What are the differences between postnatal illnesses?

From baby blues to postnatal depression: the differences between them and where to get help

PNI

Baby blues

It’s natural to feel a bit down, tearful and anxious right after giving birth – you have just birthed another human being, remember, and you’re sleep deprived with a new baby keeping you up at all hours.

Baby blues are very common, with around 60-80 per cent of women going through this period of emotional comedown after giving birth. It’s thought to be linked to the chemical and hormonal changes your body is going through after giving birth.

The difference between baby blues and postnatal depression (PND) is that baby blues will resolve by itself. It’s not an illness and will go away on its own within about a fortnight once you and your newborn settle down into a routine. More serious illnesses are more long lasting. For now, make sure you’re eating well and getting as much sleep as you can – and accept help if it’s offered. And remember this too shall pass.

Postnatal anxiety

Postnatal anxiety shares a lot of symptoms with postnatal depression, but it’s important to be able to recognise the two separately. If a racing pulse, thumping heart, breathlessness and sweating are among your symptoms, you may have postnatal anxiety.

‘This immense responsibility, even though I’d planned for it and expected it, mixed with the most intense feeling of love and protectiveness, made everything start to feel scary,’ says Sarah, 35 and mum to Jack, three. ‘Everything seemed like a threat to him and I felt anxious a lot of the time that some harm would come to him.

‘I saw that PND didn’t really fit with how I was feeling and there were other mums out there with symptoms that sounded much more like mine. I found support through charities who were able to signpost me to the right support groups and eventually a counsellor.’

Postnatal depression

The main difference between the baby blues and postnatal depression is that baby blues should fade away after about a fortnight, PND can last for months. Symptoms of postnatal depression can start at any point in the first year after giving birth and may develop suddenly or gradually.

Symptoms include:

  • A persistant feeling of sadness and low mood
  • Lack of energy and feeling tired all the time, but still struggling to sleep even when you get the opportunity
  • Feeling you’re unable to look after your baby
  • Problems concentrating and making decisions
  • A loss or increase in appetite
  • Feeling agitated, irritated or apathetic, even about things you used to enjoy
  • Feelings of guilt, hopelessness and self-blame
  • Difficulty bonding with your baby
  • Thoughts about hurting your baby, suicide or self-harm

Difficulty bonding with your baby does not mean you don’t love your baby. And having thoughts about harming yourself or your baby does not mean your baby is in danger, but you do need to seek help. Admitting how you’re feeling to healthcare professionals, family and friends can be the first step to getting better, it doesn’t mean your child will be taken away from you. There may be no reason for the way you’re feeling; PND is an illness like any other and it’s not your fault.

You’re not alone; as many as 1 in 10 women suffer from PND. But you do need to speak to your GP or health visitor as they are trained to spot PND. Postnatal depression can last for months at a time and may not necessarily go away by itself.

‘I was constantly in tears and I was too afraid to be alone. I felt like I wasn’t good enough to look after my son,’ admits Carole, 29 and mum to Charlie, three.

‘I was very fortunate to have a great GP who listened to everything I said and was quick to diagnose PND. I was put on antidepressants and recommended to a psychiatrist. I still occasionally have bad days, but on those days I now understand that it’s Ok if all I can do is turn CBeebies on for my son and sit on the sofa. Tomorrow will be a better day,’ she says.

'Unlike baby blues, which may be transient, postnatal anxiety and depression describe conditions that can go on longer and persist, or that are recurrent beyond the first weeks after delivery,’ says Dr Peter Ilves, a GP for mental health service Big White Wall and tutor for Connecting with People. ‘The conditions can affect your general ability to function, bond with your baby, establish breastfeeding, and if left without support and expert intervention can sometimes worsen rapidly.’

‘It is often difficult to talk about this but don't hold back. Make sure you discuss how you feel with your hospital or community midwife, a health visitor or your GP. If things rapidly worsen, you want to harm yourself or experience bizarre symptoms such as voices, visions or odd ideas, you or your family should talk to your GP, the out-of-hours doctors’ lines, ambulance service or accident and emergency department. It is rare but this may indicate a depression with psychosis.’

Postnatal illnesses can be as severe as post-traumatic stress disorder if you have had a particularly difficult labour, or postpartum psychosis. If you are suffering from traumatic flashbacks and nightmares, hallucinations or delusions, or thoughts about harming yourself or your child, seek help immediately.

'If in doubt, ask. If you do not understand, ask again. If you are concerned, seek help. Never fear talking about your mental wellbeing and health; help is out there,' says Peter.

Tillie Mabbutt from the Pre and Postnatal Depression Advice and Service (PANDAS) Foundation says, ‘Discussing how you are feeling with loved ones is also important so that they can support you as you need. Likewise, joining a local peer support group or online will allow you to speak to others feeling the same way.’

Help is out there, and as well as healthcare professionals the following charities and more are there to help and offer information, advice and support:

PANDAS
APNI
Anxiety UK

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