Postnatal depression (PND, postpartum depression or the baby blues) is a spontaneous form of depression that occurs in some women just before, or soon after childbirth, and is a response to the effect on the brain of sudden changes in hormone levels.
In its mildest form most women have some feelings of up and down emotions with teary episodes in the first week after delivery. This is normal and passes within a few days.
Women with true postnatal depression experience constant unhappiness for which there is no reason. They are unable to sleep, lose appetite and weight, and feel there is no purpose in living. They may feel unnecessarily guilty, have a very poor opinion of themselves, feel life is hopeless, find it difficult to think or concentrate, worry excessively about their infant or neglect the child. Rarely it may lead to attempted or actual suicide. It is diagnosed after careful psychiatric assessment.
Emotional and practical support from the partner, family and friends are vital in assisting an affected woman in her recovery. Counselling and support groups may also be beneficial. If necessary medications are prescribed to control the production of depressing chemicals in the brain (eg. fluvoxamine, moclobemide, nefazodone, paroxetine, venlafaxine) while hospitalised or given intensive home support. About one in every 500 mothers are hospitalised for postnatal depression. Shock therapy (electroconvulsive therapy – ECT) may be used as a last resort for those women whose depression is prolonged and life threatening. Virtually all cases settle with support and medication in a few weeks.