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Postnatal Depression

“I started to fall to pieces and think I was not coping as a mum. I was not doing things right as a mum and that I was failing as a mother”
- Jenny

“I sat there and bawled for hours and hours. I just sat there and felt a shambles. I remember sitting here in the middle of the room looking around and thinking how do I clean that up... not knowing how to clean it up.”
- Jane

Worried Frown

What is postnatal depression?

Everybody feels down from time to time but depressive illness is more than that. It is when several symptoms occur over the same time period.

The symptoms of depression are:

Tiredness

 

Low/Flat Mood



Aches
and Pains

Worry

Negative
Thoughts


Concentration
and Thinking
Difficulties


 

Depression can range from mild to severe

Postnatal depression is very similar to clinical depression occurring at any other time except that there is the added complication of a baby (or two!). Psychiatrists call clinical depression a “major depressive episode” or for people who have suffered from more than one episode “depressive disorder”.

Severe depression is a serious illness and needs assessment and treatment. 

References

Appleby L, Koren G, Sharp D. Depression in pregnant and postnatal women: an evidence-based approach to treatment in primary care. British Journal of General Practice 1999; 49:780-782.
Austin MP. Antenatal screening and early intervention for "perinatal" distress, depression and anxiety: where to from here? Arch Womens Ment Health 2004; 7:1-6.
Barnett B, Morgan M. Postpartum psychiatric disorder: who should be admitted and to which hospital? Australian and New Zealand Journal of Psychiatry 1996; 30:709-714.
Beck CT. Predictors of postpartum depression: an update. Nursing Research 2001; 50:275-285.
Boyce PM, Condon JT. Mood disorders in pregnancy and the puerperium. In: Joyce PR, Mitchell PB, eds. Mood Disorders: Recognition and Treatment. Sydney: University of New South Wales, 2004.
Brockington I. Diagnosis and management of post-partum disorders: a review. World Psychiatry 2004; 3:89-95.
Brockington IF. Postnatal depression. In: Brockington IF, ed. Motherhood and Mental Health. New York, NY: Oxford University Press, 1996.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 1987; 150:782-786.
Forty L, Jones L, Macgregor S, Caesar S, Cooper C, Hough A, Dean L, Dave S, Farmer A, McGuffin P, Brewster S, Craddock N, Jones I. Familiality of postpartum depression in unipolar disorder: results of a family study. American Journal of Psychiatry 2006; 163:1549-1553.
Hendrick V, Altshuler L, Strouse T, Grosser S. Postpartum and nonpostpartum depression: differences in presentation and response to pharmacologic treatment. Depression and Anxiety 2000; 11:66-72.
Murray L, Cooper P, Hipwell A. Mental health of parents caring for infants. Archives of Women's Mental Health 2004; 6:71-77.
O'Hara M, Zekoski EM. Postpartum depression: A comprehensive review. In: Kumar RC, Brockington IF, eds. Motherhood and Mental Illness. Cambridge: Butterworth & Co., 1988.
Oates M. Postnatal mental illness: Its importance and management. In: Gopfert M, Webster J, Seeman M, eds. Parental Psychiatric Disorder: Distressed Parents and their Families. Cambridge: Cambridge University Press, 1996.
Oates M. Perinatal psychiatric disorders: a leading cause of maternal morbidity and mortality. British Medical Bulletin 2003; 67:219-229.
Stewart DE, Robertson E, Dennis CL, Grace S. An evidence-based approach to post-partum depression. World Psychiatry 2004; 3:97-98.
Wilson DA, Bobier C, Macdonald EM. A perinatal psychiatric service audit in New Zealand: patient characteristics and outcomes. Arch Womens Ment Health 2004; 7:71-79.
Wisner KL, Perel JM, Peindl KS, Hanusa BH, Piontek CM, Findling RL. Prevention of postpartum depression: a pilot randomized clinical trial. American Journal of Psychiatry 2004; 161:1290-1292.
Yonkers KA, Ramin SM, Rush AJ, Navarrete CA, Carmody T, March D, Heartwell SF, Leveno KJ. Onset and persistence of postpartum depression in an inner-city maternal health clinic system. American Journal of Psychiatry 2001; 158:1856-1863.

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