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Postnatal Depression (Postpartum Depression)

A type of clinical depression that occurs after childbirth.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Postnatal Depression (Postpartum Depression)

Pregnant women usually expect the days and weeks following the birth of their child to be a happy time. But many have also heard of severe mood swings that often start a few days after giving birth, known as the baby blues. If the sadness does not go away, it might be the start of a depression.

Depression after childbirth is called postnatal (or postpartum) depression. It is quite similar to the kind of depression that can affect people in any phase of life. Except for one major difference: mothers often feel very guilty about not being able to care for their baby because they are so unwell. Many mothers feel too ashamed to speak with others about how they are feeling. They are afraid of not living up to the idea of a "good mother" and might become more and more withdrawn. Some women say that they no longer recognized themselves.

Taking care of a newborn baby is a real challenge. Some women do not get the emotional and practical help that they need. It is not always easy to deal with all of the changes that need to be made to care full-time for a new baby. Coping with the everyday stress and getting used to your new life can be very difficult — and sometimes it may even be depressing... Read more about Postnatal Depression

What works? Research summarized

Evidence reviews

Depression: The Treatment and Management of Depression in Adults (Updated Edition)

This clinical guideline on depression is an updated edition of the previous guidance (published in 2004). It was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage depression in adults.

Depression in Children and Young People: Identification and Management in Primary, Community and Secondary Care

This guideline has been developed to advise on the identification and management of depression in children and young people in primary, community and secondary care. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, carers, and guideline methodologists after careful consideration of the best available evidence. It is intended that the guidelines will be useful to clinicians and service commissioners in providing and planning high-quality care for children and young people with depression while also emphasising the importance of the experience of care for patients and their families.

Hypnosis during pregnancy, childbirth, and the postnatal period for preventing postnatal depression

Mental illness during pregnancy and the postnatal period can consist of a short period of mood swings, crying spells, irritability (baby blues), depression and postnatal psychosis. Postnatal depression (PND) falls along this spectrum. The morbidity caused by PND is enormous. Possible symptoms can include depressive mood, loss of interest or pleasure in daily activities, anxiety, irritability, insomnia, feelings of guilt, and thoughts of suicide in the first three months after giving birth. These can negatively impact on infant feeding, maternal‐infant interaction and the mother's perceptions of infant behaviour. Several psychological or psychosocial interventions appear to be effective for treating the disorder, such as cognitive‐behavioural therapy, counselling with or without antidepressants, health visitor‐led counselling, peer support, and interpersonal psychotherapy. In regard to prevention however, psychosocial or psychological interventions have not shown a clear benefit in preventing the development of PND. Although hypnosis has been used for a long time to reduce pain during labour and birth, the effectiveness of hypnosis for preventing PND has not yet been evaluated. Hypnosis can be described as a heightened state of focal concentration and receptivity to the suggestions of another person. This person brings about the hypnotic state by focusing the person's attention on a monotonous routine. This review included one study (involving 63 women) but it did not contribute any data to this review. There is insufficient evidence from randomised controlled trials to determine whether hypnosis is effective for preventing PND when compared with usual antenatal, birthing, or postnatal care procedures. Two trials are currently underway however, which may provide further information in the future.

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Summaries for consumers

Hypnosis during pregnancy, childbirth, and the postnatal period for preventing postnatal depression

Mental illness during pregnancy and the postnatal period can consist of a short period of mood swings, crying spells, irritability (baby blues), depression and postnatal psychosis. Postnatal depression (PND) falls along this spectrum. The morbidity caused by PND is enormous. Possible symptoms can include depressive mood, loss of interest or pleasure in daily activities, anxiety, irritability, insomnia, feelings of guilt, and thoughts of suicide in the first three months after giving birth. These can negatively impact on infant feeding, maternal‐infant interaction and the mother's perceptions of infant behaviour. Several psychological or psychosocial interventions appear to be effective for treating the disorder, such as cognitive‐behavioural therapy, counselling with or without antidepressants, health visitor‐led counselling, peer support, and interpersonal psychotherapy. In regard to prevention however, psychosocial or psychological interventions have not shown a clear benefit in preventing the development of PND. Although hypnosis has been used for a long time to reduce pain during labour and birth, the effectiveness of hypnosis for preventing PND has not yet been evaluated. Hypnosis can be described as a heightened state of focal concentration and receptivity to the suggestions of another person. This person brings about the hypnotic state by focusing the person's attention on a monotonous routine. This review included one study (involving 63 women) but it did not contribute any data to this review. There is insufficient evidence from randomised controlled trials to determine whether hypnosis is effective for preventing PND when compared with usual antenatal, birthing, or postnatal care procedures. Two trials are currently underway however, which may provide further information in the future.

Dietary supplements for preventing postnatal depression

Postnatal depression is a common condition that affects women and may impact on their babies. Common symptoms of postnatal depression include fluctuations in mood, mood changes, suicidal ideation and preoccupation with infant well‐being ranging from over‐concern to frank delusions. There is currently not much evidence regarding interventions that might prevent or treat postnatal depression. A diet lacking in certain vitamins, minerals or other nutrients may cause postnatal depression in some women. Correcting this deficiency with dietary supplements might therefore prevent postnatal depression. Examples of possible dietary supplements aimed at preventing postnatal depression include omega‐3 fatty acids, iron, folate, s‐adenosyl‐L‐methionine, vitamin B12 (cobalamin), B6 (pyridoxine), B2 (riboflavin), vitamin D and calcium.

Antidepressant medication for preventing postnatal depression

We examined the evidence to see whether antidepressants can prevent women from experiencing depression in the postnatal period, when compared with any other treatment, sham treatment (placebo), or standard clinical care. The studies we identified included only women who had previously experienced postnatal depression, and had a higher risk of experiencing postnatal depression again.

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More about Postnatal Depression

Photo of a young adult woman

Also called: Puerperal depression, Post-partum depression, Post-natal depression, PPD

Other terms to know:
Depression, Major Depression (Major Depressive Disorder), Pregnancy (Gestation)

Related articles:
Depression After Childbirth: Treatment Approaches

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