The feelings that someone who has postnatal depression may have will likely depend on the severity of the condition and they are also likely to change on a daily basis.
Some of the feelings that are common, and which help clinicians to make a diagnosis of postnatal depression, include:
- Persistent low mood.
- Irritation and frustration.
- Lack of motivation.
- Feeling unable to or not wanting to manage the baby’s needs.
- Problems sleeping.
- Reduced or increased appetite.
- Unable to enjoy previously pleasurable activities or spending time with their baby.
- Feelings of isolation and despair.
- Persistent aches and pains.
We will now explore each of the above in more detail.
The experience of low mood is different to when a woman has baby blues, because in postnatal depression, the feeling is persistent and can go on for many months, even when it is being treated. Some women may find that they feel worse at certain times of the day, such as in the morning when the day ahead may feel unmanageable, or in the evening when they feel that they have spent another ‘worthless’ day and have not accomplished anything meaningful.
Feelings of irritability may mean that the woman gets irrationally angry or frustrated with her partner, baby or with other children. Irritability makes someone feel as though nothing they do goes right or that they should not even bother trying something because there is no point. This can then lead to feelings of guilt and hopelessness, which do nothing but help feed into the depression.
Exhaustion is common for women who have a new baby, because caring for a baby can be an incredibly tiring and demanding job that never seems to end. This can be made worse if the woman has a poor support system or is managing as a single parent.
Being exhausted can cause women to have no motivation to do anything, and in some severe cases, this can lead to loss of personal hygiene routines and general self-care. It can also mean that the woman may also neglect the care of her baby, although severe neglect in postnatal depression is rare.
Even though some women may be completely exhausted, sometimes, postnatal depression affects their sleeping patterns and this can lead to insomnia. Insomnia may be caused by worry and anxiety about their ability to care for their baby or general worry about whether or not they are doing a good job. Some women have concerns that they are not bonding with their baby and all of these worries can make them unable to fall asleep even when their baby is still sleeping.
Changes to appetite
Appetite changes are common for women who have postnatal depression. Some women are so consumed by their baby’s care needs that they actually forget to eat. For some women, postnatal depression means that their appetite is completely diminished and they no longer get any enjoyment from preparing and eating meals.
For some women, however, an increase in appetite occurs because they find that they are eating for comfort. Whilst this may make them feel better in the short term, ultimately, it may result in guilt about gaining weight; for women who have pre-existing body image issues this can prove very problematic.
Relationship with baby
One problem for women that can cause extreme guilt is that they do not enjoy spending time with their new baby. The postnatal period is often portrayed by the media as a time when women and their babies go through a joyous period of bonding and it comes across as the happiest time in a woman’s life. However, the reality of the postnatal period is often quite different.
Mother’s that do not suffer from postnatal depression are likely to have a period of baby blues anyway, but postnatal depression can mean that women do not enjoy being with their baby, especially if he or she is especially demanding. Problems such as colic can mean that babies only sleep for short bursts and spend a lot of time crying and this can be completely overwhelming for women, meaning they feel as though they cannot cope.
The exhaustion that this causes can mean that they have no time or get no pleasure from things they used to enjoy because they are too tired, and their mood is too low to enjoy them.
Postnatal depression can mean that a woman has negative and guilty thoughts that are with them for most of their waking hours and can even interrupt their sleep.
Some examples of negative thoughts that a woman who is experiencing postnatal depression may have include:
- ‘I am not a good mother’.
- ‘I shouldn’t be feeling like this’.
- ‘I can’t cope’.
- ‘My baby doesn’t love me’.
- ‘I haven’t got the confidence to tell anyone how I am feeling’.
- ‘Everyone things I am a failure’.
As well as negative thoughts, women may also experience thoughts of anxiety regarding their baby and themselves, which can be very overwhelming:
- ‘My baby is ill’.
- ‘My baby has not put on enough weight’.
- ‘My baby has put on too much weight’.
- ‘My baby is quiet – they must have stopped breathing’.
- ‘I am going mad’.
- ‘I am seriously ill’.
Many of these thoughts are normal and come as part of adjusting to a new lifestyle but they can become very intrusive and, for many women, thinking negative and anxious thoughts can become their normal way of looking at things and this can be very tiresome.
Anxiety caused by negative thinking can result in some physical symptoms, which may also be experienced as part of postnatal depression:
- Rapid heart rate.
- Shallow breathing.
- Fear that you are losing control or going mad.
When someone experiences negative thinking patterns all the time, this can affect their physical health and they may feel as though they are tense all the time, causing aches and pains that affect their overall well-being. When psychological and physical symptoms combine, someone can be left feeling very unwell and this can cause them to withdraw from their social life and, as such, feel isolated and alone.
