Postnatal Depression and Postpartum Anxiety: The Ultimate Guide


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post natal depression and anxietyEverybody feels horrible at some point when they have a newborn.

But there is a fine line between normal sadness, frustration, exhaustion, fear of the unknown or absolute fatigue, and either postnatal depression or postpartum anxiety.

Postnatal depression and anxiety often go undiagnosed, as parents just think that it is part and parcel of being new parents.

70-80% of women experience negative thoughts after having a baby, this is often called the baby blues and is related to hormones re-balancing in the first few days after birth.

Postnatal Depression and Postpartum Anxiety: The Ultimate Guide

Article includes:

What is Postnatal Depression (PND)?
Postnatal Depression Symptoms
What Causes Postnatal Depression?
Postnatal Depression Treatment
Natural Treatments for Beating Postnatal Depression
What is Postpartum Anxiety?
What causes Postpartum Anxiety?
Postpartum Anxiety Symptoms
Postpartum Anxiety Treatment

What is Postnatal Depression (PND)?

About 1 in 10 women experience post natal depression after having their baby.

Depression can happen any time during pregnancy, or up to a year after your baby is born, and still be called postnatal depression. It can also occur within these time frames after a miscarriage.

The symptoms of postnatal depression usually start within a first few months of the birth, or it can start with the normal “baby blues” that simply do not go away.

Believe it or not fathers can also experience depression at this time, especially if their partner is depressed. Depression in new fathers is often not recognized well and is not usually called ‘postnatal depression’ but that is exactly what it is.  

PND can be totally debilitating for anyone experiencing it, and it can lead to devastating situations if it is left untreated. Depressed people are not in their right mind, they are not thinking straight, and they can do things they would usually not ever dream of doing.

Women often report feelings of wanting to harm themselves or their baby, and that feeling is terrifying. For women that don’t have anyone to talk to about these feelings can be completely overwhelming.

Postnatal Depression Symptoms

These are the most common symptoms of PND

  • No sense of enjoyment
  • Feeling worthless, hopeless, useless
  • Blaming yourself when things go wrong, even if it’s not your fault
  • A feeling of disdain towards, or just no bond with baby
  • Feeling grumpy, irritable or angry
  • Tearful or sad
  • Feeling overwhelmed
  • Tiredness
  • No motivation
  • Can’t think clearly, poor memory and concentration
  • Can’t make decisions
  • Worry a lot
  • Negative thinking
  • Scary thoughts
  • Suicidal thoughts
  • Thoughts of hurting yourself or baby
  • Trouble sleeping
  • Appetite changes
  • Body aches and pains and headaches
  • Feeling hot and cold or “flu” like
  • Loss of sexual interest
  • Not looking forward to things

You can see how so many of these are mistaken for what is to be expected after having a baby. Depression is a continuum, and you can be a little bit depressed and be able to manage the symptoms yourself.

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However, you need to be honest with yourself about what is normal, and what is going too far. Obviously you will feel tired when a baby wakes you up a million times a night. But the inability to get out of bed, or the need to sleep constantly, is not normal.

Having a newborn is overwhelming. But feeling so overwhelmed that you cannot decide what to wear, or eat for breakfast is not normal.

To be considered depression, you have to had at least two weeks of persistent low mood, as well as four of the following: increased or decreased appetite, sleep disturbance, psycho motor agitation (fidgeting, pacing, hand-wringing), feeling always tired, feelings of worthlessness, low concentration or thoughts of self (or baby) harm, suicide/infanticide (1).

A mother may be diagnosed with postpartum depression if the symptoms begin within the first 4 weeks of delivery, but some studies suggest that depressive episodes are significantly more common in women in the first three months after delivery (2).

What is the Difference Between the Baby Blues and Post Natal Depression

The baby blues is a normal reaction to fluctuating hormones and the huge life upheaval that a newborn can cause.

As many as 4 out of 5 women experience the baby blues in the first few weeks of having a new baby.

