Antenatal & postnatal depression

 

Click above to watch a video from Best Beginnings with Dr Alain Gregoire on depression in the antenatal & postnatal period.

 

Contact information for your local maternity service

East and North Hertfordshire (The Lister Hospital): 01438 284 124

West Essex (The Princess Alexandra Hospital): 01279 827 286 

South and West Hertfordshire (Watford General Hospital): 01923 217 343

Contact information for your local health visiting service

Hertfordshire health visiting service:  0300 1237572

West Essex health visiting service:   0300 247 0122

Perinatal depression

Perinatal depression is depression experienced during pregnancy (known as ante or prenatal depression) or after childbirth (known as postnatal depression). Many people are aware of postnatal depression (PND) but it's less commonly known that you can experience it during pregnancy as well.

Becoming a parent brings a wide range of emotions, ranging from joy to excitement to stress and apprehension. The physical changes you go through can also affect your mood and feelings, and it's common to experience more ups and downs than usual - check out common symptoms in the bullet points below. But depression is more than just a low mood - it's a serious condition that affects your physical and mental health. Untreated, it can affect not only you but also the people around you - your loved ones and even the baby's own development. Around 10-15% of new mothers will experience postnatal depression. It can range from being relatively mild to very severe but it is also a very treatable illness if you get the right help.

Symptoms to look for in ante and postnatal depression might include (but are not limited to):

  • sad and low
  • tearful for no apparent reason
  • worthless
  • hopeless about the future
  • tired
  • unable to cope
  • irritable and angry
  • guilty
  • hostile or indifferent to your husband or partner
  • hostile or indifferent to your baby

  • Lost concentration
  • Have disturbed sleep
  • Find it hard to sleep - even when you have the opportunity
  • Have a reduced appetite
  • Lack of interest in sex
  • Have thoughts about death

Note: - some of these experienced - like lack of concentration, disturbed sleep and lack of interest in sex - are all common after becoming a parent, but it's still important to mention them to your doctor if you're concerned you might have postnatal depression.

If you experience any of the following symptoms (known as "Red Flag symptoms"):

  • New thoughts of violent self-harm
  • Sudden onset or rapidly worsening symptoms
  • Persistent feelings of estrangement from your baby

Then you need urgent referral to a specialist mental health team.

We know that talking about how your are feeling can often be very difficult, however, there is help out there. You do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping' - this is a common misconception. Health professionals are aware of how common depression can be during the perinatal period, and are able to support you and your family. There will be a range of treatment options open to you -

Self-help:

There are lots of different types of self-help available to you for mild to moderate depression so you should be able to find an approach that suits you. The Maternal Mental Health Alliance has some suggestions, and provides you with the option of exploring how you might be feeling through a workbook approach. There are also a number of online self-help information pages such as Mind's Self-care tips for pregnancy and after having a baby.

You may also find the Baby Buddy app useful. It contains masses of useful information about your physical and mental health in pregnancy and after the baby has arrived.

Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing.

You can also look at online Cognitive Behavioural Therapy (CBTS) programmes as well as self-help guides from the NHS.

Talking therapy is a NICE recognised therapy delivered by a therapist either face to face, over the telephone or in groups. The therapy is available wherever you live via the NHS and is completely free. Women in the perinatal period (antenatal and up to 1 year post-birth) will be prioritised for talking therapy treatment. There are many different types of therapy available including Cognitive Behavioural Therapy (CBT), which has proved very effective for depression. You should receive your treatment within 6 weeks of the initial referral (NICE 2014).

Local talking therapy services: Hertfordshire and West Essex

Medication - You will need to seek the advice of your GP. For mild to moderate depression, talking therapy is the first choice of treatment and medication won't usually be considered until you have undertaken some therapy. The medications for treating depression are called antidepressants and there are lots of different ones to choose from. If you are pregnant or breastfeeding there are still antidepressants that you can take, but you need to discuss this with your GP. Please see further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

 

For more information, help and support see below: 

Local Hertfordshire: Specialist Perinatal Mental Health Team  call 0300 124 0939 (out of hours mental health helpline 0800 6444 101).

Local west Essex: Perinatal Mental Health Service | Essex Partnership University NHS Trust (eput.nhs.uk) call 01245 315637 / 01702 538170

Local talking therapy service in Hertfordshire or West Essex

NHS : Mental health problems and pregnancy - NHS (www.nhs.uk)

BUMPs: Bumps - Best use of medicines in pregnancy

MIND Hertfordshire: Mums Matter | Hertfordshire Mind Network (hertsmindnetwork.org)

MIND Essex: Understanding Depression - Mid & North East Essex Mind (mnessexmind.org)

RCOG: RCOG welcomes RCM perinatal mental health roadmap | RCOG

Tommy's pregnancy and post-birth wellbeing plan The pregnancy and post-birth wellbeing plan | Tommy's (tommys.org)

Baby Buddy is the multi-award winning free app that guides you through pregnancy, birth, parenting and beyond. You can explore the web version of Baby Buddy or download the full version of the app for free on the App Store and Google Play. There is a lot of information including videos about your physical and mental health.