Depression (Postnatal).pdf

Postnatal depression

Fact sheet 22

Adjusting to life as a mother can be dificult. In fact, for many women, having a baby is the most

signiicant life-changing event they will ever experience. Adjusting to this major life change, as

well as coping with the day-to-day demands of a new baby, can make some women more likely to

experience depression at this time, particularly if they’ve experienced depression in the past.

hOW cOMMON Is POstNataL

DePRessION?

hOW DO YOU KNOW IF YOU haVe

POstNataL DePRessION?

Postnatal depression (PND) affects almost 16 per cent of new

mothers in Australia. As with depression, PND is common.

One in ive females and one in eight males. Around one million

Australian adults and 160,000 young people live with depression

each year.

Postnatal depression has the same signs and symptoms as

depression.WomenwithPNDcanexperienceaprolonged

period of low mood, reduced interest in activities, tiredness and

disturbance of sleep and appetite and negative thoughts and

feelings. To ind out about the general symptoms of depression,

go to the series of depression checklists at

www.beyondblue.org.au.

What caUses POstNataL

DePRessION?

The Edinburgh Postnatal Depression Scale (see below) is

a set of questions designed to see if a new mother may have

depression. The answers will not provide a diagnosis – for that

you need to see a doctor or other health professional. The

answers will tell you however, if you or someone you know, has

symptoms that are common in women with PND.

Like depression which occurs at any other time, postnatal

depression doesn’t have one deinite cause – but it’s likely to

result from a combination of factors including:

• apasthistoryofdepressionand/oranxiety

If you have concerns that you or someone you know has PND,

please consult a doctor.

• astressfulpregnancy

• depressionduringthecurrentpregnancy

To complete this set of questions, mothers should circle the

numbernexttotheresponsewhichcomesclosesttohowthey

have felt IN THE PAST SEVEN DAYS.

• afamilyhistoryofmentaldisorders

• experiencingsevere‘babyblues’

• aprolongedlabourand/ordeliverycomplications

1 I have been able to laugh and see the funny side of things.

0 As much as I always could

1 Not quite so much now

2 Deinitely not so much now

3 Not at all

• problemswiththebaby’shealth

• dificultybreastfeeding

• alackofpractical,inancialand/oremotionalsupport

• pasthistoryofabuse

2 I have looked forward with enjoyment to things.

• dificultiesincloserelationships

0 As much as I ever did

1 Rather less than I used to

2 Deinitely less than I used to

3 Hardly at all

• sleepdeprivation

• beingasingleparent

• havinganunsettledbaby(e.g.dificultieswithfeeding

and sleeping)

3 I have blamed myself unnecessarily when things went wrong.

• havingunrealisticexpectationsaboutmotherhood

3 Yes, most of the time

2 Yes, some of the time

1 Not very often

0 No, never

• movinghouse

• makingworkadjustments(e.g.stoppingorre-startingwork).

For more information www.beyondblue.org.au or beyondblue info line 1300 22 4636

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Postnatal depression

Fact sheet 22

4 I have been anxious or worried for no good reason.

The total score is calculated by adding together the numbers

you circled for each of the 10 items. The higher the score, the

more likely it is that the person completing the questionnaire is

distressed and may be depressed.

0 No, not at all

1 Hardly ever

2 Yes, sometimes

3 Yes, very often

Scores provide only a rough guide as to whether a

woman has postnatal depression. For a full diagnosis, it

is important to see a doctor.

5 I have felt scared or panicky for no very good reason.

3 Yes, quite a lot

2 Yes, sometimes

1 No, not much

0 No, not at all

hOW Is POstNataL DePRessION

tReateD?

There is a range of effective treatments for managing PND.

6 Things have been getting on top of me.

3 Yes, most of the time I haven’t been able to cope at all

2 Yes, sometimes I haven’t been coping as well as usual

1 No, most of the time I have coped quite well

0 No, I have been coping as well as ever

Psychological treatment

Psychological treatment, whichisoftenreferredtoas‘talking

therapy’ has generally been found to be the most effective way of

treating postnatal depression. Psychological treatment can help by:

7 I have been so unhappy that I have had dificulty sleeping.

• changingnegativethoughtsandfeelings

3 Yes, most of the time

2 Yes, sometimes

1 Not very often

0 No, not at all

• encouraginginvolvementinactivities

• speedingrecovery

• preventingdepressionfromgetting serious again.

