Questions And Answers

If I have PND, will I have to go on medication?

Not necessarily. It depends on:

• How unwell you are
• Whether you agree
• What has already been tried

There are other treatment options which you can discuss with your health professional. These are covered in the Treatments section. Remember also, that going on medication is not a failure – no one likes to need medication - but there are many illnesses where medication is needed.

Having depression is like trying to play cricket with a broken bat. Sometimes medication can fix the bat but you still have to do the batting and face the balls (stresses of life) yourself.

What helps if I get depressed

or anxious in pregnancy?

Firstly, it is important to tell a professional how you are feeling. They can help assess how much it is affecting you. You can be taught ways to reduce anxiety and depression. These techniques are often successful. Sometimes medication is needed as well. There are no guarantees that medication won’t affect the baby - although it is thought that most medication is safe. It is also thought that if you have significant anxiety or depression this may affect your developing baby. See Medication section.

Should I stop breastfeeding if I have PND?

Only if you want to. Some women find it is a big relief to stop breastfeeding and do feel better. There have been published reports of women feeling worse after stopping breastfeeding and others of women who feel a lot better.

Most medications used to help PND can be taken while breastfeeding without causing any recognisable problems for the infant – see Medications section.

If you do stop breastfeeding, it can feel like a big loss and you grieve for this loss. Unfortunately many people can be unhelpful by being very pro-breast feeding. Whatever you decide remember the best thing for your baby is whatever is best for you.

I have had PND and want to get pregnant again.

What can I do to keep well this time?

There is alot you can do to reduce your chances of becoming unwell. Talk to your supports. Work out what helped last time and what didn’t. Do the things that helped. Avoid the things that didn’t. Make a plan to manage stresses and, if you can, develop a plan to manage sleep deprivation, but be flexible.

Sometimes even with the best made plans and help, depression still raises its ugly head – this is not your fault. Work out your early warning signs. If they return, recognise them and seek help early. Do not wait until you are much worse.

Can I breastfeed when I’m on medication?

Most of the medication used for depression and anxiety is not known to cause any negative effects on the baby (see specific medication in Medication). Most of these medications can theoretically get into the breast milk (because they are soluble in fat) but in exceedingly small amounts- often too small to be measured by sensitive medical tests. One exception to this is Lithium.

Occasionally people on higher doses of certain medications, or those who are sensitive to some medications may feel a bit drowsy, especially at night - so extra care or help may be needed in handling your baby. Antidepressants are not known to impair the production of breast milk and may occasionally enhance it.

 How dangerous is PND?

PND can range from mild to severe. There are also different types of mood disorders or depression and this can affect how dangerous it is.

At its most mild it is not at all dangerous and generally gets better with good support (emotional and practical), sleep and time.

At it's most serious it can be life threatening (from suicide or inattention) and can pose a risk to the baby. If you have any serious concerns then assessment by a mental health professional is needed.

An unwell mother should be asked "have you ever thought of taking your own life", "have you ever felt scared you might hurt yourself"  "have you ever had scarry or dangerous thoughts about your baby? ...what were those thoughts?"  "Have you ever felt like harming your baby?"  Asking these questions could save someone's life. Suicide has been the single biggest cause of maternal death (death in the first 6 weeks after having a baby) in several western countries in recent decades. 

My partner has PND.

Can I trust her with the baby?

Probably, but you may need help to make this judgement. Talk to family members and close friends who know your partner well and how she is at that moment. The situation can change from day to day. This risk should also be assessed by a health professional and discussed with you.

PND does not mean your partner is crazy or going to do anything unpredictable. PND will make it much harder for her to cope with any demands. Babies can be very demanding in that they need a lot of patience and care. However, most women with PND remain aware of their baby’s needs and are able to meet those needs, at least enough to keep the baby physically safe.

Driving may be a concern if your partner’s concentration is not very good.

Can my baby pick up my anxiety?

Yes, to some extent. There are many factors that affect this including characteristics of both you and your baby. (See Baby)

I don’t feel anything for my baby. Is this normal?

This does happen for some people when they get very depressed or if they have been separated from their baby in some way - for example if the baby had been very sick and in hospital. Mothers and fathers can feel ashamed and worried about this lack of feeling and hide it from others. It is actually much more worrying if a parent doesn’t care how they feel.

It is important to recognise this and get some help. It does not mean you are a ‘bad’ parent or that you will continue to feel nothing – feelings can, and usually do, change. Relationships, even with your baby, can take time to develop.

Are all these problems, just due to my hormones?

That’s putting it too simply. For some women sudden changes in hormones do seem to play a role. This is probably what happens when mothers suffer from "The Blues" (see The Blues).

Unfortunately a great many women put these feelings down to their hormones and don't seek help. They find it easier to blame their hormones than think these feelings could be due to depression, which is harder to understand.

How long after giving birth is postnatal depression considered postnatal?

There is no exact answer to this question. Depression occuring after a baby is born is not greatly different to depression occuring at other times, thus there is not clear distinction between postnatal depression and the clinical diagnosis of a major depressive episode.

What is different is the presence of a baby, or if something has happned to the baby the process of grief around this. There are many theories about the role of hormones and about sleep deprevation, and these factors are probably important but we have no definite evidence yet. The most common time for depression to peak after having a baby is between three and six months after birth. Most services internationally set an arbitrary date of 12 months after birth for the onset of depression to be called postpartum, but there is no particular scientific reason for this.

Page last updated 4 September 2014

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