Introduction

Definition of postpartum depression and anxiety

Postpartum, or postnatal, depression is a type of depression parents may develop after having a baby.¹ Similarly, postpartum, or postnatal, anxiety is a feeling of worry, fear, or unease that parents may develop after having a baby that is persistent and distressing.²  

Importantly, feelings of sadness or anxiety immediately following the birth of your baby are normal and are often referred to as the ‘baby blues’.³ Only when these feelings become long-term may you, or your partner, be diagnosed with postpartum depression or postpartum anxiety. 

Importance of understanding postpartum depression and anxiety for new parents

Understanding postpartum depression and anxiety is important for new parents. You may be able to recognise the symptoms in yourself, or your partner, and these may last for a long time if not managed. The condition may begin to impact you, your baby, or your family if not managed properly. Importantly, most people make a full recovery from postpartum depression or anxiety with the right support. 

Overview of what the outline will cover

This article will introduce postpartum, or postnatal, depression and anxiety. We will explain how postpartum depression and anxiety can be recognised in yourself or in your partner, the potential impact, and how it may be treated or prevented.  

Understanding postpartum depression and anxiety

What is postpartum depression?

Postpartum, or postnatal, depression is a type of depression that may develop in parents after having a baby.¹ 

Symptoms and signs 

There are a wide range of symptoms of postpartum depression, but the most common are listed below.⁴ 

• Persistent low mood and feelings of sadness
• A loss of interest and lack of enjoyment in hobbies and the wider world
• A lack of energy and feeling tired all the time
• Difficulties sleeping at night 
• Having trouble looking after yourself and your baby
• Avoiding social contact
• Difficulties concentrating on tasks 
• Feeling more indecisive than usual 
• Having scary thoughts - for example, about harming your baby 

Symptoms of postpartum depression develop gradually so many people do not realise they are struggling with the condition.⁴ 

Causes and risk factors

Many factors can lead to the development of postpartum depression. The most important factors increasing your risk of developing the condition are listed below.⁵ 

• If you have a history of mental health problems or conditions, including previously being diagnosed with depression
• If you were diagnosed with a mental health problem or condition during pregnancy
• If you have little or no support around you, for example having no close family or friends 
• If you have difficulties in your relationship with your partner
• If you have experienced recent stressful life events, for example losing someone close to you 
• If you have experienced physical or psychological trauma at some point in your life 
• If you struggle to exercise, have a poor diet, or struggle to sleep 

However, parents will often develop postpartum depression without any of the above risk factors.⁵ Having a baby is a huge, life-changing situation that may trigger the condition in some individuals.⁵ 

What is postpartum anxiety?

Postpartum, or postnatal, anxiety is a type of anxiety (a feeling of worry, fear, or unease) that may develop in parents after having a baby that is persistent and distressing.²

Symptoms and signs 

Postpartum anxiety causes various symptoms, including:²

• Feeling anxious all of the time and not being able to stop it or control it 
• Feeling worried or restless
• Feeling a constant or recurring sense of dread
• Being irritable and feeling constantly on edge 
• Avoiding certain places, or doing certain things 
• Often seeking reassurance 
• Having panic attacks 

Panic attacks often last between 5-20 minutes.⁶ They start very quickly and often for no reason.⁶ Panic attacks can be very frightening, but they are not dangerous.⁶ During a panic attack you may feel:⁶ 

• Your heartbeat going very fast or ‘racing’
• A large sense of dread or sudden fear of dying
• Pain in your chest 
• Breathless or as though you can’t get enough air into your lungs
• Dizziness 

Causes and risk factors

There is not just one individual cause of postpartum anxiety.⁷ As a new parent, you are welcoming big and stressful changes to your life, as well as learning to look after your baby, dealing with little sleep, and possible financial pressures, among other factors.⁷ These can make you feel more worried and anxious, which may lead to the development of postpartum anxiety.⁷ 

Various factors can increase your likelihood of developing postpartum anxiety.⁸ Examples of these factors include:⁸ 

