9 Of The Most Common Myths About Postnatal Depression

Professor Jim Dornan, a leading obstetrician and gynaecologist from Ireland, discusses some of the common misconceptions surrounding PND.

Birth is traditionally a time associated with huge joy to the parents, wider family and society at large. So when the mother becomes depressed, either overtly or covertly, for no apparent reason, the common reaction is “What have you got to be depressed about? Sure you've got a lovely healthy baby”. But the response often is “I don't know, I just am”, or more worryingly, “I'm fine, don't worry.”

Depression by definition is a condition of sadness, greater than that warranted by objective reason.

Myth 1: Postnatal depression always occurs after birth

While symptoms of postnatal depression can develop in the first few weeks and months of caring for a new baby, it is not the only time a parent can suffer from  depression.

Indeed, when a prospective mother first gets the news that she’s expecting, of course if the pregnancy is wanted, she's first and foremost happy, but her head can quickly become full of concerns. Will I miscarry? Will the baby be normal? Will the birth be OK? Will the pregnancy make me fat? Will the pregnancy affect my work? Will the pregnancy affect my relationship with my partner and family? Will I have to cancel future plans? Can I afford this baby? Will I have to stop some not so great habits? And how?

So yes, PND, as the name suggests, mostly occurs after birth, but in many cases not only are the seeds planted antenatally, but indeed previously perfectly health women can become clinically depressed before the birth in many cases.

It may feel difficult or embarrassing to admit feeling depressed before or after having a baby, but know that you are not alone – it’s estimated that 20 per cent of women and 10 per cent of men can experience anxiety or depression during pregnancy or the early stages of parenthood.

It’s important to see your healthcare provider as soon as you can, especially if the symptoms don’t fade after one or two weeks, begin to get worse, make it difficult for you to cope, care for your baby, complete routine tasks, or if you begin to have dark thoughts about harming the baby or yourself.

Myth 2: Only birth mothers get PND

Any parent can experience depression associated with having a new baby, including mothers, fathers and adoptive parents.

Of course if there have been problems with the birth, such as maternal and baby expectations not achieved or you've experienced medical problems associated with the birth, then it's perfectly reasonable to have anxiety and even depression. It's the apparently unexpected depression that really challenges all involved.

For biological mothers, hormonal changes can play a role in postnatal depression, however other risk factors for postnatal depression such as stress, sleep deprivation and a lack of support can be experienced by any new parent.

A 2010 study found that 10 per cent of men also develop antenatal or postnatal depression, particularly within the first three to six months after the baby is born.

Certain genetic predispositions and a history of mental illness may also increase the risk of developing PND.

Early intervention is best, which is why it’s important that any new parent experiencing symptoms of PND seeks prompt treatment.

Myth 3: A person experiencing PND cries all the time

PND is very individual – one person’s experience might be different to another’s in a variety of ways, and it may not always be easy to tell if a loved one is suffering from it. Basic personality characteristics come into play, with some freely sharing their anguish, and others keeping it all bottled up.

While bouts of tearfulness can certainly be a sign of postnatal depression, other symptoms to look out for can include:

  • a change in appetite
  • difficulty sleeping
  • difficulty bonding with baby
  • anxiety or panic attacks
  • fatigue, or loss of energy
  • no longer showing interest in activities normally enjoyed
  • anger, irritability or severe mood swings
  • a withdrawal from family and friends

Myth 4: PND will go away by itself

While PND is highly treatable, a person cannot simply ‘get over it’ on their own. Please take this in. Everyone needs help to ‘get over it.’

If a parent thinks they might be experiencing symptoms of PND, the best course of action is to visit a health nurse or GP to discuss their symptoms and get professional advice and support. He or she will work with the mother to establish a suitable treatment plan to help the recovery process.

Along with the expert input from a qualified healthcare professional, support from loved ones can hugely help someone with PND on the road to recovery.

Myth 5: If you have PND, you have to take antidepressants

Antidepressants can really help relieve the symptoms of PND and may be included as an important part of a person’s successful treatment, but they are not prescribed in every case.

Speaking about your symptoms with your doctor as soon as you are aware of them is the best first step to recovery.

Support from family and friends, both practical and emotional, is important for many mothers with PND. Counselling and therapy can be extremely effective, and exercise and participation in group therapy and support sessions can also prove beneficial.

Every experience of PND is unique and, generally, successful recovery requires a combination of supports and treatment methods.

Myth 6: It’s normal to feel depressed after giving birth

As many as four out of five new mothers experience the ‘baby blues’ within the first few days after giving birth. It leaves a new mum feeling low and teary, though it generally lifts before long. If those feelings persist and intensify over time, however, it may be a sign of PND or postnatal anxiety, in which case it’s important to seek some help. The placenta is a veritable hormone factory, and when it suddenly switches off at birth, there just have to be consequences.

Myth 7: All mothers with PND think about harming their children

Parents with PND can and often do, feel closely connected to their baby. For others, depression that hasn’t yet been treated can make it difficult for a mother or father to feel as though they’re bonding with their baby. While we’re talking of bonding, I would just stress, don't force it. Bonding can occur during pregnancy, or indeed any time after the birth. Many report that bonding can occur even many years after birth.

So, if a parent doesn't feel the magical ‘bonding’ in the immediate aftermath of birth, relax, you're not unique, and it will happen.

In some cases, thoughts of self-harm may arise, which is another symptom of PND. Thoughts of harming a baby may be symptomatic of postnatal psychosis, which is a different illness altogether.

Postpartum psychosis, or puerperal psychosis, is very rare, affecting approximately one in every one thousand women. It typically occurs within the first week or two after giving birth and signs and symptoms are severe, including hallucinations, paranoia, disorientation and thoughts of or attempts to harm the self or the baby. It can put the safety of the mother and child at risk and requires immediate emergency care.

Myth 8: Getting more sleep will cure PND

A lack of adequate, good quality sleep is one of the most common difficulties any parent of a new baby can have. Evidence suggests a direct connection between a lack of sleep and PND, and although getting good rest may help temporarily alleviate the symptoms, simply getting more sleep will not cure the problem.

Myth 9: You can’t get depressed while pregnant

Anxiety and depression are the most common mental health issues both during pregnancy and after a baby is born. Women are more likely to suffer PND if they had antenatal depression, but early treatment of the latter can reduce a woman’s risk of developing postnatal depression – making early intervention important for effective treatment. If in doubt, speak out.