Postnatal depression

Expert review by:

Dr Samantha Wild, Clinical Lead for Women's Health and Bupa GP
Michelle Sheridan, Midwife, Bupa UK

Content review by:

Pippa Coulter, Freelance Health Editor

Page last reviewed: November 2023
Next review date: November 2026

Postnatal depression is a type of depression that you can develop after having a baby. This will usually be within the first year. Postnatal depression can make you feel very low. There are treatments and support available that can help you to feel better.

About postnatal depression?

Postnatal depression is no different to depression you can get at any other time. It’s referred to as postnatal depression if you have recently had a baby. Postnatal depression most often starts within the first couple of months after giving birth. But you may get it up to a year later.

Lots of people feel overwhelmed, tearful and emotional for a few days after having a baby. This is sometimes called the baby blues and usually starts within three to 10 days after your baby is born. Baby blues usually pass within a few days, without the need for treatment or additional support.

Postnatal depression is more intense and lasts longer than the baby blues. It affects between one and two in 10 women within a year of giving birth.

You can get depression while you’re pregnant too. This is called antenatal or prenatal depression. Perinatal depression covers both antenatal and postnatal depression. Partners of people who have recently given birth can also experience depression. Some people refer to this as postnatal depression too. There can be many reasons for this. They include having extra responsibilities, financial pressures and lack of sleep. Relationship problems can also be a factor.

If you need help now

This page is designed to provide general health information. If you need help now, please use the following services.

Samaritans
116 123 (UK and ROI) - This helpline is free for you to call and talk to someone.
www.samaritans.org
NHS Services has a list of where to get urgent help for mental health.
Mind website. Click the ‘Get help now’ button on the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.
If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999 or go to your local accident and emergency department.

Causes of postnatal depression

Postnatal depression can happen to anyone and it’s important to know that it’s not your fault. Having a baby is a huge life change. Adjusting to the extra responsibility of looking after a new baby can take time.

Depression is usually caused by a combination of several factors. There are many factors that affect your chance of getting postnatal depression. You’re more likely to get it if:

you’ve had mental health problems such as depression in the past, including during pregnancy
you had the ‘baby blues’ after you gave birth
you don’t feel that you have enough support
you suffered abuse or neglect in childhood, or had an unstable family life
you have low self-esteem
your living conditions are stressful – for example, you’re having money, housing or employment problems
you’re in an unhappy or abusive relationship
you’ve had a recent major life event, such as a bereavement, relationship break-up or you’ve lost your job
it took a long time for you to get pregnant
your partner is depressed
your pregnancy wasn’t planned
you have two or more children
you have a family history of depression
your baby was premature or has had health problems

Just because these factors increase your risk, you can still become depressed without having any of them. Or, you may have some of these factors and never develop postnatal depression. Having postnatal depression is not something you can help. And it is no reflection on your ability to care for your baby.

Symptoms of postnatal depression

Postnatal depression symptoms start within a year of having your baby. You may:

feel low and tearful much of the time
feel anxious or irritable
not enjoy things you normally do
feel guilty and worthless
feel hopeless
find it hard to concentrate or make decisions
feel like you have no energy
have problems sleeping even when your baby is asleep
not want to see friends and family
lose your appetite
lack interest in your baby or partner, or have negative feelings towards them
have thoughts about harming yourself or your baby

Anyone can have these feelings from time to time after having a baby. But if you’ve been feeling like this most of the time, for two weeks or more, you may have postnatal depression. Having a baby takes a lot of adjustment for anyone. But if you have postnatal depression, you may feel that you can’t cope and worry constantly about your baby. You may also feel detached from your baby and find it hard to bond with them.

Seeking help

If you think you may be depressed, tell your GP, health visitor or midwife. They won’t judge you – they’re used to helping women who have postnatal depression. They will be focused on getting you the help and support you need to feel better and look after your baby.

If you feel that you can’t look after your baby or are having thoughts about harming yourself or your baby, get urgent help. Either go to your nearest accident and emergency (A&E) department or contact one of the services listed in our section: If you need help now. You can also call 999 if necessary.

Postpartum psychosis

Postpartum psychosis is a rare and very serious form of postnatal depression. About one to two in 1,000 people develop it after having a baby. If you have postpartum psychosis, you may:

have rapid mood swings, switching between feeling really happy and excited then severely depressed
have hallucinations where you see or hear things that aren’t there, or delusions where you may believe something that isn’t true
feel confused and disorientated

The symptoms usually start within days or weeks of having a baby and come on quite suddenly. If you’re having any of these symptoms, speak to your GP, midwife or health visitor straightaway. If you don’t feel able to speak to a health professional, try to talk to someone who you can trust. They can support you in getting help. If you need to, go to your local A&E department or contact one of the services in our section: If you need help now. It’s important to get any treatment and support you need as soon as possible.

