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see also Postnatal depression resources - www.nevdgp.org.au/info/topics/depression.htm

Postnatal depression

It is quite common for women to feel emotional and flat after childbirth; this is apparently due to hormonal changes and to the anticlimax after the long-awaited event. There are two separate important problems:

1. postnatal blues

2. postnatal (or postpartum) depression

Postnatal blues

'The blues' are a very common problem that arises in the first 2 weeks (usually from day 3 to day 5) after childbirth.

What are the symptoms?

• feeling flat or depressed
• mood swings
• irritability
• feeling emotional (eg. crying easily)
• tiredness
• insomnia
• lacking confidence (eg. in bathing and feeding the baby)
• aches and pains (eg. headache)

What is the outcome?

Fortunately 'the blues' are a passing phase and last only a few days. It is important to get plenty of help and rest until they go away and you feel normal.

What should you do?

All you really need is encouragement and support from your partner, family and friends, so tell them how you feel.

• Avoid getting overtired: rest as much as possible.
• Talk over your problems with a good listener (perhaps another mother with a baby).
• Accept help from others in the house.
• Allow your partner to take turns getting up to attend to the baby.

If the blues last longer than 4 days, it is very important to contact your doctor.

Postnatal depression

Some women develop a very severe depression within the first 6 months (usually in the first 6 months) after childbirth. They seem to get 'the blues' and cannot snap out of it.

What are the symptoms?

Some or all of the following may occur:

• a feeling that you cannot cope with life (eg hopelessness, helplessness)
• continual tiredness
• feeling a failure as a mother
• sleeping problems
• eating problems (eg. poor appetite or overeating)
• loss of interest (eg. in sex)
• difficulty in concentrating
• tension and anxiety
• feeling irritable, angry or fearful
• getting angry with the baby
• feeling rejected
• marital problems (eg. feeling rejected or paranoid)

What is the outcome?

This is a very serious problem if not treated, and you cannot shake it off by yourself. There is a real risk of a marriage breakdown because you can be a very miserable person to live with, especially if your husband does not understand what is going on. If it is severe, there is a risk of suicide and even of killing the baby.

What should you do?

You must be open and tell everyone how you feel. You need help. Take your baby to the childhood centre for review. It is most important to consult your doctor and explain exactly how you feel. Your problem can be treated and cured with antidepressant medicine.

Support groups

There are some excellent support groups for women with postnatal depression, and it is worth asking about them and joining them for therapy.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia