As many as one in five women develop a mental illness during pregnancy, or in the 12 months after having a baby – and postnatal depression affects roughly one in 10 women within the year that they give birth.
The problem has been exacerbated by the pandemic, with referrals to specialist perinatal mental health services at an all time high.
However, studies show that as many as 70% of women hide or underplay their perinatal mental health problems, which likely means that the true figures for women suffering with their perinatal or maternal mental health are much higher.
Yet, despite this, pregnant women and new mothers have no access to specialist community perinatal mental health services in almost half of the UK.
But it’s a condition that must be taken seriously: Suicide is a leading cause of maternal deaths in the UK within a year after childbirth.
It can be difficult watching someone struggle from the outside – but if you have a friend or loved one who you think might need help, it’s so important to check in with them and make sure they’re OK.
Here’s how you can try to offer help and support.
What are the signs of postnatal depression?
According to Navit Schechter, CBT Therapist and founder of Conscious & Calm, postnatal depression (PND) can present itself in many different ways.
‘You might notice that your friend or loved one has stopped looking after themselves in the way they usually do, are not seeing their friends and family as much or have stopped leaving the house,’ she tells Metro.co.uk.
‘When people experience postnatal depression, it’s common for them to lose interest or pleasure in the day-to-day things that they previously enjoyed – seeing them do less of these as a result.
‘You might also notice that your friend or loved one is eating more than usual or not enough and is feeling low, guilty, irritable, anxious, overwhelmed and hopeless, perhaps being more snappy with others than usual.’
Navit explains that PND commonly affects the way a person thinks about things, so it’s common for someone with postnatal depression to become self-critical, for example having thoughts that they are a bad parent, selfish and unable to look after their baby properly.
‘They may also feel indifferent about their child or feel detached from them and not feel able to enjoy their baby in the way that they expected,’ she says.
‘This can make it hard for them to bond with their baby and look after their other children and can exacerbate the negative thoughts they have about themselves, maintaining the feelings of depression.’
Psychologist Emma Kenny explains that PND can also present itself in physical ways.
‘For example, someone might experience high levels of anxiety resulting in palpitations, sweats, feeling like they can’t catch their breath, feeling exhausted, unable to concentrate, unable to sleep, not really feeling able to eat, feeling sick and nauseous,’ she says.
‘All of these things are indicators that an individual might be struggling with postnatal depression.’
Navit adds that many of these symptoms are common in the early days of having a baby and so, sometimes, it can be hard to distinguish the normal challenges and struggles of parenthood from the signs of postnatal depression, especially if symptoms come on gradually.
‘If symptoms persist or start after the first few weeks then it may indicate it’s time to seek help,’ she advises.
PND can affect both men and women – and it’s equally important to offer support to both.
It’s important to distinguish between ‘baby blues’ and postnatal depression
All too often, postnatal depression is referred to as the ‘baby blues’ – but these are not the same thing.
According to Mind, the ‘baby blues’ is a ‘brief period of low mood, feeling emotional and tearful around three to 10 days after you give birth’. This feeling usually only lasts for a few days and is generally quite manageable.
‘Postnatal depression is a much deeper and longer-term depression. This usually develops within six weeks of giving birth and it can be gradual or sudden.
‘It can range from being mild to very severe.’
‘Baby blues is a common condition mothers experience after giving birth,’ explains Dr Thuva Amuthan founder of Dr.Derme Clinics. ‘If this lasts more than 2 weeks after giving birth this could be post natal depression.
Dr Amuthan advises that your friend or loved one might be suffering from this if they:
- Appear to be sad consistently
- Stop enjoying the thing they used to or lose interest
- Lack energy or feel tired all the time
- Have difficulty getting to sleep or staying asleep
- Experience trouble bonding with the baby
- Keep to themselves or avoids contact with others
- Struggle with concentration and decision making
- In severe cases, have thoughts about hurting the baby
How to broach the subject with a loved one you’re worried about
If you think that a friend or loved one is potentially struggling with postnatal depression then finding the right time to talk to them is important.
‘Try and find a time when there will be as few interruptions as possible and let them know that you’ve been thinking about them,’ suggests Navit.
‘Asking how they’re feeling is a good place to start. You can also let them know that you’ve noticed that they seem down/tense/anxious and are wondering how they’re doing.