Baby blues will make you feel:

  • Exhausted
  • Grumpy and angry
  • Overwhelmed
  • Worried/anxious
  • Baby-brained

Baby blues will pass in a week or two as your hormones settle down, and you get in to the routine of new-baby life. Eat a high nutrient diet, sleep as much as you can and ask for help from friends and family.

True postnatal depression can often be missed, partly because women worry they shouldn’t be feeling this way and they try to put on a brave face for the world.

If you are feeling that they baby blues aren’t going away for you, or your symptoms are extreme, then you need to visit your GP or speak to your midwife or health visitor as soon as you can, please don’t put it off.

What Causes Postnatal Depression?

Most experts believe that PND is caused by a combination of factors. Some women are more sensitive to the hormonal changes that happen after having a baby. Social, emotional and psychological factors also play a large role.

In traditional societies that truly support each other, postnatal depression isn’t a thing that happens very often at all. Usually the mother lives with extended family that all pitch in to help and support her.

You are more likely to suffer from PND if you were depressed while you were pregnant, or before you became pregnant, or if your family has a history of depression, postnatal depression, or mental illness.

Although a history of depression increases your risk of PND, it doesn’t mean that you will automatically get it.

You are at Higher Risk of PND if you Experience any of the Following:

  • Premature birth
  • Traumatic birth
  • Physical problems because of the birth (anaemia, pain, incontinence etc)
  • Baby has health problems
  • Breastfeeding difficulties
  • Irregular and demanding sleeping or feeding patterns
  • Difficulty adjusting to the changes that are taking place in your body
  • Problems with housing, work, or finances
  • Relationship problems.
  • Are finding it hard to adjust to changes in relationships with your family and friends.
  • Lack of support
  • Feeling isolated
  • Feel inadequate or overwhelmed
  • Have feelings relating to past experiences that having a baby has stirred up, such as the absence or death of a parent

There is a free version of the Edinburgh PND screening tool here for you to use to screen yourself. A score of 10 or more suggests you need to see a doctor to discuss this further.

Postnatal Depression Treatment

Treatment really depends on the severity of the symptoms. For mild postnatal depression, close monitoring, extra support and natural treatments may be all that is required.

If after a couple of weeks (or sooner if symptoms worsen) if you are still struggling, go back to your doctor for re-assessment.

For more severe cases, professional counseling, and / or medications may be prescribed. There are some medications that are safe to take when you are breastfeeding, so talk to your doctor about the options.

Natural Treatments for Beating Postnatal Depression

Treating postnatal depression naturally is generally only appropriate in less severe situations. However the support, rest and diet aspects are perfect to go alongside medication and professional counseling in severe cases.

  1. Omega 3 fatty acids – Women with PND have been shown to have low omega 3s, and increasing your intake has been shown to reduce symptoms – try walnuts, oily fish, chia seeds or omega 3 supplements (3).
  2. Vitamin D – The best way of getting Vitamin D is getting some sunlight for 15-30 minutes everyday. Also eating pasture raised butter, pasture raised egg yolks, cheese and mushrooms (4).
  3. Diet – Eat a high nutrient diet to ensure your body is getting all the vitamins, minerals and fats that it needs to make the happy hormones that you need.
  4. Exercise – One of the best things you can do to naturally combat postnatal depression is to get out and exercise for 30 minutes a day 3-5 days per week.
  5. Rest – The old adage of sleep when baby sleeps is great in theory, but often very hard to do. Try and get someone to watch baby for a couple of hours so you can go and rest without worry.
  6. Take time out – Leave baby with someone that you trust and go and do something for yourself, not once, but regularly. Go and sit at the seaside, or for a walk around the block, or a long shower. Do something that you enjoy.
  7. Talk – Join coffee groups, visit relations and friends and get yourself some social support.

If you are struggling, please reach out to your doctor, a friend or local social support agency.

post natal depression and anxiety

What is Postpartum Anxiety?

