Treating postnatal depression

Speak to your GP or health visitor as soon as possiblei f you think you might have postnatal depression .

With appropriate treatment and support, most women make a full recovery, although it can take time.

The three main types of treatment are self-help strategies, therapy and medication, which are all described in more detail below. Talk to your GP about the pros and cons of different treatments so you can decide together whats best for you.

Your GP might also want to check your physical health to see if there are any problems that may need to be addressed as well. For instance, you may be anaemic after having given birth and that could add to any feelings of depression you might have.

Self-help

Looking after a baby can be stressful and challenging for anyone, and it can be even tougher if you're dealing with postnatal depression as well.

There are a number of things you can try yourself to improve your symptoms and help you cope. These include:

• talk to your partner, friends and family try to help them understand how you're feeling and what they can do to support you
• don't try to be a "supermum" accept help from others when it's offered and ask your loved ones if they can help look after the baby and do tasks such as housework, cooking and shopping
• make time for yourself try to do activities that you find relaxing and enjoyable, such as going for a walk, listening to music, reading a book or having a warm bath
• rest when you can although it can be difficult when youre looking after a baby, try to sleep whenever you get the chance, follow good sleeping habits and ask your partner to help with the night-time work
• exercise regularly this has been shown to help boost mood in people with mild depression (read more about exercise for depression )
• eat regular, healthy meals and don't go for long periods without eating
• don't drink alcohol or take drugs , as this can make you feel worse

Ask your health visitor about support services in your area. They may be able to put you in touch with a social worker, counsellor or local support group. It can be reassuring to meet other women who are going through something similar.

Find postnatal depression support and information in your area .

Psychological treatments

Psychological therapies are usually the first treatment recommended for women with postnatal depression.

The main types used are described below.

Guided self-help

Guided self-help involves working through a book or an online course on your own or with some help from a therapist.

The course materials focus on the issues you might be facing, with practical advice on how to deal with them.

The courses typically last 9 to 12 weeks.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a type of therapy based on the idea that unhelpful and unrealistic thinking leads to negative behaviour.

CBT aims to break this cycle and find new ways of thinking that can help you behave in a more positive way.

For example, some women have unrealistic expectations about what being a mum is like and feel they should never make mistakes. As part of CBT, you'll be encouraged to see that these thoughts are unhelpful and discuss ways to think more positively.

CBT can be carried out either one-to-one with a therapist or in a group. Treatment will often last three to four months.

Interpersonal therapy

Interpersonal therapy (IPT) involves talking to a therapist about the problems you're experiencing.

It aims to identify problems in your relationships with family, friends or partners and how they might relate to your feelings of depression.

Treatment also usually lasts three to four months.

Antidepressants

Antidepressants may be recommended if you have moderate or severe depression and you don't want to try psychological treatment or psychological treatmentdoesn't help.

They may also be used if you have mild postnatal depression and a previous history of depression.

Antidepressants work by balancing mood-altering chemicals in your brain.They can help ease symptoms such as low mood, irritability, lack of concentration and sleeplessness, allowing you to function normally and helping youcope better with your new baby.

Antidepressants usually need to be taken for at least a week before the benefit starts to be felt, so it's important to keep taking them even if you don't notice an improvement straight away. You'll usually need to take them for around six months after you start to feel better. If you stop too early, your depression may return.

Antidepressants and breastfeeding

If youre breastfeeding, talk to your doctor about suitable medicines, as not all anti-depressants are safe to take while breastfeeding.

Your doctor should explain any risks of taking antidepressants and you should be offered the type with the least risk for you and your baby.

Side effects

General side effects ofantidepressants include:

• feeling sick
• blurred vision
• a dry mouth
• constipation
• dizziness
• feeling agitated or shaky

These side effects should pass once your body gets used to the medication.

Severe postnatal depression

If your postnatal depression is very severe and it doesn't respond to the treatments above, you'll probably bereferred to a specialist mental health team.

Yourteam will be able to try additional treatments, such as:

• more intensive CBT
• other psychological treatments, such as psychotherapy
• therapies such as baby massage to help you bond better with your baby, if this has become a problem
• different medications
• electroconvulsive therapy (ECT) where electrodes are placed on your head and pulses of electricity are sent throughthe brain, which may improve your mood by changing the balance of chemicals in your brain

If it's thought that your depression is so severe that you're at risk of harming yourself or others, you may be admitted to hospital or a mental health clinic.

Your baby can either be looked after by your partner or family until you're well enough to return home, or you can stay in a specialised "mother and baby" mental health unit .

Antidepressants

Antidepressant medicine is used to treat depression. For example fluoxetine, paroxetine.

Anxiety

Anxiety is an unpleasant feeling when you feel worried, uneasy or distressed about something that may or may not be about to happen.

Brain

The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.

Counselling

Counselling is guided discussion with an independent trained person, to help you find your own answers to a problem or issue.

Depression

Depression is when you have feelings of extreme sadness, despair or inadequacy that last for a long time.

Dose

Dose is a measured quantity of a medicine to be taken at any one time, such as a specified amount of medication.