Many women experience mood swings after the birth of a baby. However, postnatal depression (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 on a daily basis with normal routines including caring for a baby.
It is important to note that PND is different from the baby blues that are common during the first week after childbirth.
For around one in seven women the stresses and emotional changes that accompany their postnatal experiences can be intense and include strong depressive mood swings, anxiety, social withdrawal, irritability and loss of enjoyment in usual activities. Postnatal disorders can interfere with the developing relationship between a mother and her baby after birth (bonding and attachment) and impose strains upon the relationship between the parents as well as causing distress for women themselves.
Severe disorders require treatment and it is very important to tell your doctor or midwife about current symptoms of distress as well as any past history or medication use.
Different types of PND
It can be helpful to know that there are different types of PND. Why? Because not only can the symptoms vary between the different types but they tend to respond best to different treatment approaches. Two main types will be discussed here:
i. Melancholic depression
Melancholic depression is relatively uncommon and affects only 1- 2 % of adults over their lifetime. This is usually a more severe form of depression than the other type of depression (non-melancholic depression) and has a more distinct genetic and biological basis. Someone who is pre-disposed to melancholic depression might have an episode of depression triggered by a stressful life event (e.g a death in the family) but this is not usually the primary cause of their depression.
Specific symptoms of melancholic depression usually include slowed cognitive processes, poor concentration, and psychomotor disturbance (agitation or slowing of physical movements) in addition to the features listed below for the non-melancholic type of PND.
Melancholic depression responds best to medical treatment such as antidepressant medication, and is less responsive to counselling or psychotherapy although the latter should complement medical treatments. Medical assessment is required as this type of PND rarely goes away without medical treatment.
ii. Non-melancholic depression
Non-melancholic depression is the most common form of PND and is linked more with psychosocial risk factors than genetic and biological causes. These disorders do not have biological or melancholic features though the depression can still be severe. This type of depression is more likely to respond to psychological approaches to treatment although medication may also be used when symptoms are severe.
Symptoms of PND
Symptoms of anxiety and depression that start during pregnancy or the postnatal period are similar to those that occur at any other time in a womanís life, but the focus of the fears and depressive concerns can be the wellbeing of the baby, or feelings of inadequacy as a parent.
As mentioned above, the major symptoms of PND can vary according to whether you have a melancholic type of depression or a non-melancholic type. Women with a melancholic type of PND will tend to experience more disturbances in their cognitive and psychomotor processes (showing a slowing of movements or agitation) than women with non-melancholic depression. Other symptoms common to both the melancholic and non-melancholic types may include:
- loss of enjoyment in usual pursuits
- loss of self-esteem and confidence
- loss of appetite and weight
- broken sleep (irrespective of baby)
- sense of hopelessness and being a failure
- a wish not to be alive
- frank suicidal thoughts or ideas
- panic attacks
- loss of libido
- fears for babyís or partnersís safety or wellbeing.
If you are experiencing any distressing symptoms that are causing you concern your Doctor, Midwife, or Child and Family Health Nurse can provide you with assistance or arrange for you to see a specialist.