What are the baby blues?

Just a few days after giving birth, you may feel moody, weepy and irritable. This is called the baby blues. It’s probably the last thing you expected to feel after the joy and elation of having your baby.

The baby blues are so common that they are considered to be normal. As many as eight in 10 mums experience some changes in their mood after giving birth.

You may feel:

• worried about your baby’s health, even though he’s fine
• anxious
• unable to concentrate
• tired, yet unable to sleep
• tearful, without knowing why

What causes the baby blues?

The baby blues are thought to be linked to hormonal changes that happen during the week after giving birth. Your body has some major adjustments to make, which may include coming down from the adrenaline high that you felt when your baby was born.

Pregnancy hormones gradually leave your body just as you are producing breastmilk. Your appetite may change, though it’s not just physical changes that are happening to you. Your emotions are likely to be put through the wringer, too. The new sense of responsibility that comes with having a baby can be overwhelming.

The reality of what parenthood involves may not hit you until you have left hospital and are spending your first few days at home. However much you love being a mum, your new role could make you feel trapped and fretful.

You may be uncertain about how to care for your newborn baby and feel a huge anticlimax after the birth. You are likely to be exhausted, but you may not be able to get a good night’s sleep or a decent nap during the day, even when your sleeping baby allows it.

What is postnatal depression?

Postnatal depression (PND) is sometimes confused with the baby blues. The baby blues are when you feel moody, weepy, tired or anxious during the first week after giving birth. These feelings will usually pass within a few days.

However, unlike the baby blues, PND is an illness that is unlikely to get better quickly, and without help. The sooner you recognise that you have PND, and get the support that you need, the less likely it is to become a severe or long-term problem.

How common is postnatal depression?

About one in eight mums in the UK seeks help from their GP for PND, so it is very common. And as some women don’t seek help, or don’t acknowledge that they have PND, the true rate is likely to be even higher than this.

You are more likely to be vulnerable to PND if you have challenges in your life such as money worries, or relationship problems.

How will I know if I have PND?

The signs and symptoms of PND are different for every mum. Your friends or family may spot the signs before you do, but you may feel:

• sad or low
• unable to enjoy anything
• extremely tired, with no energy
• hopeless
• a sense of guilt
• lacking in appetite
• miserable
• tearful
• anxious

Most mums have at least one of these feelings, some of the time. It’s normal to have good days and bad days. But if you’re feeling these symptoms on most days, or much of the time, and they don’t get better, you could have PND.

When does PND usually happen?

PND often develops within the first few months after giving birth, particularly in the first five weeks. But it could start at any time in the first year.

You may have been really enjoying looking after your baby before depression crept up on you. If you were depressed while you were pregnant, your baby’s arrival may not have helped to lift your depression.

What causes PND?

Experts don’t fully understand why some women become depressed and others don’t. It’s likely to be for a few reasons, rather than just one cause. You could be vulnerable to depression with your second baby, even if you were fine with your first, or vice versa.

Sometimes, the things you have to face every day just get on top of you, and make it harder for you to look after yourself, rest and eat well. Certain circumstances may make it harder for you to cope, such as if:

• You have been depressed before, or have had problems with your mental health, or were depressed during a previous pregnancy.
• You don’t have a supportive partner, or have no family or friends living nearby.
• You’re having money, housing, work or relationship problems.
• You had a difficult labour, and health problems afterwards.
• Your baby was born prematurely, or is unwell.
• You are finding it difficult to breastfeed.
• Sad memories have been stirred up after your baby was born, such as the death of one of your parents.

How is PND treated?

With help, you will get better. Your GP or health visitor will want to support you, so that you can look after yourself and your baby well. Be reassured that having PND does not mean that you are a bad mother, or that you will have your baby taken away from you.

If you have mild PND, your GP may suggest self-help strategies, and recommend a book that could help. If you have moderate to severe PND, you may be treated with:

Talking therapies

Though talking to your partner or a friend can help, they may find it difficult to understand what you are going through.

Your GP may be able to refer you to a support group, counsellor or psychotherapist. She also may be able to arrange cognitive behavioural therapy (CBT) or interpersonal therapy (IPT). CBT can teach you coping strategies, while IPT explores whether problems in your relationships with others may be contributing to your depression.

Hypnotherapy and hypnosis, can be very effective in treating depression, and are gaining wider recognition. Hypno-analysis (psychotherapy using hypnosis) seeks to uncover the root cause of the negative feelings and emotion, thus removing the symptoms.

Waiting lists for these therapies tend to vary in different areas. Some charities can put you in touch with a trained volunteer who is used talking to mums with PND.

If your PND is more severe, you may be referred to a mental health team, which is likely to include specialist nurses, as well as a psychologist or psychiatrist.

How can I help myself to overcome PND?

Try to get lots of rest

Sleep or rest whenever possible. If someone is able look after your baby for a couple of hours, put on some soothing music, have a warm drink, and relax. Try to nap when your baby is sleeping, and forget your to-do list for a while.

Eat a healthy, well-balanced diet

With all the new demands on your body, eating well is important. Try not to go for long periods without eating, to avoid a dip in your blood sugar levels. Food fuels your energy and immune system, so a balanced diet will prevent you from becoming tired and feeling run down.

Exercise

It may be the last thing you feel like doing, but exercise will help you to feel better in mind and body. You could join an exercise class, or your GP may refer you to a personal trainer or an exercise scheme.

If it’s a struggle to get started, try to keep your goals manageable. Just going for a walk with your baby can help to lift your mood. If you did yoga or Pilates classes while you were pregnant, you could go along again now.

Meet other mums

Having a baby can be isolating, but if you have PND, you may feel particularly alone. Joining a baby massage group at your local children’s centre or GP surgery will help you to meet other mums. It may also help you to bond with your baby.

Be kind to yourself

Taking care of yourself and your baby are the most important things. Try not to load yourself up with tasks that aren’t essential. Leave any big decisions for when you’re better, and be realistic about what you can achieve. Try to treat yourself once in a while.

How can my partner, friends and family help?

It can be hard for those closest to you to understand how awful you’re feeling. But they have an important part to play in helping you to get better. Tell them what you are going through and give them any information you have about PND. Your partner may also be depressed, and understanding how to support you could help him to feel better, too.

Ask loved ones for help, because practical support, such as helping around the house or preparing food, can go a long way towards lifting your mood. Just an hour or so of them babysitting, so you can rest or have time alone or with your partner, will help to refresh you.

Where can I find out more about PND?

• Beyond Blue is the government’s website with information and advice about depression.
• Just speak up is the government’s website about post-natal depression.
• The Blue Pages is full of information about treatment for depression that works and links to the free online treatment programs MoodGym and ECouch.

• You can call Lifeline on 13 11 14 for someone to talk to and ideas about where to seek help at any time of the day or night.
• Visit the BabyCenter postnatal depression board to talk to other mums who know how you are feeling.