Causes and Prevention of PND

The following information has been taken from the Royal College of Psychiatrists (RC PSYCH) website which can be found here

What causes PND?

Many possible causes for PND have been suggested. There is probably no single reason, but a number of different stresses may add up to cause it.

You are more likely to have PND if you:

  • have had mental health problems, including depression before
  • have had depression or anxiety during pregnancy
  • do not have support from family or friends
  • have had a recent stressful event – e.g. death of someone close to you, relationship ending, losing a job.

There may be a physical cause for your depression, such as an underactive thyroid. This can be easily treated.

PND can start for no obvious reason, without any of these causes. Also having these problems does not mean that you will definitely have PND.

Can postnatal depression be prevented?

We don’t know enough about PND to prevent it in the first place. The following suggestions seem sensible and may help to keep you well.

  • Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired.
  • Do make friends with other women who are pregnant or have just had a baby. It may be more difficult to make new friends if you get PND.
  • Do find someone you can talk to. If you don’t have a close friend you can turn to, try the National Childbirth Trust or The Pandas Foundation. Their local groups are very supportive both before and after childbirth.
  • Do go to antenatal classes. If you have a partner, take them with you. If not take a friend or relative.
  • Don’t stop antidepressant medication during pregnancy without advice. Around 7 in 10 women who stop antidepressants in pregnancy relapse if they stop the medication.  You need to discuss the risks and benefits of continuing treatment in pregnancy and breastfeeding.
  • Do keep in touch with your GP and your health visitor if you have had depression before. Any signs of depression in pregnancy or PND can be recognised early.
  • Do make sure that you have treatment for depression in pregnancy. This may be a talking therapy or medication.
  • Do accept offers of help from friends and family.

Recognising postnatal depression

The first thing is to recognise you have had a depressive illness. Don’t dismiss it as the ‘baby blues’. Don’t assume it’s normal to feel like this when coping with a baby.

There are lots of reasons why women delay seeking help. You may:

  • not realise what is wrong
  • worry about what other people think
  • feel ashamed to admit that you are not enjoying being a mother.

Some women worry that their baby will be taken away.  In fact, you are doing what is best for your baby and for yourself by getting help for your PND. Doctors and health visitors want to get the care you need so you can look after your baby.

People are now more aware of depression in general. This means PND shouldn’t be missed so often.

Doctors, midwives and health visitors usually ask new mothers about their mental health. They may ask you to fill in a questionnaire or ask the following questions:

  • During the last month, have you been bothered by feeling down, depressed or hopeless?
  • During the last month, have you been bothered by having little interest in pleasure or in doing things?
  • Is this something you feel you need or want help with?

It is important to answer these questions honestly so that you can be offered help if you need it. If your answers suggest you might have PND, you should see your GP. Your GP will need to ask more questions to confirm the diagnosis.