Talk to someone you trust, such as your partner or a friend. Or ask your health visitor to call in and visit you. Many midwives and health visitors have been trained to recognise postnatal depression and have techniques that can help. If they can't help, they will know someone in your area who can.

 

It's also important to see your GP. If you don't feel up to making an appointment, ask someone else to do it for you if you think that you may be depressed.

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Remember that:

• A range of help and support is available, including therapy.

• Depression is an illness like any other, that needs to be treated.

• It's not your fault you're depressed - it can happen to anyone.

• Being depressed does not mean that you're a bad parent.

• It does not mean that you're going mad.

• Your baby will not be taken away from you - babies are only taken into care in very exceptional circumstances.

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Postnatal post-traumatic stress disorder

Postnatal post-traumatic stress disorder (Postnatal PTSD) is a type of anxiety disorder that is also known as birth trauma. Living with the effects of a traumatic birth can feel very challenging, especially as it can also be accompanied by other postnatal mental health conditions, feelings of guilt and low self-esteem.

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Symptoms of post-traumatic stress disorder

The symptoms of postnatal PTSD can occur alone, or in addition to the symptoms of postnatal depression, and usually develop straight after the birth or months afterwards.

 

They can include the following:

• Physical sensations, such as pain, sweating, feeling sick or trembling

• Vivid flashbacks (feeling that the trauma is happening right now)

• Intrusive thoughts and images

• Nightmares

• Intense distress at real or symbolic reminders of the trauma

• Physical sensations such as pain, sweating, nausea or trembling

• Panicking when reminded of the trauma

• Being easily upset or angry

• Extreme alertness, sometimes known as 'hypervigilance'

• Finding it hard to sleep, even when you have the chance

• Irritability or aggressive behaviour

• Finding it hard to concentrate, including on simple or everyday tasks

• Being jumpy or easily startled

• Self-destructive or reckless behaviour

• Other symptoms of anxiety.

 

Postnatal PTSD is often the result of a traumatic birth, such as a long or painful labour, or an emergency or problematic delivery. It can also develop after other types of trauma, such as:

• A difficult labour with a long and painful delivery

• An unplanned caesarean section

• Emergency treatment

• Other shocking, unexpected, and traumatic experiences during birth.

• A fear of dying or your baby dying.

• Life-threatening situations.

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Treatments for postnatal PTSD

There are various treatments that you may be offered for postnatal PTSD which usually involves talking therapies. Your doctor should discuss these options with you, so that you can decide together about the best treatment for you:

 

• Identify your triggers - certain experiences, situations, sensations, or people seem to trigger flashbacks or other symptoms.

• Confide in a friend, family member, your GP or a trained listener at a helpline.

• Seek out some peer support to share other peoples experiences e.g. side-by-side.

• Seek out specialist in advice and support for postnatal PTSD e.g. the Birth Trauma Association.

• Trauma-focused cognitive behavioural therapy (CBT), which is specifically designed to treat PTSD.

• Be patient and compassionate with yourself as you recover at your own pace.

• Look after your health: eat well, do some physical activity, and spend time outdoors.

• Try to be patient with yourself. Don't judge yourself for needing time and support to recover from postnatal PTSD

• Eye movement desensitisation and reprocessing (EMDR). 

• Medication is not normally offered to treat PTSD itself. But there are a few related reasons why your doctor may offer you medication:

• It is common to also experience anxiety and depression alongside PTSD. Your doctor might offer you medication to treat those symptoms. 

• Your doctor might offer you medication to help you feel more stable and able to care for your baby. 

• Sometimes there are long waiting lists for talking therapies in your area. Your doctor may offer you medication to help you while you wait for therapy.

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Postpartum psychosis

https://www.nct.org.uk/life-parent/how-you-might-be-feeling/postpartum-psychosis-what-it

 

Postpartum psychosis (sometimes called puerperal psychosis or postnatal psychosis) is a serious mental health illness that can affect a woman soon after having a baby. It affects around 1 in 500 mothers after giving birth.  It is a severe psychiatric illness that can develop within hours of childbirth which should be treated as a serious medical emergency, requiring urgent attention and medical or hospital treatment.

