relationships or what has happened to you in the past.

Some counselling and psychotherapy services will see you more quickly if you have recently had a baby. Ask your GP or health visiting team about services in your local area.

Medication

If your symptoms haven’t improved with support or a talking therapy, your GP may prescribe medication.

There are several types of antidepressants.  They all work equally well, but have different side-effects. They are not addictive and can all be used safely to treat postnatal depression.

Antidepressants take at least two weeks to start working and you’ll need to continue taking them for around six months after you start to feel better. If you’re thinking of stopping the course of medication early, see your GP. Don’t just stop.

Antidepressants and breastfeeding

Make sure that your GP knows that you are breastfeeding. For many antidepressants, there is no evidence that they cause problems for breastfed babies, so breastfeeding is usually possible, but you’ll need to talk it through with your GP.

Some antidepressants have been used in breastfeeding for many years and your GP can provide up-to-date information and advice.

Existing mental health illnesses

For people with existing mental health issues, having a baby can bring real challenges. You may need further support from your mental health team, or specialist care from a perinatal mental health service.

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If you are in the care of mental health services, it’s a good idea to talk to your mental health practitioner if you’re planning a pregnancy, having a baby or looking ahead to the birth of your baby. They can go through treatment and support options with you, so it’s important to be honest with them.

If you are pregnant, you may be offered an antenatal contact, after 28 weeks pregnancy, from your health visitor who will ask about your mental health.

Useful links

• Association for Post Natal Illness: Provides telephone helpline, information leaflets and a network of volunteers who have themselves experienced postnatal depression. Helpline number: 020 7386 0868
• Depression Alliance: Information, support and understanding for people who suffer with depression, and for relatives who want to help. Self-help groups, information, and raising awareness for depression. Tel: 020 7407 7584. Email: info@depressionalliance.org
• Cry-sis: Provides self-help and support for families with excessively crying and sleepless and demanding babies. Helpline number: 08451 228669
• Family Action: Support and practical help for families affected by mental illness, including ‘Newpin’ services – offering support to parents of children under-5 whose mental health is affecting their ability to provide safe parenting. Tel: 020 7254 6251
• Home Start: Support and practical help for families with at least one child under-5. Help offered to parents finding it hard to cope for many reasons. These include PND or other mental illness, isolation, bereavement, illness of parent or child. Tel: 0800 068 6368
• National Childbirth Trust: Support and information on all aspects of pregnancy, birth and early parenthood. Local groups and telephone helplines. Helpline number: 0300 330 0700
• Netmums: A website offering support and information on pregnancy and parenting. There is a specific section on offering support. There is also information on local resources and support groups.
• PANDAS Foundation: An organisation that helps individuals and their families with pre and postnatal depression advice and support. They also offer support to families in the antenatal period. Helpline number (open 9am to 8pm): 0843 2898401
• The Samaritans: Confidential emotional support for those in distress and are experiencing feelings of distress or despair, including suicidal thoughts. 24-hour helpline number: 08457 90 90 90 (UK) or 116 123 (Ireland). Email: jo@samaritans.org
• Relate: Relationship support including couple and family counselling. Face-to-face, telephone or online counselling. Tel: 0300 100 1234
• Reaching Out