‘Spending time listening to what your friend or family member has to say, without judgement, trying to “fix” anything or take away their pain can be very comforting and help them feel understood and heard.’
The most important thing to remember is that there’s nothing wrong or shameful in having postnatal depression, adds Emma.
You shouldn’t feel afraid of asking a friend if they’re ok, and flagging that you’ve noticed a decline in their behaviour, whether emotionally or physically.
Emma advises that you can simply say something like: ‘I can’t help but notice that you look like you’re struggling a little bit at the moment and I just want to check in because I would really like to support you.’
You can even then give the suggestion that they may be suffering from postnatal depression, or even just maybe a modality of the baby blues – but it’s very important to distinguish between the two.
How to actually help someone with PND
Firstly, it’s important to reassure anyone who is potentially suffering from PND that it’s completely normal for women who’ve gone through such a rigorous experience of having a child and dealing with the consequences of that to feel like this.
‘You can encourage anyone you might be worried about to get help – and offer to go to the doctor’s with them,’ says Emma. Here, they would likely do the Edinburgh scale with a GP, which would introduce them to the possibility that they are struggling with PND.
‘The most important thing is to normalise it,’ she continues. ‘It’s an awful thing when you’re feeling it – but so many women can relate.
‘Always reassure any new mums that this isn’t a sign of failure,and they haven’t done anything wrong. And, importantly it can be remedied – but you need to take action.’
If the person you’re worried about says they’re fine, or is uncomfortable asking for help, you can try to help with some of the practicalities.
‘For example, you can offer to go round for a couple of hours a few times a week, and allow them to have a bath, get some sleep,’ Emma suggests.
‘You can bring round cooked meals and help with mundane activities, help them prioritise things they need to do – anything that might shift that physical strain from them.’
It can, of course, be very difficult to see our friends or family struggling and not feel able to receive the support that’s available to them.
‘Asking them what would be helpful (rather than making assumptions) can mean they get the help they really need,’ suggests Navit.
‘For some people, it’s easier to accept help e.g. letting them know “I”m going to bring dinner round for all of you tomorrow” than it is reaching out for it e.g. “let me know if I can do anything to help”.’
Feeling hopeless and lonely are common symptoms of postnatal depression so it’s normal for people to feel like no-one will understand how they are feeling and that there is no way out, explains Navit.
‘Helping your friend or loved one to understand that this isn’t the case and that there is all sorts of help available can help them feel less isolated.
‘If you’re worried, you can speak to another close family members or their GP, midwife or health visitor for support.’
What not to do
Ivana Poku is a the author of Motherhood – The Unspoken, a maternal mental health advocate, motivational speaker, award-nominated blogger, and award-winning mentor.
She advises that what we should definitely never do is downplay the condition.
‘PND is an illness like any other and should be treated that way,’ she emphasises.
‘People definitely shouldn’t try to fix a person with depression. PND is way more than just a low mood so any attempts to “cheer them up” can make them feel even more miserable because they often cannot control the way they feel.
‘If they could, it would not be an illness,’ she adds.
‘The best thing you can do for a person who suffers from depression is let them feel the way they feel, show your support, and give them strength to talk and seek help.’
Ivanu adds that, according to research, approximately 58% of new mothers with postnatal depression do not seek medical help.
‘They often don’t understand the condition and fear the consequences of reporting the problem,’ she says.
‘So what you can also do is help them get better educated on postnatal mental health.’
Why it’s so important to seek help and/or offer help
‘It’s really important that anyone who’s suffering with PND gets the help they need,’ Navit stresses.
‘It’s been shown that PND not only affects the mothers or fathers mental health but also the child’s wellbeing and development.
‘However with the right support, most will make a fully recovery and can go on to form a good connection with their child.’
Emma adds that if you have PND or you suspect that you might be dealing with PND, it’s important to go and get help, because – although rare – it can become something more serious.
‘In rare cases, PND can be related to postpartum psychosis, which is very debilitating, incredibly scary, and can often result in the mother requiring some very specialized attention – even inpatient facility attention,’ she says.
‘So, at the first sign that somebody is losing their capacity to cope, it’s so important they know they’re not failing and that this can be dealt with.’
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