Postnatal Depression – The Facts

by Women’s Health Queensland Wide.

Each year, tens of thousands of Australians are affected by postnatal disorders. These disorders do not only impact on the lives of women themselves but also on all those close to them, their partners, children, other family members and friends. Yet, many members of our community are quite unaware of the signs and symptoms, or even the existence of the conditions.

There are three different types of postnatal disorders:

The postnatal ‘blues’ or ‘baby blues’
Postnatal ‘blues’ is a brief period of emotional distress, which occurs around 3-10 days after delivery in up to 80 percent of all women who give birth. Women with the ‘baby blues’ feel very emotional and may be tearful, irritable or anxious. The ‘blues’ is thought to be caused by several factors including the sudden changes in hormone levels after childbirth, anxiety about the transition from hospital to home and breastfeeding, and sleep deprivation. The ‘blues’ is a transient state and generally disappears within a few days.

Postnatal depression
Postnatal depression (or PND) is sometimes confused with the more common postnatal disorder ‘baby blues’. However, there are important differences between the two. In postnatal depression the symptoms are more severe and persist for longer. Between 10 and 20 percent of women who give birth will suffer from postnatal depression, which can develop following the birth of any child, not just the first.

According to research, women may even experience depression during pregnancy (ie. antenatal depression). Depression at this time can predispose a woman to postnatal depression.

Postnatal psychosis
This is a rare and severe postnatal disorder, affecting only 1-3 of every 1000 mothers.

The remainder of this article will focus on postnatal depression.

While the baby blues occurs soon after delivery, PND can occur at any time in the first year following childbirth, but usually arises in the first four months. The symptoms of PND differ for each woman and are not just limited to feelings of depression and sadness. Many women experience feelings of inadequacy and worthlessness and think that they are a failure as a mother. Other women feel very angry, resentful or irritable. Women who expected to be extremely happy and fulfilled at this time in their life often feel guilty or ashamed about these emotions.

It is also common for women to experience confusion and a lack of concentration or memory difficulties. These symptoms can make performing simple tasks difficult, leaving her feeling frustrated as well as mentally exhausted. PND can also interfere with a woman’s decision making and problem-solving skills. All these factors magnify her feelings of inadequacy and inability to cope.

For some women, postnatal depression is characterised by anxiety that can result in panic attacks or phobias. Women who experience the sweats, dizziness, pounding heart and breathing difficulties commonly associated with anxiety disorders may often initially believe that they are experiencing a heart attack or that they have some other life threatening illness. The presence of these symptoms may mean that women do not initially consider that they have postnatal depression, believing that they are suffering from a purely physical condition.

Other symptoms of PND include changes in appetite and weight (such as over-eating, under-eating, weight gain or loss) and sleep disturbances that are unrelated to the baby (early morning awakening, sleeping excessively or insomnia). Women also commonly report feeling constantly exhausted and wanting to withdraw socially. Another symptom of PND that is important to recognise is the loss of interest in sex. This can be upsetting for a woman and can also create misunderstanding or conflict within her relationship with her partner.

What causes PND is still unclear, but it appears that, rather than a single cause, a range of factors (biological, psychological and sociocultural) contribute to its development. These factors also differ greatly between women as individuals have different life experiences, circumstances and ways of coping with stressful life events. While it is important that women have some understanding of what factors may have put them at risk of postnatal depression, determining the cause/s should not become the focus.

Treatment for PND depends largely upon the severity of the woman’s condition and her individual circumstances. The first step is to contact a health professional, whether it be a general practitioner, child health nurse or midwife. Often this is a difficult step for a woman as she may feel embarrassed or ashamed to tell someone that she is not coping. Sometimes a woman’s partner, family or friends may need to assist her in seeking help. It is important to seek treatment for PND as soon as possible, as the sooner treatment is commenced, the shorter the recovery time.

A health care professional can determine the most appropriate form of treatment and, if necessary, see that the woman is referred to other relevant health professionals, such as a psychiatrist, psychologist or counsellor. If a woman finds that the health care professional that she contacts is unsympathetic she may need to consult another, in order to find someone who listens to her concerns and with whom she feels comfortable.