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The most severe symptoms tend to last 2 to 12 weeks, and it can take 6 to 12 months or more to recover completely from the condition. But with treatment and the right support, most people with postpartum psychosis do make a full recovery.

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An episode of postpartum psychosis is sometimes followed by a period of depression, anxiety and low confidence. It might take a while for you to come to terms with what happened. 

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Some mothers have difficulty bonding with their baby after an episode of postpartum psychosis or feel some sadness at missing out on time with their baby. With support from your partner, family, friends and your mental health team, or talking to others with lived experience, you can overcome these feelings.

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Many people who've had postpartum psychosis go on to have more children. Although there is about a 1 in 2 chance you will have another episode after a future pregnancy, you should be able to get help quickly with the right care and the risks can be reduced with appropriate interventions.

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Symptoms of postpartum psychosis

Symptoms usually start suddenly within the first 2 weeks after giving birth - often within hours or days of giving birth. More rarely, they can develop several weeks after your baby is born and can include:

• Restlessness, feeling over-active or energetic.

• Unable to sleep or feeling as though you do not need to sleep.

• Manic mood - talking and thinking too much or too quickly, feeling excited, ‘high’ or ‘on top of the world.

• A low mood - showing signs of depression, being withdrawn or tearful, lacking energy, having a loss of appetite, anxiety, agitation or trouble sleeping.

• Severe mood swings - sometimes a mixture of both a manic mood and a low mood - or rapidly changing moods.

• Loss of inhibitions.

• Feeling suspicious or fearful.

• Feeling very confused and disorganised thinking.

• Behaving in a way that's out of character.

• Hallucinations - hearing, seeing, smelling, or feeling things that are not there (particularly about your baby).

• Delusions - thoughts or beliefs that are unlikely to be true.

 

It’s unlikely that you will recognise the symptoms in yourself, so it’s mostly up to your partners, friends, and family to get help for you.

 

If you do suspect a case of postpartum psychosis, it should be treated as a medical emergency:

• See a GP immediately or call 111.

• Go to A&E or call 999 if you or someone you know is in imminent danger.

 

You should then receive a referral to a specialist perinatal mental health service for assessment. This should happen within four hours of any symptoms starting suddenly.

 

If you have been assessed as being at high risk of perinatal mental health issues, then you will have a care plan in place. A care plan will let you and your friends and family know how to get help quickly if symptoms appear.

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Causes of postpartum psychosis

We're not sure what causes postpartum psychosis, but genes, hormonal changes, disrupted sleep patterns and past mental health status appear to be some of the main causes:

 

• Hormone level changes.

• Disrupted sleep patterns.

• Previous diagnosis of severe mental illness bipolar disorder or schizophrenia.

• Genetic tendency - a family history of mental health illness, particularly postpartum psychosis, and perinatal mental illness (even if you have no history of mental illness).

• If you developed postpartum psychosis after a previous pregnancy.

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Treatment for postpartum psychosis

Treatment for postpartum psychosis usually happens in hospital. Ideally, this would be with your baby in a specialist mother and baby (MBU) psychiatric unit which can provide you with expert treatment without separating you from your baby. But you may be admitted to a general psychiatric ward until an MBU is available.

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With the right support and treatment most women make a complete recovery, although this may take a few weeks or months.

You may be prescribed 1 or more of the following treatments:

• Antipsychotics medication - to help with manic and psychotic symptoms, such as delusions or hallucinations.

• Mood stabiliser medication (for example, lithium) - to stabilise your mood and prevent symptoms recurring.

• Antidepressant medication - to help ease symptoms if you have significant symptoms of depression and may be used alongside a mood stabiliser.

• Electroconvulsive therapy (ECT) - sometimes recommended if all other treatment options have failed, or when the situation is thought to be life threatening.

• Psychological therapy - cognitive behavioural therapy (CBT), talking therapy that can help you manage your problems by changing the way you think and behave.