8 I have felt sad or miserable.

Medication

Medication can play an important role in helping people with

depression manage from day to day. Some people may worry

about how antidepressants will affect a baby who is breastfed.

However, remaining on medication can be important in order to

avoid signiicant depression which can have a negative impact

for both mother and baby.

3 Yes, most of the time

2 Yes, quite often

1 Not very often

0 No, not at all

9 I have been so unhappy that I have been crying.

3 Yes, most of the time

2 Yes, quite often

1 Only occasionally

0 No, never

If the mother is breastfeeding, speciic types of medications

are preferred. While a number of factors will inluence the

choice of antidepressant, SSRIs – Sertraline, Citalopram and

Fluvoxamine–havebeenfoundtobeleastlikelytocauseany

harm to infants.

10 The thought of harming myself has occurred to me.

The decision to take medication is up to the individual and

should be made in consultation with a doctor, after considering

the risks and beneits to both the mother and infant. For more

details visit www.beyondblue.org.au or call the beyondblue

info line on 1300 22 4636 (local call).

3 Yes, quite often

2 Sometimes

1 Hardly ever

0 Never

(Furtherreading:Buist,A.‘GuidelinesfortheUseofSSRI’sin

pregnant Women’, Obstetrics and Gynecology, Vol. 7, No. 4,

Summer2005,pp.18-20).

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For more information www.beyondblue.org.au or beyondblue info line 1300 22 4636

hOW tO heLP YOURseLF IF YOU

haVe POstNataL DePRessION

• Lookafteryourself.Seeksupportforyourownneedsby

joiningasupportgroup,keepingintouchwithyourfamily

doctor and taking time out. By keeping yourself physically

and mentally healthy, you will be better equipped to support

the person with the illness.

• Expectthatapersonwithpostnataldepressioncanbemoody,

irritable, volatile, teary and withdrawn. Try not to take what they

say as a personal attack.

• Contactadoctororhospital,ifthewomanbecomesathreat

to herself or others.

• Seekhelpandtreatmentfromadoctororotherqualiied

health professional.

• Seekfriendshipswithotherwomen,includingothermums

who have postnatal depression.

• Organisechildcareoraskfriendsorfamilytolookafterthe

child/renoccasionallytoallowyoutohavetimetoyourself.

• Makesureyoutaketimetodothethingsyouenjoylike

reading a book, listening to music or having a bath.

• Spendsometimewithyourpartnertohelpnurturethe

relationship.

• Developasupportsystemoffriends,familyand

professionals and accept help.

• Restrictvisitorswhenfeelingunwell,overwhelmedortired.

• Takethingsonestepatatime.

• Don’tbottleupfeelings–discussthemwithfriends,family

and your partner.

• Eatabalanceddiet.

• Practisedeepbreathingandmusclerelaxationtechniques.

• Trytoestablishgoodsleepingpatterns.

• Learnaboutpostnataldepression.

• Callapostnataldepressionsupportserviceormental

health crisis line if things are getting tough and other help

is not available.

WheRe tO Get heLP

• A doctor whoisaGeneralPractitioner(GP)isagoodirst

step. In some cases, the person may be referred to

a mental health specialist like a psychiatrist or psychologist.

ForalistofGPswithexpertiseintreatingdepression

and related disorders visit the beyondblue website

www.beyondblue.org.au and click on Find a Doctor or

call the beyondblue info line on 1300 22 4636 (local call).

• Psychiatrists are doctors who specialise in mental health.

They can make medical and psychological assessments,

conduct medical tests and prescribe medication. Some

psychiatrists use psychological treatments.