Medication, psychotherapy and counselling are all used in treating PND. It may be recommended for some women with severe PND to be hospitalised for a period of time. The thought of hospitalisation can be very frightening, but it often provides a vital step to recovery. Mother-baby units, where mother is admitted with the baby, are available at some hospitals. Complementary therapies and help from a support group can also be useful in managing postnatal depression. Women with PND do recover, but recovery is a gradual process.

Women with a history of PND should be closely monitored during subsequent pregnancies due to the risk of recurrence.

Hopefully, creating better awareness of PND within our society will lead to an improved understanding of the illness and its effect on women and their loved ones. Greater recognition of the illness will allow women or their partners, family and friends to seek help early and, therefore, assist in the recovery process.


Understanding Postnatal Disorders
By Women’s Health Queensland Wide and Women’s Infolink

Understanding Postnatal Disorders aims to provide a brief, easy to read overview of some of the issues surrounding postnatal disorders, especially postnatal depression.

The booklet is designed for women with postnatal disorders as well as their partners, family and friends. It does not seek to provide a comprehensive discussion of postnatal disorders, but rather an introduction to some of the main areas of interest.

Understanding Postnatal Disorders outlines the different types of disorders, possible risk factors for postnatal depression and its impact on relationships. It explores the myth of motherhood and covers information on steps for recovery. The booklet also contains personal stories from people who have experienced postnatal depression as well as resource lists.

Individuals can access hardcopies of this booklet for free from Women’s Health Queensland Wide. The booklet is also available on the Centre’s website. See details below.

The following books are available for free loan from Women’s Health Queensland Wide. For more titles and to request a book online, see the searchable library catalogue on the Centre’s website or call Women’s Health Queensland Wide.

Postnatal Depression: Families in Turmoil
By Lara Bishop

Postnatal Depression: Families in Turmoil details one woman’s courageous struggle to overcome PND. The book presents information about PND, its signs and symptoms, risk factors, diagnosis, treatment and support avenues. It also includes personal stories from women and their partners.

Postnatal Depression: A Practical Guide for Australian Families
By Lisa Fettling

The book is divided into five chapters: Signs and symptoms of PND; Professional help; Help yourself, help from family and friends; Men, too, live with PND and Understanding PND. The strength of the book is in its factual information, illustrated by excerpts from personal stories of over 200 people who have experienced PND or its effects. In addition, the professional help chapter contains comments from health professionals who treat women with PND. These stories make the book easy reading, a must for women with PND who often find concentrating on large tracts of text difficult.

Postnatal Depression: Your Questions Answered
By Erika Harvey

Author, Erika Harvey, follows a similar format to other books on PND, including information on what PND is, contributing factors to PND, treatment options and tips on looking after yourself. The book also includes some general parenting information such as problems with breastfeeding and sleeping difficulties, hurdles that many parents face but ones that can become extremely stressful for those also trying to cope with PND. The inclusion of a chapter dedicated to PND and ‘special babies’, examining multiple births, births involving assisted conception and for those who have a baby who is ill or disabled, is a useful addition.

Depression After Childbirth: How to Recognise, Treat and Prevent Postnatal Depression
By K. Dalton

Surviving the Baby Blues: Recognizing, Understanding and Overcoming Postnatal Depression
By J. Feinmann

On Thin Ice: Experiences of Australian Women with Pre and Post Natal Depression
By S. Hauptberger

This Isn’t What I Expected: Overcoming Postpartum Depression
By K.R. Kleiman & V.D. Raskin

Postnatal Depression: Facing the Paradox of Loss, Happiness and Motherhood
By P. Nicholson

Postpartum Depression: Every Woman’s Guide to Diagnosis, Treatment and Prevention
By S.L. Roan

Postnatal Disorders Support Group
This site also provides links to other support organisations.

Women’s Health Queensland Wide
Tel: 07 3839 9962 or toll free 1800 017 676 (from outside Brisbane)

Women’s Health Queensland Wide provides free health information and education services for women throughout the State. The services include a health information line, lending library, health information resources and women’s health seminars. The Centre also has a database of health care providers/services with an interest in PND.