Postnatal depression: signs, and getting support

Postnatal depression is a type of depression that can follow having a baby. The NHS describes signs such as persistent low mood, losing enjoyment in things, feeling unable to cope, guilt, anxiety, poor sleep even when you have the chance to rest, and difficulty bonding with your baby. It can begin in pregnancy or at any point in the first year after birth. If you recognise some of these signs, the NHS advises speaking to your GP, health visitor or midwife, even if you only have a few of them.

Key points

• The Royal College of Psychiatrists says postnatal depression affects at least 1 in 10 mothers.
• The “baby blues” are very common in the first days after birth and usually pass within about 2 weeks. Postnatal depression lasts longer or gets worse.
• Fathers and partners can also become depressed after a baby is born.
• It is an illness, not a sign of being a bad parent, and it usually improves with treatment.
• Your GP, health visitor or midwife can help. In England you can also refer yourself to NHS Talking Therapies.

What are the signs of postnatal depression?

The NHS lists the following as possible signs. You do not need to have all of them:

• Feeling low or sad most of the time, and finding it hard to enjoy things.
• Feeling hopeless, or as if you cannot cope.
• Feeling guilty or worthless, or like a bad parent.
• Feeling anxious, frightened or constantly worried.
• Feeling restless or irritable.
• Sleeping poorly, even when you have the chance to rest.
• Finding it hard to concentrate or make decisions.
• Having difficult feelings about your baby, or finding it hard to bond.
• Having thoughts of suicide, self-harm or harming your baby.

The Royal College of Psychiatrists adds that some people withdraw from other parents, family or professionals, feel tearful, notice changes in appetite or have excessive fears about the baby’s health.

Many new parents hide how they feel, because they expect to feel happy or worry what others will think. Postnatal depression can also look different from the outside. Someone may seem to be coping well while feeling empty, numb or overwhelmed inside.

Is it postnatal depression or the baby blues?

Feeling tearful, anxious or irritable in the first few days after birth is very common. The Royal College of Psychiatrists says more than half of women feel very emotional in the first week, and this is known as the baby blues. The NHS says it usually passes within about 2 weeks.

If those feelings carry on beyond that, get worse, or start to make it hard to get through the day, it may be postnatal depression. Only a health professional can make that assessment, and it is always fine to ask.

When does postnatal depression start?

The NHS says symptoms can begin during pregnancy, soon after the birth, or up to a year afterwards. The Royal College of Psychiatrists notes that it often starts within the first couple of months, but can start several months later, and that around a third of women with postnatal depression had symptoms that began in pregnancy.

Why does it happen?

The NHS says the exact cause is not known, but the stress of caring for a newborn, lack of sleep and hormonal changes may all play a part. It also lists things that may make it more likely, including:

• Having had depression or another mental health problem before or during pregnancy.
• Recent difficult life events, such as a bereavement or losing a job.
• Having a baby who is premature or unwell, or having twins or more.
• Having little support from people around you.
• Difficulties in your relationship.

Postnatal depression can also happen when none of these apply. It is not caused by anything you did or did not do.

Can partners get postnatal depression?

Yes. The NHS says fathers and partners can also develop depression after a baby is born. The Royal College of Psychiatrists notes that partners of women with postnatal depression have a higher risk of depression and anxiety themselves. The arrival of a baby changes sleep, routines, relationships and identity for everyone in the family, and partners sometimes feel their own struggles should come second. If you are a partner and you are finding things hard, your GP can help you too. Our page on life transitions covers some of the wider changes that becoming a parent can bring.

How do I get support?

The NHS advises contacting your GP, health visitor or midwife if you think you might have postnatal depression. They will ask about how you are feeling and may use a short questionnaire. Many parents fear that their baby will be taken away if they ask for help. The NHS says this is very rare, and that your care team will support you to care for your baby.

In England you can also refer yourself to NHS Talking Therapies if you are 18 or over (16 or over in some areas). The NHS describes talking therapies such as cognitive behavioural therapy (CBT) as one treatment option, alongside support from your GP or a specialist perinatal mental health team. Some people are offered antidepressants. If you have any questions about medication, including while breastfeeding, talk to your GP.

The NHS also suggests some things that may help alongside treatment:

• Talking to someone you trust about how you feel.
• Asking for practical help with shopping, housework or childcare.
• Resting and sleeping when you can.
• Getting some gentle exercise, even a short daily walk.
• Joining a local parent and baby group or support group.
• Making a little time for things you enjoy.
• Avoiding alcohol and drugs as a way of coping.

The NHS says postnatal depression often improves within 3 to 6 months, though it can last longer, and that treatment makes recovery more likely. Charities such as Mind and PANDAS also offer information and support for families.

What about frightening thoughts about the baby?

Some new parents have sudden, unwanted thoughts or images of their baby being harmed, which can be very distressing. The NHS notes that OCD can start during pregnancy or after birth, with fears of harming the baby. Unwanted thoughts like these are a recognised experience, and your GP or health visitor can help. You can read more in our guide to intrusive thoughts.

Postpartum psychosis is a different and much rarer illness. The NHS says it usually starts suddenly within the first two weeks after birth and should be treated as a medical emergency. Signs can include hallucinations, beliefs that are unlikely to be true, very high or low mood, and confusion. If you are worried about yourself or someone else, see a GP urgently the same day, call NHS 111, or call 999 if someone is in immediate danger.

How therapy can help

Becoming a parent can bring up feelings about your own childhood, your relationship and your sense of who you are. As an integrative psychotherapist registered with the BACP, I offer a calm space to talk about this without judgement, drawing on person-centred, psychodynamic and CBT-informed ideas. Therapy can sit alongside the care you receive from your GP or health visitor. I work with adults individually and with couples, so we can also think about how the changes are affecting your relationship. You can read more about how I work with depression, and online counselling may be easier to fit around life with a baby. Sessions are available in Farringdon, Central London, or online, in English or Turkish.

If you are in crisis, call 999, go to A&E, call NHS 111, or contact Samaritans on 116 123 (free, 24/7).

If you are finding life after having a baby hard, you are welcome to get in touch to arrange an initial consultation. There is no need to have the right words, and we can go at a pace that feels manageable.