Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health problems, including possible causes, treatments and support options. Also has information for friends and family, including support and advice for partners.

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What is perinatal depression?

If you experience depression while you are pregnant or after giving birth, this may be known as:

antenatal depression – while you are pregnant
postnatal depression (PND) – during roughly the first year after giving birth
perinatal depression – any time from becoming pregnant to around one year after giving birth.

Lots of people are aware of postnatal depression. But it is less known that many people experience antenatal depression, and some people may experience both.

The information on this page is about perinatal depression, so it is relevant if you are experiencing either antenatal or postnatal depression. It covers:

What's the difference between the 'baby blues' and postnatal depression?

The 'baby blues' is a brief period of low mood, feeling emotional and tearful around three to 10 days after you give birth. You are likely to be coping with lots of new demands and getting little sleep, so it is natural to feel emotional and overwhelmed. This feeling usually only lasts for a few days and is generally quite manageable.

Postnatal depression is a much deeper and longer-term depression. This usually develops within six weeks of giving birth and it can be gradual or sudden. It can range from being mild to very severe.

Signs and symptoms of perinatal depression

These are some of the common signs and symptoms of perinatal depression:

How you might feel

If you have perinatal depression, you might feel:

down, upset or tearful
restless, agitated or irritable
guilty, worthless and down on yourself
empty and numb
isolated and unable to relate to other people
finding no pleasure in life or things you usually enjoy
a sense of unreality
no self-confidence or self-esteem
hopeless and despairing
hostile or indifferent to your partner
hostile or indifferent to your baby
suicidal feelings.

"I found it hard because whilst people talk about postnatal depression there is very little discussion of mental ill health in pregnancy and it's supposed to be such a joyful time."

How you might behave

If you have perinatal depression, you might find that you:

lose concentration
find it hard to sleep, even when you have the chance
have a reduced appetite
lack interest in sex.

Some of these experiences are common during pregnancy and after becoming a parent. But it's still important to mention them to your doctor if you're concerned you might be experiencing perinatal depression.

"I felt selfish and guilty for feeling negative and low. This made me isolate myself further and compounded the problem."

Treatments for perinatal depression

There are various treatments that you may be offered for perinatal depression. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you:

Talking therapy

The talking therapies you may be offered include cognitive behavioural therapy (CBT) or interpersonal therapy (IPT). These are short-term therapies recommended to treat depression.

Medication

This is most likely to be an antidepressant. If you have any concerns about taking medication, you can talk to your doctor or pharmacist. We also have information about taking antidepressants while pregnant or breastfeeding.

A combination of talking therapy and medication

Some people find that taking medication helps them feel stable enough to get the most out of a talking therapy. But other people find medication or talking therapies are more helpful on their own.

Sometimes there may also be long waiting lists for talking therapies in your area. Your doctor may offer you an antidepressant to help you while you wait for therapy.

Electroconvulsive therapy (ECT)

If you have very severe depression which doesn't respond to other treatments, your doctor may suggest electroconvulsive therapy (ECT). ECT can work very quickly, so doctors may suggest that you have it shortly after giving birth. This is to help you care for and bond with your baby as soon as possible.

ECT can be used during pregnancy, but there may be concerns about giving you anaesthetic while pregnant. You can speak to your doctor about this.

See our page on treatments for depression for more information.

"Whilst I was worried about getting PND, I wasn't expecting to become so unwell in pregnancy. It was a mixture of hormones, lack of medication, worries about giving birth and sickness in the first trimester that contributed to my illness."

Self-care for perinatal depression

Experiencing perinatal depression can be very difficult, but these are some steps you can take that might help:

Be kind to yourself

You might have many expectations for yourself as a parent, but none of us can meet all our expectations all the time.

Don't beat yourself up if you don't do something you planned to, or if you find yourself feeling worse again. Try to treat yourself as you would treat a friend, and be kind to yourself.

Keep a mood diary

This can help you keep track of any changes in your mood, and you might find that you have more good days than you think. This can also help you notice if any activities, places or people make you feel better or worse.

See our useful contacts page for links to online mood diaries, including mood tracking apps to use on your phone.

Look after your hygiene

When you're experiencing depression, it's easy for hygiene to not feel like a priority. But small things can make a big difference to how you feel. For example, you could take a shower and get dressed, even if you're not going out of the house.

Speak to people with similar experiences

Often we can feel that we are the only ones feeling how we do. There are peer support and advice groups available to share thoughts, feelings and experiences.

Contact Mind's Infoline or visit a local Mind to find out about peer support options in your area.

Contact specialist organisations

PANDAS offers information and support for people experiencing antenatal and postnatal depression. See our useful contacts page for other organisations that can help.

Ask for help

Where possible, ask for and accept help from those around you. Practical and emotional support from family, friends and community can be vital in helping you to cope.

For more ideas, see our page on ways to look after your mental health when becoming a parent.