Patient information · Mental health and women's health
Postnatal depression
common, treatable, and nothing to be ashamed of
Postnatal depression affects more than one in ten women, and a significant number of fathers and partners too. It is not a reflection of how much you love your baby or how capable you are. It is treatable, and treatment works better the earlier it starts.
Call 999 or seek emergency help now if there is
- any thought of harming yourself or your baby that feels like an intention
- hearing or seeing things others cannot, or strongly held unusual beliefs
- severe confusion, agitation or not sleeping at all for more than a night or two
- rapid mood swings, elation, or behaving out of character
- feeling unable to keep yourself or your baby safe
- these symptoms in the first two weeks after birth, when onset is often abrupt
Postpartum psychosis is rare but is a medical emergency requiring same-day assessment — it develops rapidly, usually in the first two weeks, and treatment is highly effective. Call 999 or your maternity unit. For support at any hour: Samaritans 116 123, PANDAS 0808 1961 776, or NHS 111 selecting the mental health option.
Intrusive thoughts are not the same as intent
Sudden unwanted thoughts about harm coming to your baby — dropping them, something happening on the stairs, a knife in the kitchen — are experienced by the great majority of new parents. They are distressing precisely because they are abhorrent to you, and that distress is what distinguishes them from intent. They are a feature of anxiety, not of danger. Women hide them for fear of losing their baby, which delays help for years. Please tell someone. Disclosing an intrusive thought does not lead to your child being removed; it leads to effective treatment for anxiety.
Baby blues or something more
- Baby blues — tearfulness, irritability and mood swings peaking around days three to five, affecting most women, and resolving within about two weeks without treatment.
- Postnatal depression — persisting beyond two weeks, or beginning any time in the first year. Low mood, loss of pleasure, exhaustion beyond ordinary tiredness, poor concentration, guilt, feeling disconnected from the baby, appetite and sleep changes, and hopelessness.
- Postnatal anxiety — often more prominent than low mood. Constant worry, checking the baby repeatedly, intrusive thoughts, panic and inability to rest even when the baby sleeps.
- Birth trauma and PTSD — flashbacks, nightmares, avoidance of anything reminding you of the birth. Recognised, and treatable.
It affects fathers and partners too
Around one in ten fathers experiences depression in the first year, and rates are higher where the mother is also affected. It more often presents as irritability, anger, withdrawal, working excessively or drinking rather than sadness. Partners are rarely asked, and rarely volunteer it. If this is you, you can be seen and treated too.
Treatment
- Talking therapy — CBT or interpersonal therapy — is first line for mild to moderate symptoms and is effective.
- Antidepressants for moderate to severe symptoms. Several are compatible with breastfeeding, passing into milk in very small amounts. You should not have to choose between treatment and feeding, and anyone presenting it that way is not up to date.
- Continue for at least six months after recovery to prevent relapse.
- Specialist perinatal mental health services exist for more severe illness, including mother and baby units where admission is needed — you would not be separated from your baby.
- Treating sleep deprivation, pain, thyroid dysfunction and anaemia matters — all are common after birth and all mimic or worsen depression.
What helps alongside
Helps
- Telling one person honestly how you actually are
- Accepting practical help — specific offers rather than 'let me know'
- Getting outside daily, even briefly
- Protecting one block of sleep, with someone else covering a feed
- Peer support groups, in person or online
Makes it harder
- Comparing yourself with social media
- Believing you should be enjoying every moment
- Isolating yourself, which is the strongest instinct
- Alcohol
- Waiting until you cannot cope before asking
Your thyroid
Postpartum thyroiditis affects around 5% of women in the year after birth and produces fatigue, low mood, anxiety, palpitations and weight change — symptoms attributed almost automatically to new motherhood or depression. It is diagnosed by a simple blood test and is treatable. It is worth checking before concluding that everything is psychological.
Why come to us. Perinatal mental health waits can be long, and this is not something to spend months waiting for. We offer unhurried appointments seven days a week — including weekends, when childcare is often easier — with thyroid function, ferritin, B12 and vitamin D checked in-house to exclude the physical causes, prescribing including options compatible with breastfeeding, and access to psychology and psychiatry without a referral. Partners can be seen too. Babies are welcome in the room.
Seen quickly, babies welcome, partners too
Psychology and psychiatry without a referral. Seven days a week, weekends included.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.