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Postnatal and antenatal depression

You might experience depression while you're pregnant, or after having a baby.

If it's while you're pregnant, this is called antenatal or prenatal depression. If it's in the year after giving birth, this is postnatal depression (PND). Some people may experience both. 

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.

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 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 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.

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

Signs and symptoms of perinatal depression

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
  • 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 feelings

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 about perinatal depression.

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.

Treatments for perinatal depression

If you're worried that you're experiencing perinatal depression, talk to your GP or health visitor. Your doctor should discuss treatment options with you, so you can make a decision together about what's best for you.

See our pages on seeking help for a mental health problem for more tips, including how to speak to your doctor. 

Talking therapy

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

If there are long waiting lists for talking therapies in your area, your doctor may recommend that you 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 and suggested this was an inevitable fall after years of trauma. 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.

Medication

Your doctor may offer you medication if you have a history of mental health problems. Or if you're experiencing moderate or severe symptoms.

They may also offer medication if your symptoms haven't improved after trying other treatments.

If you're offered 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 well enough to get the most out of talking therapy. But other people find medication or talking therapy are more helpful on their own.

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

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.

Electroconvulsive therapy (ECT)

If you have very severe depression which doesn't respond to other treatments, your doctor may suggest electroconvulsive therapy (ECT). Your doctor may also suggest ECT if your health is at risk. Or if 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. You can speak to your doctor about this.

See our page on treatments for depression for more information. 

This information was published in March 2024. We will revise it in 2027.

References and bibliography available on request.

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