Diagnosis of postnatal depression

Your midwife, health visitor or GP will usually ask you about your mental health and how you’re feeling at your postnatal appointments. This is a good opportunity to tell them if you’re feeling low or depressed.

You can also contact your health visitor or GP at any time if you need help for mental health problems. They’ll ask you some questions about how you’ve been feeling. They may use a standard questionnaire to do this. This will help them assess whether you may have postnatal depression. They’ll want to know about any physical symptoms you have too, and how you are coping with looking after your baby.

If you have postnatal depression, your health visitor or GP may be able to support you and organise any treatments you need. Sometimes, they may suggest referring you to specialist mental health services. This might be perinatal mental health services (a specialist service for pregnant women and those with babies under a year old). Or it might be your local community mental health team. These specialist services are usually only needed if you have more severe postnatal depression.

Self-help for postnatal depression

Most people with postnatal depression feel better within a few months. But it can affect some people for longer – this can be a year or more. There are many things you can do to help yourself cope with postnatal depression. Here are some suggestions.

Talk to someone you trust, such as your partner, a friend or family member about how you’re feeling. If they know what the problem is, they can support you in getting the help you need.
Sleep or rest whenever you get the chance. Try to get some sleep while your baby sleeps, and if you can’t sleep, at least try to rest and relax.
Grow your support network. You could try local groups for new parents. Your midwife or health visitor may be able to give you information on these. Ask someone to go with you if you find it difficult at first. There are also online parenting communities you can join.
Ask for help with caring for your baby when you need it. Take up any offers of help with housework, cooking meals, shopping and childcare – don’t feel guilty about accepting support.
Make time for things you enjoy, even if it’s just a few minutes to read a book or watch TV.
Try to stick to a healthy balanced diet and regular meals, even if you don’t really feel like eating.
Try to get some regular, gentle exercise. Even just a walk in the fresh air with your baby can help.
Don’t use alcohol or drugs to cope with your feelings – they will make your depression worse.
Get in touch with organisations that support parents with postnatal depression. For contact details, see our section: Other helpful websites.

The most important thing is to be kind to yourself. You’re going through a tough time. Take help when it’s offered and remind yourself that these feelings often pass with time.

Treatment of postnatal depression

Treatment options for postnatal depression include talking therapies and medicines. Which treatment is right for you will depend on several factors. These include how severe your postnatal depression is and whether you’ve had treatment for depression before. It also depends on whether you are breastfeeding. Your doctor can explain what options are available and the benefits and risks of each. They will then support you in making a decision.

Talking treatments

If you have mild symptoms of postnatal depression, your doctor may suggest a guided self-help programme. These are based on the principles of cognitive behavioural therapy (CBT). CBT aims to change how you think and behave in different situations. In guided self-help, you’re provided with printed information or a web-based programme. A professional trained in CBT supports you on the programme.

If you have more severe depression, they may offer you face-to-face CBT sessions.

CBT technique for unhelpful thoughts (animation)

Cognitive behavioural therapy (CBT) is a type of therapy that can help to improve your mental health. It aims to change negative thoughts and beliefs you may have, that can affect how you feel and behave.

Hundreds of automatic thoughts pop into our head every day. Sometimes these are negative and unhelpful. But thoughts are not facts, so it’s helpful to challenge our thinking. A ‘thought record’ is one CBT technique that can help you look at negative thoughts in a more balanced way.

This exercise works well if you have a notepad and pen to write down your answers.

Step 1. Think about the situation that’s upsetting you. What emotions and feelings do you have?

How intense are they? Rate the intensity from one to 10, with 10 being the most intense.

Step 2. What is the negative thought?

Try and be specific about the thoughts running through your mind and write them down. Perhaps something hasn’t gone as well as you’d have liked. Your thoughts start spiralling and you start to think that everything always goes wrong and maybe even that you’re a bad person.

Step 3. Now it’s time to put your thoughts on trial. Focus on the facts – is there any factual evidence that this thought is true?

Does everything always go wrong? Are you really a terrible person? Was what happened your responsibility entirely? Would you say the same things to someone you cared about who was in this situation?

Step 4. Now, what is the evidence that this thought is not true?

Can you think of a time when something you did went well? What about your friends and family and how much they care and value you? What are the good things in this situation?

Step 5. Weigh up the evidence. Is there an alternative thought? A more balanced and realistic way of looking at things?

Perhaps alternative thoughts could be: Things didn’t go as well as I’d liked, but that’s ok. Everyone makes mistakes sometimes. I am a good, kind person. I am human and doing the best I can.

Step 6. Check back in with yourself. How do you feel now? Rate the intensity again from one to 10.

Remember, the way that you think about a situation affects how you feel. Try this exercise next time automatic negative thoughts start to affect you.

If you are worried about your mental health, please see your GP for help and support.