Life with a newborn is terribly stressful. That is enough to make the calmest mama panic. But postpartum anxiety is when this panic becomes all-consuming.

Generally, there are two different categories of anxiety: one having to do with “contaminating” your baby, for example, worrying that he’s going to eat something he shouldn’t, or that he is going to catch germs from the environment.

The other category centers around accidentally harming your child, like if you were to drop baby on the floor, or for them to stop breathing while you aren’t watching.

Postpartum anxiety is harder to spot as the mother isn’t necessarily depressed or sad or mopey, in fact they are often chirpy, high energy and always busy doing something.

Their houses are often completely spotless. They appear to be super-coping.

What is the Difference Between Postnatal Depression and Postpartum Anxiety?

How does postpartum anxiety differ from postpartum depression?

They are sort of two sides of the same coin. Depression is often viewed as being about the past, about things we have lost, like a loss of independence and the life you once lived.

On the other hand, anxiety tends to be more focused on the future, whether it is a realistic fear or not is besides the point. It’s also not uncommon for women with postpartum anxiety to also experience postpartum depression, but they can have anxiety on its own as well.

A recent study suggests that postnatal anxiety may actually be more common than PND (6), but it is more likely to go unnoticed and undiagnosed.

What causes Postpartum Anxiety?

Similar to PND, postpartum anxiety is caused by a reaction to fluctuating hormones combined with external and internal pressures.

If you have had an anxiety condition in the past, you are more likely to get one again. Women who are naturally “worriers” and tend to over think things are more prone to suffering from postpartum anxiety.

Expectations play a huge role in the condition. If you expect that life is now supposed to be perfect, and reality isn’t lining up with that expectation, it makes some people anxious.

Previous experiences can increase the risk – having had a baby in the past die of SIDS or something similar would make even the most naturally calm person super on-edge that it would happen again.

Postpartum Anxiety Symptoms

Women with postpartum anxiety find it hard to let go of normal everyday concerns, so much so that it starts affecting their life.

Some common symptoms of anxiety are:

  • An all consuming need to keep the house clean and tidy
  • A constant fear that the baby will get sick or catch germs
  • Obsessive worry about any aspect of baby – enough food, sleep, behavior
  • Seeking reassurance about something over and over
  • A nagging fear that they will hurt the baby – drop it, leave it somewhere, forget to feed it
  • Unable to sit still or focus on anything
  • Fidgeting or pacing
  • Trouble falling asleep or staying asleep
  • Lack of appetite or a bizarre strictness over food
  • Classic panic attack symptoms – racing heart, dizzy, tight chest, shortness of breath, headaches or gut ache
  • An irrational fear of going out of the house – will cancel appointment without a clear reason

Postpartum Anxiety Treatment

The treatment for postpartum anxiety is very similar to that of postnatal depression.

Women will benefit from a high nutrient diet, containing plenty of vitamin D, B and Omega 3.

Fresh air, exercise and sunshine help to brighten anyones spirits, and it would be ideal to go outside every day if you can, even if it is just to the letterbox to start with.

Talk to someone. Call your friends in and tell them, a real friend will support you, you really don’t have to have it all together!

Talk to your GP or a counselor, as well as to your partner of course. You may need some medication to help as well.

Join a coffee group, and ask a friend to pick you up and not take your excuses for an answer when you try to cancel and stay home. Getting out of the house and with other mamas is exactly what you need to be doing.

Postnatal Depression and Postpartum Anxiety

If you are struggling with any of what we have discussed here, I implore you to seek help and support. If someone isn’t listening, move on mama, and find someone that will.

You are worth it, your baby is worth it.

Don’t sit there in the dark crying those silent tears alone any more.

You are not alone. 

You are one of millions who go through this, who are going through this with you. Reach out. You are worth helping, you are not crazy. You are unwell, and you need some love, some understanding and some support.

 

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