How postnatal depression affects the mother
Postnatal depression can have a severe impact on the mother because it has a direct impact on her ability to lead a normal life and carry out day-to-day activities. At its worst, the mother may feel like her inability to cope makes life not worth living. Depression can cause people to see no hope for the future and, sometimes, this can lead to thoughts of self-harm or suicide.
Many women who have postnatal depression are unable to prioritise correctly, which can mean that whilst their baby is screaming with hunger, they are loading their dishwasher or vacuuming the carpet.
Many of these responses are due to the fact that some women will not want others to know that they cannot cope or that they are experiencing depression and so they feel the need to maintain an image of being in control, even if this means that their baby’s needs are not met as a result.
One of the most resounding effects of postnatal depression is usually the impact of the mother feeling as though she has failed. There is a lot of societal pressure for women to feel as though they have to do everything, and whilst some women can completely dismiss these demands, for others they are taken on board and deemed as a way that they have to live their lives.
Trying to care for a new baby as well as trying to maintain a household can be a very daunting task, and for some women, trying to achieve this is what has a big influence on the development of postnatal depression.
Lack of bonding
Fears of failure can also mean that mothers do not bond with their baby in a meaningful way. Psychologist John Bowlby argued in the 1960s that attachment to a primary caregiver was essential for a baby’s initial development and on their own ability to forge positive relationships in the future.
He stated that there was a ‘critical period’ in which bonding or attachment should occur and if this time expired without bonding being achieved, then this would negatively impact the child in the future. The ‘critical period’ for bonding to take place is, according to Bowlby, between birth and approximately 24 months, which happens to coincide with the time when postnatal depression is most likely to occur.
Whilst Bowlby’s theories have been heavily criticised, they are still influential and are thought to be one of the reasons why mothers are given their babies to hold as soon as they are born (whenever this is possible) in order to encourage bonding.
Most women will bond with their baby automatically and they will know instinctively how to respond when he or she is in distress. They will coo to them, comfort them and hold them close to show the baby that they are there. However, maternal instincts are not automatic for some women and for those who have postnatal depression any instincts might be overridden by the condition, which makes them unable to bond effectively whilst they have it.
Lack of bonding may occur because the mother is too exhausted to care for her baby properly. She may have had a traumatic birth or a caesarean section, which coupled with lack of sleep means she cannot care effectively for her child and may, therefore, rely on others to help. This may lead to guilt as she feels as though bonding is happening with other people and not with her.
Also, a woman who has postnatal depression may feel resentful towards her child for the development of her condition and this can cause her to not want to look after her child, or in some cases even touch or look at him or her. This lack of positive feeling in the ability to bond with the baby can lead to intense guilt and shame, and in some extreme and tragic cases this can cause the woman to harm the baby or herself, but this is uncommon.
The Effect of Postnatal Depression on Others
The family and friends of the woman who has postnatal depression may be left feeling helpless because they do not know how to react to what she is going through.
Sometimes, this may mean that they avoid seeing her because they do not know what to do or say and this can make things worse as she then feels isolated and detached from the people around her. It can be extremely distressing for people around the woman to see her not respond to her baby’s needs and this may be another reason why they avoid seeing her.
Many partners may feel resentful that this has happened to their wife or girlfriend and this can cause tension, both in the relationship and with the partner’s other relationships as well, as they may be uncharacteristically angry or frustrated for much of the time.
Partners may also feel left out and neglected because the woman simply cannot find the energy to interact with them in the way that they used to. Many partners can sometimes feel responsible for what is happening and may take unrealistic steps to ‘fix things’. For example, they may become a workaholic to ensure that their baby does not suffer financially in the future for what they see as a negative start to their life.
Depression in partners
Partners may also begin to develop some level of depression, because if the women’s postnatal depression means she is struggling to carry out daily activities, the partner will have a lot of added responsibilities likely on top of doing their own job as well. They may feel exhausted and some partners may feel as though they cannot ask for help as they too feel like this would be an admission of failure to adjust to having a new baby.
In order to lessen the impact of postnatal depression, people around the woman should be patient and understanding. They should listen to her concerns and encourage her to talk openly about her feelings. This should help her to feel less alone and more supported rather than like she is going through the condition alone.
If the woman is feeling overwhelmed by daily activities, then it may help to offer support but not to take over and to ensure that she gets time alone for herself, even if this means just a 30-minute nap or an hour to have a bath or read a book.
If there is a lack of understanding about postnatal depression, then it may help if the woman and her partner seek guidance together about what is happening and what they can do to help her to recover. This may involve doing their own research or they may visit their GP who will help them to understand the condition and offer guidance about support and treatment if they think it is required.
Partners and other family members should not neglect their own health and ensure that they too are asking for help and support when they need it, even if this is something that they find difficult or are reluctant to do.