Postnatal and antenatal depression

Developing depression after having a baby, or while pregnant, is more common than many people realise. But with the right support and treatment, you can get better.

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

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

The 'baby blues' is a brief period of low mood, feeling emotional and tearful around 3 to 10 days after birth.

You're likely to be coping with lots of new demands and getting little sleep. It's natural to feel emotional and overwhelmed. This feeling usually only lasts for a few days and is generally manageable.

Postnatal depression (PND) is a much deeper and longer-term depression. This usually develops within 6 weeks after birth. It can be gradual or sudden. And it can range from being mild to very severe.  So it's important to know the signs.

Signs and symptoms of perinatal depression

Signs that you may have postnatal or antenatal depression include feeling:

• 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
• That you find no pleasure in life or things you usually enjoy
• A sense that things don't feel real
• No self-confidence or self-esteem
• Hopeless and despairing
• Hostile or indifferent to your partner
• Hostile or indifferent to your baby
• Suicidal

You may also 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 you can still mention them to your doctor if you're worried that it's a sign of something more serious.

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.

Treatments for perinatal depression

If you're a new or expectant parent it can be difficult to share what you're struggling with. You might feel:

• Pressure to be happy and excited
• Worried you're a bad parent, or that others will judge you 
• Like you should focus on your baby instead of yourself
• Like you ought to be managing everything well
• Scared that someone will take your baby away from you, if you're open about your feelings

But having mental health problems is not your fault. You can ask for help – and treatment is available. 

If you're worried, talk to your GP, midwife or health visitor as soon as possible. Together you can make a decision about what's best for you.

The most common treatment options are therapy and antidepressant medication.

Our self-care tips for pregnancy and after having a baby also has some tips for helping yourself.

Therapy and counselling

Your doctor may offer you some therapy, such as cognitive behavioural therapy (CBT). This is a short-term therapy recommended to treat depression. We have more information on therapy and counselling, including finding a therapist.

If there are long waiting lists for talking therapies in your area, you can also try an alternative to therapy. These can help you manage your mental health while you're on the waiting list.

I had CBT sessions with a wonderful psychologist who taught me how to think differently... She made me feel it was okay to not to feel okay, that my depression was justified, that I didn’t need to feel guilty. It was like coming out from a very dark place into a world of sunlight and joy and it was the best feeling ever.

Antidepressant medication

Your doctor might offer to prescribe you some antidepressant medication.

This is more likely if:

• Your symptoms are moderate or severe
• Your symptoms haven't improved after trying other treatments
• You have a history of mental health problems

If you have concerns about taking medication, you can get advice from your doctor or pharmacist. We also have information about taking antidepressants while pregnant or breastfeeding.

A combination of therapy and medication

Some people find that taking medication helps them feel well enough to get the most out of talking to a therapist. And if you're on a therapy waiting list, medication could help while you wait.

But other people find medication or talking therapy are more helpful on their own.

If your symptoms haven't improved with either therapy or medication alone, your doctor may suggest that you try both together.

What if treatment doesn't help, or isn't suitable for me?

If the treatment you've got in place isn't working, and you are severely unwell – talk to your doctor again. These are some options to consider.

Specialist community mental health team

You may be referred to a specialist community perinatal mental health team. This is for people with severe postnatal depression where treatment isn't helping.

If you're referred to this team, you may be offered additional treatments. This may include more intense CBT, different talking therapies, and other types of medication.

I began to have suicidal thoughts. I had a plan of how to end my life. It wasn’t that I wanted to die, I just saw no value in me being alive. It was at this point that I knew I had to see the GP.

Electroconvulsive therapy (ECT)

If you have very severe depression which doesn't respond to other treatments, your doctor may suggest electroconvulsive therapy (ECT). 

This isn't suggested often. But it's more likely if:

• Your physical health is at risk
• Your baby's health is at risk

ECT can work very quickly, so doctors may advise 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 may come with higher risks. 

Read our information about electroconvulsive therapy (ECT) to learn more.

Published: April 2024

Next review planned: April 2027

References and bibliography available on request.

If you want to reproduce this content, see our permissions and licensing page.