When it comes to treating postnatal mental ill health, you need to get help from your GP. You can also talk to your public health nurse (health visitor) who is trained to identify and help you manage low to moderate mood. With the right treatment, most women make a full recovery from postnatal depression over time.
Treatment takes three main forms:
- Self help
There are a number of things you can try yourself if you are experiencing low mood. Many women 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 be a ‘super mum’ or ‘wonder woman’ – it’s fine to say yes to help from others when it’s offered. Ask your loved ones to help with tasks like 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
- 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 public health nurse 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 public health nurse for more information
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 public health nurse (health visitor) who can make a referral for you.
Talking about your feelings can be helpful, however depressed 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. It can be a relief to be honest about how you are feeling. A therapist can also help you to understand and make sense of your difficulties.
Public health nurses (health visitors) are also trained to offer support to mums who may be struggling with postnatal illness. When you have your post birth visit from the public health nurse six to eight weeks after the birth, they will talk to you about how you’re feeling emotionally. They will ask you three questions:
- During the last month have you often been bothered by feeling down, depressed or hopeless?
- During the past month have you often been bothered by having little interest or pleasure in doing things?
- 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 questionnaire, called the Edinburgh Post Natal Depression Score. 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.
It’s important to remember that talking treatments are usually very safe, but sometimes they can bring up bad memories from the past, which can make you low or distressed, or affect your relationships with those people close to you. Talking therapies can have long waiting lists. However, many GPs now have a counsellor within the practice, and may refer you to them while you’re waiting.
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.
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 public health nurse (health visitor) about services in your local area, or see the links below:
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, but some are safer than others if you are breastfeeding so discuss this with your GP.
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.
Women with existing mental health illnesses
For women 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.
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 will be offered an antenatal contact, after 28 weeks pregnancy, from the public health nurse (health visitor) who will ask about your mental health. They can help you and your partner to complete the Boots Family Trust – Well Being Plan. Many women have found the plan useful for making sure loved ones know how to support them if they become ill after the birth.
- 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: firstname.lastname@example.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: email@example.com
- Relate: Relationship support including couple and family counselling. Face-to-face, telephone or online counselling. Tel: 0300 100 1234
- Reaching Out
Leicestershire Partnership NHS Trust runs the first dedicated perinatal mental health ChatHealth text messaging service- called Mum’s Mind. This confidential service offers advice and information to support mothers during pregnancy and baby’s first year.
The service operates Monday to Friday between 9am and 4pm, excluding bank holidays. All texts will be responded to by a member of the perinatal mental health team within 24 hours. Outside of the working hours, you’ll receive a message back to inform you that your text will be responded to once the line reopens.
Mum’s Mind: 07507 330 026
The Mum’s Mind service is not a crisis service and does not provide general advice on baby care- this is available through LPT’s original ChatHealth service on 07520 615381 (Leicester city) or 07520 615382 (Leicestershire and Rutland).