Puerperal Psychosis & related illnesses

Post Natal Depression

Background

Post Natal Depression is a chronic illness. All chronic means is that it lasts quite some time - i.e. it's not a temporary thing like the Baby Blues. As a very rough guide, if you've had the baby blues for more than two weeks and it hasn't gone away, there is a chance you might have post natal depression.

If you're worried, see a doctor or talk to your health visitor or midwife. They can point you in the right place to get you through it. And do tell your partner so he can do his best to support you.

About 1 in 10 mums get post natal depression - it's very common.

Common symptoms

Depression is actually a complicated illness, and traditionally it is scored in an appointment with a doctor or a psychiatrist to assess how severe the depression is, or even if it exists. Depression has a long list of symptoms, some of which are physical, some of which are purely psychological.

Psychological symptoms

Physical symptoms

What causes it?

Hormones

There's a theory that the same thing is to blame for post natal depression as for the baby blues: a lack of cortisol in the blood. The theory goes that women who get post natal depression can't make the hormone GCH in sufficient quantities to cope, so they can't cope spiral into depression.

This information is adapted from © DISCOVER, December, 1995

Don't forget that having a baby is an emotionally and a physically trying time. The change in hormones, plus the added responsibility of looking after the baby is enough to trigger this condition in some women.

Genetics & history

There is a genetic element to depression and post natal depression. Likewise if you've suffered either before, statistically you're more likely to suffer again ... but that doesn't mean you will!

In our NHS Trust, it's routine for a mum-to-be to fill in a form for the midwife that details information about her. This information includes:

If you're predisposed to having depression - you've suffered it before, or you know someone who's directly related to you who's suffered, your midwife and health visitor should pay you special attention to make sure it's caught early if you're unlucky.

How long does it last?

Unfortunately there is no answer to this question. Post Natal Depression can last a long time - six months or more, but it can also be relatively short lived. It really is down to the woman: how well she responds to treatment and how supportive her family and partner are.

Treatment

Post Natal Depression, once identified, is highly treatable. You will get better, but it might take some time. You need to understand that with mental health, there is no "one size fits all" solution. You can't just pop pills and feel better - it needs a lot more work than that.

Counselling

Do not underestimate this! Counselling can work for you, and it is very powerful. It works by facilitating you to talk about your thoughts, your feelings and to explore them. What you do about them is entirely your own choice, but by drilling down to the "whys", you can make decisions about what you do about them.

The BCAP's definition of counselling says that counselling is always at the request of the client as no one can properly be 'sent' for counselling.

It is, though, something a doctor can recommend. Indeed, it is probably something they should recommend.

Depressive illnesses in general respond very well to this kind of treatment.

Drug treatment

Drugs work best with counselling. The drugs that are offered are typically Prozac (Fluoxetine), Seroxat (Paroxetine) or Effexor (Venlafaxine). These are all antidepressant drugs and work by increasing the levels of serotonin in your brain.

Serotonin is often called the "happy hormone", hence antidepressants are often called "happy pills". That's not strictly true. A common misunderstanding is that they work immediately. The don't, which is why counselling is still very important. In fact, if you're given antidepressants, you'll be taking them for a number of months - the changes that they cause in the brain take time. But if you give them the time, odds are they will work.

ECT

You shouldn't need this, as it's only used in very severe cases - almost certainly those worse than yours. ECT stands for electro- convulsive therapy and, in a nutshell is an electric shock delivered to your brain. If this is offered to you, don't panic, because apart from being very effective, it is also painless.

ECT is one of those things that works, but no one really understands why. The easiest way to think of it is like the reset button on a computer, or jump-starting a car.

Do I have Post Natal Depression?

If you're worried, tell your midwife, health visitor or GP. If you feel uncomfortable about it, talk to your partner or to your family. Be honest. If you feel miserable and that you can't cope, tell someone. It's a common and very treatable condition, and there really is no need for you to suffer: but if you don't ask for help, you might not get it.

Don't be embarrassed about it, and don't be frightened that you might have it. If someone diagnoses you with post natal depression, it can actually be a relief to know that you have a condition that thousands of women share ... and that you will eventually get better.

If you want to talk anonymously, use the Samaritans on 08457 909090, or post a message in this site's forum.

Helping someone with Post Natal Depression

Firsty, be there. Don't be shocked, horrified or disappointed: be the shoulder to cry on, and encourage her to get help. Help out with the baby and anything else she doesn't feel able to do, but do not take over as this may well feed any feelings of worthlessness. The last thing she's going to want to see is you doing everything, so encourage but do not force her to muck in.

Read up on the condition to help you understand. Talk about it and if you are worried about yourself or her, call the midwife or health visitor, or the Samaritans if you need absolute anonymity. You can also talk about it in this site's forum.