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Postnatal Depression

POSTNATAL DEPRESSION

Postnatal Depression

POSTNATAL DEPRESSION

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Postnatal depression (PND), also called postpartum depression, is a serious mental health condition that affects up to a third of South African women. If you’ve had PND before, your risk increases to 30% with each pregnancy.

PND is not the same as the “baby blues.” The “baby blues” tend to occur two to three days after giving birth, when it is very common to feel depressed and anxious. You may cry for no reason, have difficulty sleeping, or question your ability to look after your baby. This can be due to variety of reasons, from changes in hormone levels, exhaustion, and challenges with breastfeeding, to psycho-emotional factors like stressful living conditions or your own difficult childhood experiences. With good support from family and friends, these feelings usually resolve in about two weeks.

PND usually starts two to eight weeks after giving birth – but can start during pregnancy or up to a year after giving birth. With PND, you don’t just feel sad; you suffer intense feelings of anxiety and depression. It is a painful, almost paralysing fear that something bad will happen to your baby, robbing you of the joy of having a child.

PND is not a character flaw or a weakness; and you are not to blame for anything. Sometimes it’s simply a complication of giving birth. If you, or someone you know, exhibits symptoms of PND, you need to seek medical attention.  If left untreated, PND may last many months or longer.

SYMPTOMS OF PND

While PND is often mistaken for the “baby blues”, the symptoms are far more intense and last longer. These may eventually interfere with your ability to care for your baby and handle other daily tasks. While PND is not a terminal illness, it can be a fatal one. It can destroy marriages, break up families, wreck careers and, in the most extreme cases, result in suicide and/or infanticide. It is a challenging condition to diagnose, as many of its symptoms are natural results of pregnancy and early motherhood.

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NEW FATHERS CAN ALSO EXPERIENCE PND

New fathers may feel sad, tired, overwhelmed, anxious, or have changes in their usual eating and sleeping patterns – the same symptoms that mothers with PND experience. Risk factors include young fathers, those with a history of depression, those experiencing relationship problems, or those who are struggling financially. This is referred to as paternal postnatal depression and can have the same negative effect on partner relationships and child development as PND in mothers can. Medication and counselling are used to help both men and women struggling with PND.

CAUSES OF PND

The exact cause of PND is not known. There are many different factors that are likely to contribute to the condition:

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TREATMENT FOR PND

PND can be treated with counselling, medicine, or both. Counselling can help you find better ways to cope with your feelings, solve problems, and set realistic goals. Antidepressants can help relieve symptoms of depression, and some can be taken while you’re breastfeeding. Keep in mind that antidepressants may take several weeks to start working.

In addition to seeking professional help, other ways to help you feel better include:

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WHEN TO SEEK PROFESSIONAL HELP

Call your healthcare professional if:

  • Your “baby blues” don’t go away after two weeks or are very intense
  • Symptoms of depression begin within one year of having your baby and last more than two weeks
  • It is difficult to work or get things done at home
  • You cannot care for yourself or your baby (like eating, sleeping, bathing)
  • You have thoughts about hurting yourself or your baby

If you are unsure about the state of your mental health, you can also complete the Bonitas SHE (self help assessment).  This will help you score your current mental state.

It is important to seek help from a qualified mental health professional if you are experiencing symptoms of depression or anxiety. Ask your partner or a loved one to call for you if necessary. Your healthcare professional will ask questions to test for depression and may also refer you for additional help and treatment.

WHAT HAPPENS IF PND IS UNTREATED?

Untreated PND can affect your ability to parent. You may:

  • Not have enough energy
  • Have trouble caring for your baby and yourself
  • Feel moody
  • Have a higher risk of attempting suicide
  • Feeling bad about yourself can make depression worse. It is important to reach out for help if you feel depressed.

Researchers believe PND in a mother can also affect the healthy development of her child which can cause:

  • Delays in language development and problems learning
  • Problems with mother-child bonding
  • Behaviour problems
  • More crying or agitation
  • Shorter height and higher risk of obesity in pre-schoolers
  • Problems dealing with stress and adjusting to school and other social situations

PND IN SOUTH AFRICA

South Africa has a high prevalence of PND. This is exacerbated by our large population of women living with HIV, who are at even greater risk of PND. Suicide, as the most severe effect of poor mental health, is a leading contributor to mortality worldwide; in South Africa it is the second most common cause of maternal death.

Our high poverty rates also contribute to our above-average prevalence of PND, as poorer women are less likely to get the mental health support they need, even though they’re more likely to experience PND and anxiety.

Remember, you don’t have to suffer alone. As well as your personal healthcare professional, you can contact the South African Depression & Anxiety Group (SADAG). They have over 160 support groups and many 24-hour toll-free emergency helplines, including:

  • Suicide Crisis Helpline: 0800 567 567
  • Mental Health Helpline: 0800 456 789 / SMS 31393
  • You can find out more on their website: sadag.org