Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health issues, including possible causes, sources of treatment and support, and advice for friends and family.

What is perinatal depression?

Perinatal depression is depression experienced during pregnancy (known as ante or prenatal depression) or after childbirth (known as postnatal depression). Many people are aware of postnatal depression (PND) but it's less commonly known that you can experience depression during pregnancy as well.

This page covers:

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

The 'baby blues' is a brief period of feeling emotional and tearful around three to 10 days after giving birth, which affects many new mothers. It's natural to feel emotional and overwhelmed after experiencing childbirth and becoming a parent, especially as you're likely to be coping with a lot of new demands on your time and attention, as well as getting little sleep. Although having the baby blues may be distressing, it's important to be aware that it doesn't last long – usually only a few days – and is generally quite manageable.

However, around 10–15 per cent of new mothers develop a much deeper and longer-term depression known as postnatal depression (PND). It usually develops within six weeks of giving birth and can come on gradually or all of a sudden. It can range from being relatively mild to very severe.

What are the common signs and symptoms?

You may experience one or more of the following symptoms:

How you might feel

  • sad and low
  • tearful for no apparent reason
  • worthless
  • hopeless about the future
  • tired
  • unable to cope
  • irritable and angry
  • guilty
  • hostile or indifferent to your husband or partner
  • hostile or indifferent to your baby

How you might behave

  • lose concentration
  • have disturbed sleep
  • find it hard to sleep – even when you have the opportunity
  • have a reduced appetite
  • lack interest in sex
  • have thoughts about death

Some of these experiences – like lack of concentration, disturbed sleep and lack of interest in sex – are all common after becoming a parent, but it's still important to mention them to your doctor if you're concerned you might have PND.

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

What are the treatments?

You may be offered:

  • talking treatments – for example, cognitive behavioural therapy (CBT) or interpersonal therapy (IPT), which are short term therapies recommended by NICE for depression.
  • medication – this is most likely to be an antidepressant. See our pages on antidepressants for more information about individual drugs, and on taking antidepressants while pregnant or breastfeeding. If you have any concerns about taking medication, you can always talk to your doctor. See our pages on talking to your doctor for more information.
  • a combination of both – many people find that taking medication helps them feel stable enough to get the most out of a talking treatment. However, other people find medication or talking treatments alone are more helpful. If there are long waiting lists for talking treatments in your area, your doctor may recommend you try an antidepressant to help you manage your mental health while you wait.

If your depression is very severe, and isn't responding to other treatments, your doctor may suggest electroconvulsive therapy (ECT). As ECT can work very quickly, doctors may suggest it can help you to care for and bond with your baby as soon as possible. See our pages on ECT for more information.

"I experienced antenatal and postnatal depression three times and was given very little professional support... I now can see how invaluable peer support can be alongside professional support."

How can I help myself cope?

Perinatal depression usually gets better in time, although it may take up to a year. Where you feel you can, ask for and accept help from those around you. Love, practical and emotional support from family, friends and community can be vital in helping you to cope.

Living with depression can make it hard to feel motivated to do things to look after yourself – but, if you can, here are some things you can try to help yourself cope:

  • Look after your hygiene. When you're experiencing depression, it's easy for hygiene to not feel like a priority. But small things, like taking a shower and getting fully dressed whether or not you're going out of the house, can make a big difference to how you feel.
  • 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. It doesn't have to take much time – for example, some mood tracking apps can be used on your phone.
  • 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.
  • Contact specialist organisations. PANDAS offers information and support for people experiencing pre- and postnatal depression. See Useful contacts for other organisations.

For more ideas, see our page on how you can look after your mental health in general when becoming a parent.

This information was published in July 2016. We will revise it in 2019.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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