Perinatal depression and anxiety

Perinatal depression is a term used for depression during pregnancy or in the year after childbirth.

Feelings of anxiety and depression can occur at any time from conception until your child is a year old. Although having a baby is supposed to be one of the most exciting and joyful experiences you’ll ever have, sometimes the reality is quite different. You may be surprised, and even alarmed, to experience feelings you hadn’t expected. Childbirth can leave you feeling exhausted and anxious, as well as shocked by the sudden changes in your life as a result of becoming a mother.


The baby blues

The baby blues is the most common and mildest form of depression. A few days after the birth, you may feel elated one moment, upset and emotional the next, and cry for no particular reason.

The blues may be caused by sudden changes in hormone levels after birth, the emotional shock of giving birth, the dawning realisation of the responsibility of caring for a small baby, and all the sudden changes that you and your family are going through. The baby blues usually disappear after a few days and you will feel more yourself again.


Perinatal depression

If your symptoms start in the antenatal period, last longer than the first two weeks, or start later within the first year, you could have perinatal depression. Perinatal depression can start any time from conception through the first year after giving birth.

Signs that you or someone you know might be depressed include:

  • a persistent feeling of sadness and low mood
  • lack of enjoyment and loss of interest in the wider world
  • lack of energy and feeling tired all the time
  • trouble sleeping at night and feeling sleepy during the day
  • difficulty bonding with your baby
  • withdrawing from contact with other people
  • problems concentrating and making decisions
  • frightening thoughts – for example, about hurting your baby

Many women don't realise they have perinatal depression because it can develop gradually.


Perinatal anxiety

Perinatal anxiety is something that some new mothers experience either before they have their baby or after. Having a child not only causes huge changes to a woman’s body in terms of the physical shock and hormonal fluctuations (which in turn can have an impact on mood), but can also have a big impact on family life, sleep levels and stress. All of these things can lead a person to become more anxious than usual. There are a number of different types of postnatal anxiety, including postnatal generalised anxiety disorder (which can present as a constant state of high anxiety, with worries about everything from your child’s health, feeding, and your ability to parent); postnatal obsessive compulsive disorder (which often involves experiencing distressing thoughts and concerns about harm coming to your baby); and postnatal health anxiety (which is a preoccupation that there may be something wrong with your baby’s health).

Signs that you or someone you know might be anxious include:

  • feeling tense, nervous and on edge
  • having a sense of dread, or fearing the worst
  • feeling like the world is speeding up or slowing down
  • feeling like other people can see that you’re anxious and are looking at you
  • feeling your mind is really busy with thoughts
  • dwelling on negative experiences, or thinking over a situation again and again (this is called rumination)
  • feeling restless and not being able to concentrate
  • feeling numb


What causes perinatal depression and anxiety?

The cause of perinatal depression and anxiety isn't completely clear. Some of the factors it has been associated with include:

  • a history of mental health problems, particularly depression, earlier in life
  • a history of mental health problems during pregnancy
  • having no close family or friends to support you
  • a poor relationship with your partner
  • recent stressful life events, such as a bereavement
  • experiencing the "baby blues"

Even if you don't have any of these symptoms, having a baby is a life-changing event that can sometimes trigger depression and or anxiety.

It often takes time to adapt to becoming a new parent. Looking after a small baby can be stressful and exhausting.


Treatments for perinatal depression and anxiety

Perinatal depression and anxiety can be lonely, distressing and frightening, but support and effective treatments are available. Your midwife, health visitor and GP will ask you regularly about your mental health at each contact in the perinatal period. It is important that you are honest about how you are feeling so that we can offer support and signpost you to a range of treatments. These include:

  • Self-helpthings you can try yourself include: talking to your family and friends about your feelings and what they can do to help; making time for yourself to do things you enjoy; resting whenever you get the chance and getting as much sleep as you can at night; exercising regularly; eating a healthy diet.
  • Psychological therapy – your midwife, health visitor or GP may be able to recommend a self-help course, or may refer you for a course of therapy, such as cognitive behavioural therapy (CBT).
  • Antidepressants – these may be recommended if your depression is more severe or if other treatments haven't helped; your doctor can prescribe a medicine that's safe to take while breastfeeding. Often a combination of medication and psychological therapy can be very effective.