• Psychologists, Mental Health Nurses, Social Workers

and Occupational Therapists specialiseinprovidingnon-

medical (psychological) treatment for depression and related

disorders. A rebate can now be claimed through Medicare

forpsychologicaltreatmentswhenyourGP,psychiatristor

paediatrician refers you to a registered psychologist, mental

health nurse, social worker or occupational therapist. This

rebate can be claimed for part of the cost for up to 12 individual

(18inexceptionalcircumstances)and12groupsessionsin

a calendar year. For more details ask your referring medical

practitioner. For a list of mental health professionals providing

treatment for which you can claim a Medicare rebate go to:

hOW tO heLP sOMeONe WIth

POstNataL DePRessION

• Rememberthatpostnataldepressionistreatable.

• Encouragethewomantoseeahealthprofessional.Offerto

go along to the session with her.

• Learnaboutpostnataldepression.

• Spendtimelistening,withoutfeelingtheneedtooffersolutions.

•Offertospendtimelookingafterthebabyorolderchildren

or discuss other childcare options so the mum can have time

to herself.

• Offertohelpwithhouseworklikecookingandcleaning.

• Letthewomanknowhowwellsheisdoingwhenshemakes

small gains.

• Encouragethewomantousesomeself-helpstrategies.

– Clinical Psychologists: www.beyondblue.org.au

under Find a Psychologist

– Psychologists: www.psychology.org.au

under Find a Psychologist

– Mental Health Social Workers: www.aasw.asn.au

under Find a Mental Health Worker

– Mental Health Occupation Therapists: www.ausot.com.au

under Find a Mental Health OT

For more information www.beyondblue.org.au or beyondblue info line 1300 22 4636

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Postnatal depression

Fact sheet 22

beyondblue: the national depression initiative

www.beyondblue.org.au

Informationondepression,anxietyandrelatedsubstance-use

disorders, available treatments and where to get help.

Post and Antenatal Depression Association Inc

(PaNDa)

www.panda.org.au

Provides information for women and their families affected by

antenatal and postnatal mood disorders about the causes and

symptoms of these disorders, as well as types of treatments

and support services available.

beyondblue info line 1300 22 4636

Informationondepression,anxietyandrelatedsubstance-use

disorders, available treatments and referral only (local call).

www.youthbeyondblue.com

beyondblue’s website for young people – information on

depression and how to help a friend.

The North Queensland Postnatal Distress

Support Group (NQPNDG)

www.nqpostnataldistress.com

Information on the causes of PND and recovery patterns of

these disorders. There is also information about and contact

details for the North Queensland Postnatal Distress Support

Groupandotherrelatedservicesinthearea.

Suicide Helpline – Victoria

1300 651 251 or www.suicidehelpline.org.au

24 hour counselling, crisis intervention, information and referral

(local call).

Suicide Call Back Service

1300 659 467

Provides counselling, information and referral to people at risk of

suicide and those concerned about someone else’s behaviour

Good Beginnings

www.goodbeginnings.net.au

Information on parenting children and details of support

services for new parents.

Mensline Australia

1300 78 99 78 or www.menslineaus.org.au

24 hour support for men with family and relationship problems

especially around family breakdown or separation – this service

provides anonymous telephone support, information and

referral (local call).

Tresillian

www.tresillian.net

Information on parenting children and details of support

services for new parents.

Karitane

www.karitane.com.au

Information on parenting children, including a section on

managing postnatal depression, and details of support services

for new parents.

Lifeline

13 11 14

24 hour counselling, information and referral (local call).

CRUfAD

www.crufad.org

Informationaboutdepression,anxietyanditsmanagement.

Moodgym

www.moodgym.anu.edu.au

Online psychological therapy.

Public Health Centres

Community public health centres also provide help and advice

on child and maternal health issues. See your local telephone

directory or health service.

Climate.tv – interactive e-health

www.climate.tv

Developedbymedicalexperts,thisisaself-management

systemforpeoplewithdepressionandanxiety.

Black Dog Institute

www.blackdoginstitute.org.au

Information on depression (including during and after pregnancy)

and bipolar disorder – speciically causes, treatments, symptoms,

getting help and current research indings.

POBox6100,HawthornWestVIC3122

T: (03) 9810 6100

beyondblue info line 1300 22 4636

F: (03) 9810 6111

E: bb@beyondblue.org.au

W: www.beyondblue.org.au

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For more information www.beyondblue.org.au or beyondblue info line 1300 22 4636

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