• If you have a history of anxiety, including previously being diagnosed with generalised anxiety disorder (GAD) 
• If you often worry in your daily life
• If there is a history of anxiety in your family
• If you are assigned female at birth
• If you have a history of trauma, such as physical or emotional trauma 
• If you have a long-term condition or pain 
• If you have experienced recent stressful situations, such as financial or relationship difficulties
• If you experienced one or several complications during your pregnancy or birth

How it differs from postpartum depression

Postpartum depression leads to feelings of sadness and a persistent low mood for more than 2 weeks, whilst postpartum anxiety leads to feeling anxious or worrying all the time, with an inability to relax or panic attacks.^1,2 You may experience postpartum depression and anxiety at the same time.

Impact on mothers, babies, and families

Postpartum depression and anxiety may have an impact on mothers, partners, babies and your surrounding family. 

Effects of postpartum depression and anxiety on mothers

Having postpartum depression and anxiety as a mother can be scary. Alongside experiencing the symptoms above, you may continue feeling anxious or sad for a long time following childbirth which may keep coming back after treatment.⁹ It may lead to a feeling of heightened stress and poor lifestyle choices, such as smoking.⁹ 

Effects on the bond between mother and baby

Postpartum depression and anxiety may make it harder for a mother and baby to develop a strong bond.⁹ Mothers may also feel less confident about their bond with their baby.⁹ 

Impact on family dynamics and relationships

When a mother or partner experiences postpartum depression or anxiety, they may feel increased strain on their relationship, as well as a reduction in other social contacts and support.⁹ This may make family dynamics more difficult.⁹ 

Coping strategies and treatment options

The NHS and Tommy’s offer detailed advice on coping strategies and treatment options for postpartum depression and postpartum anxiety, respectively. In the next section, we will outline some examples to help manage your condition. 

Self-care strategies for coping with postpartum depression and anxiety

Here we list some examples of things you may be able to do yourself to help cope with postpartum depression and anxiety recommended by the NHS. 

• Talking to your family and friends about your feelings
• Making time for you to do things or hobbies you enjoy
• Increasing the amount of rest and sleep you get as much as possible 
• Trying to exercise regularly, for example going on a walk 
• Eating a healthy diet 

Engaging in self-care strategies has been shown to reduce the symptoms of postpartum depression.¹⁰ 

Seeking professional help: therapy and counselling

If you are concerned about a potential diagnosis of postpartum depression or anxiety, speak to your healthcare professional. They may refer you to specialised therapies or counselling to help you cope. 

Medication options and considerations

If the above strategies do not help the symptoms of your postpartum depression or anxiety, your healthcare professional may discuss medication options with you. Usually, they will initially offer you an antidepressant that is safe to take if you are breastfeeding your baby.¹¹ 

Importance of social support networks

Building a good support network around you is really important if you, or your partner, have postpartum depression or anxiety. Try to talk to your friends and family about how you are feeling and how they may be able to help. Several organisations have detailed websites which offer further support and advice for individuals struggling with postpartum depression and anxiety. These include the Association for Postnatal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS). 

Prevention and support

The NHS and Tommy’s websites offer in-depth advice on the prevention and available support for individuals with postpartum depression and postpartum anxiety, respectively. Whilst you are pregnant it can be useful to anticipate potential challenges, for example, if you have a history or current diagnosis of depression or anxiety. It is also useful to build your support network by attending antenatal or postnatal classes and meeting other new parents who may be dealing with similar challenges. 

Summary

Postpartum depression describes a type of depression parents may develop after having a baby, and postpartum anxiety describes a type of anxiety leading to feelings of worry, fear, or unease that parents may develop after having a baby that is persistent and distressing. There are many signs of postpartum depression and anxiety which you may recognise in yourself or your partner. The conditions can have a big impact on you, your partner, family and baby so it is important to acknowledge the symptoms, understand self-coping strategies and seek help from your healthcare professional if you are concerned. The NHS and Tommy’s offer further detailed advice on postpartum depression and anxiety, respectively.