Postpartum Depression (PPD) and Postnatal Anxiety (PNA)

What is it?

Firstly it’s important to understand that there is not one real cause factor. It can happen to anyone. We go through physical changes and huge drops in hormones. There are also emotional issues that can be caused by lack of sleep or support. If you already have a history of depression or anxiety, or had a difficult pregnancy or birth then you’re at an increased risk as well.

The Gentle Counsellor Podcast 2020

Postnatal depression or postpartum depression is when you feel sad, angry, empty, and emotional that is more than what is known as the ‘baby blues’ which generally happens on day 3 and only lasts a day or so. If you have extreme exhaustion, mood swings, insomnia, crying spells, and/or anxiety for more than 2 weeks then that can be an indication of suffering from postpartum depression.

1 in 7 women are diagnosed with postpartum depression. (ref)

Postpartum anxiety or postnatal anxiety generally goes hand in hand with postpartum depression. That is more so where the anxiety comes in, you may constantly be in fear of something happening to your child, and feel immense guilt and worry all the time.

1 in 4 people experience anxiety regardless of being a woman in postpartum. (ref)

There is also another one that isn’t as well known called postpartum rage and that again is generally experienced with postpartum depression. The symptoms are more when you go from 0 to 100 and feel that sort of uncontrollable rage or outbursts, but then you realise after and may feel remorse or guilt and wonder why you couldn’t control your temper.

Postpartum Depression can happen anytime during the 2 years from giving birth.

What are the signs?

What you need to look out for.

  • Depressed mood
  • Severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep caused by insomnia
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Hopelessness
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Difficulty with concentrating or making decisions
  • Severe anxiety
  • Panic attacks

If untreated this can last months or even years.

What can we do?

During pregnancy your health care practitioners are likely to give you a pamphlet of information on postpartum depression. Most forms will ask for a history, so make sure to be honest and let them know if you have a history of depression or anxiety as this will prompt them to check in. However, do not rely on this only. It is crucial to make everyone around you in your support network aware of the signs of postpartum depression.

Can I continue breastfeeding?

Yes! The research shows that the longer that you breastfeed the greater the mental health outcomes are for you and your child. Stopping can make things worse with the sudden drop in hormones. If you planned to breastfeed and stop before you are ready to (pain, attachment issues, lack of support, etc) you are at greater risk for developing PND. (references listed below)

Sadness and depression during (and after) weaning. By Kelly Bonyata, IBCLC, Becky Flora, IBCLC and Paula Yount

Breastfeeding and Depression. By Philippa Pearson-Glaze IBCLC

The relationship between postpartum depression and breastfeeding. By Aisha Hamdan and Hani Tamim

What if I have to take Medication for my symptoms?

Medication in combination with emotional support is effective and safe to use in breastfeeding. Speaking to your GP is the first step in getting a management plan. Preferable first-line therapy includes but are not limited to the SSRI sertraline due to its safety profile and tolerability. (ref)

In Australia, Rodney Whyte is an excellent resource for specific safety in lactation.

Mr Rodney Whyte – Senior Pharmacist at Monash Health – M-F 9am-5pm

E: rodney.whyte@monashhealth.com

T: (03) 9594 2361

A quick note on Dysphoric Milk Ejection Reflex (D-MER). The symptoms of PPD are similar except in the case of D-MER these only happen during the few seconds before the mother’s milk ejection reflux occurs when breastfeeding, expressing, or leaking. (ref)

More information:

Please seek professional help. When visiting your GP you can ask for a mental health care plan that gives you 5 or more rebated sessions through medicare. When looking for a psychologist find one who specialises in postpartum depression. On google searches most will list their area of specialisation or expertise, or you can just ask. Remember they are there to help you. They want to help you.

PANDA Helpline – 1300 726 306 Open Mon to Fri, 9am – 7.30pm

https://www.panda.org.au/

Lifeline Helpline – 13 11 14 Open 24 Hours

https://www.womenshealth.gov/…/postpartum-depression

Beyond Blue has a mental health checklist with a short quiz that you can take here

https://healthyfamilies.beyondblue.org.au/…/mental…

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