Giving birth can be a time of great excitement, exhaustion, shock and stress. Women are often unprepared for the reality of birth and having a new person to care for.
Almost half new mothers feel weepy three or four days after the birth, which is known as ‘baby blues’. It requires no medical treatment, just support and rest and confidence-boosting by those around including partner, family and health professionals.
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This affects one in ten mothers and usually sets in two weeks to two years after the birth. It can result in the woman becoming listless and unable to cope with the demands of the home and baby.
Many of the symptoms are similar to those of general depression with the woman becoming emotionally withdrawn and being overwhelmed with feelings of despair, guilt and worthlessness.
Eating and sleeping patterns may alter markedly and the mother may lose interest in everything including the baby and be unable to concentrate or carry out daily tasks.
Stressful events before the birth, a traumatic delivery or low self-esteem may contribute to post-natal depression. The arrival of a new baby and the unavailability of the mother can allow the partner to feel abandoned and unable to trust in the relationship.
Post-natal depression can undermine the couple’s relationship even when the depression is over. It may be helpful to consider couple counselling if the relationship remains under pressure, to get a realistic perspective on the feelings of disappointment and loss that can accompany post-natal depression.
Usually treatment is available through the GP or in the community. In severe cases mother and baby may be treated in hospital - often in specialist mother and baby units where there is help to protect the bond between the two.
Puerperal psychosis is relatively rare, affecting less than one in 500 women, but early diagnosis can alleviate suffering. It is often marked by a period of intense activity and over-confidence when the mother may talk excitedly and hardly eat and sleep.
This period of euphoric energy and confidence may also coincide with a lack of interest in the new baby. Both mother and baby are at risk of serious neglect and medical attention is essential.
Some mothers become deluded that they have not had a baby or have given birth to a messiah or devil. A following period of depression often sees the mother overwhelmed with exhaustion and guilt, unable to cope with the simplest tasks.
Mania, depression and schizophrenia can all be present and need specialist help. Medication is usually essential.
Postnatal depression statistics
The most common form of postnatal disturbance is the ‘baby blues’ which is said to be experienced by at least half of all western mothers. This usually lasts between 12 and 24 hours, generally occurring between the third and sixth day after the birth.
An incidence figure of 10 per cent of all new mothers is most often quoted, with other studies showing a figure between 3 per cent and 22 per cent. However, it is argued that around 50 per cent of these cases will never come to medical attention.
Puerperal psychosis is a severe and relatively rare form of postnatal depression affecting between 0.1 and 0.2 per cent of all new mothers.
What should I be looking for in a counsellor or psychotherapist?
There are currently no laws in place stipulating what training and qualifications a counsellor must have in order to treat postnatal depression. However, the National Institute for Health and Clinical Excellence (NICE) have developed a set of guidelines that provide advice about the recommended treatments, including the following:
If you develop depression while pregnant or after giving birth:
- If you have mild or moderate depression you may be offered treatments such as an exercise programme, self-help, short-term psychological treatments or counselling.
- If you have mild depression but you have had severe depression in the past, you may be offered an antidepressant if you prefer not to have psychological treatment or it has not helped you.
- If you have moderate depression and have had depression before, or you have severe depression, you may be offered a psychological treatment, or an antidepressant if you prefer. If these treatments do not help you on their own, you may be offered both together.
These treatments usually help, but if they don't, you may be offered a different drug or electroconvulsive therapy (ECT).
Read the full NICE guidelines:
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Content written/edited by Denise Pickup BACP (Accred) in 2008. All content displayed on Counselling Directory is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional.
Whilst we endeavor to ensure all information is accurate, Counselling Directory make no representations or warranties of any kind, whether express or implied, as to the accuracy of the information included within the website. Any dependence you place on such information is therefore strictly at your own risk.
- Depression: roots and symptoms
- Mothers and Fathers with Postnatal Depression (PND)
- Depression: The sweeping sadness
- Can counselling really help depression?
- Post-Natal Depression
- Understanding Postnatal Depression
- Baby Blues or Postnatal Depression?
- How Do I Know If I Have Post Natal Depression
- Beyond the Baby Blues - Post Natal Depression
- Mother Nature: Can Evolution Contribute to Post Natal Depression?
- Post Natal Depression
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