Postnatal depression and anxiety
It is common, it is treatable, and telling someone does not put your baby at risk. Those three things are the ones people most need to hear, so they are going first.
If you need help right now
- In danger of harming yourself or anyone else — call 999, or go to A&E. That is the NHS’s own instruction, and it applies whatever time it is.
- Cannot speak to a GP, or do not know what to do next — call 111. Open 24 hours.
- Just need to talk — Samaritans, free, on 116 123. Any hour of any day. You do not have to be in crisis to ring them, and you do not have to explain yourself first.
In short
- The baby blues are not postnatal depression. Feeling low, anxious or irritable for a few days is very common and usually passes within 2 weeks.
- Postnatal depression can start any time in the first year — and it can start in pregnancy, before the baby arrives at all.
- It is not only sadness. Rage, numbness, anxiety and an inability to enjoy anything are just as common, and are missed far more often.
- Fathers and partners get it too. The NHS says so plainly.
- It usually gets better in 3 to 6 months with treatment, though it can last longer.
- Many antidepressants are safe while breastfeeding. Do not rule out help on that basis before you have asked.
- Postpartum psychosis is different and is an emergency. It is rare, it comes on fast, and it needs same-day help.
Baby blues, or something more
Feeling down, tearful, anxious or short-tempered in the first few days after birth is very common. The NHS calls this the baby blues, and the defining feature is that it usually goes away within 2 weeks.
The line worth holding onto is simple: if it lasts longer than two weeks, or it is getting worse rather than better, that is the point to tell someone. Not because two weeks and one day is a magic threshold, but because past that point it is no longer the thing that resolves on its own.
It does not have to start at the birth
Postnatal depression can begin during pregnancy, in the days after birth, or at any point up to a year afterwards. A lot of people discount what they are feeling at seven or eight months because the baby is no longer new and they assume they have missed the window to call it postnatal. They have not.
What it actually looks like
The picture most people carry is a mother who cannot stop crying. That version exists, but it is not the most common one, and expecting it is the main reason people fail to recognise this in themselves.
More recognised
- Low mood that does not lift
- Crying, or wanting to
- Feeling hopeless
- Trouble sleeping even when the baby sleeps
Missed far more often
- Not being able to enjoy anything, including the baby
- Guilt — usually about not feeling what you expected to feel
- Anxiety that will not switch off
- Anger and irritability out of proportion to the trigger
- Feeling flat and detached rather than sad
- Withdrawing from people who want to help
Guilt deserves its own mention, because it is the symptom that stops people asking for help. Feeling nothing much for a baby you expected to adore is a recognised feature of an illness. It is not a verdict on you as a parent, and it is not permanent.
Thoughts of harming yourself or the baby
In more severe postnatal depression these thoughts can happen, and they are frightening enough that people hide them. Please do not. They are a recognised symptom that health professionals are trained for and have heard before. Tell your GP, midwife or health visitor today — or if you feel you are in danger of acting on them, call 999 or go to A&E now.
When it is anxiety rather than depression
Plenty of people in the first year are not flat, they are wired. Checking the baby is breathing over and over. Unable to hand them to anyone else. Playing out disaster scenarios in vivid detail. Physically unable to rest during the window when rest is possible.
Some vigilance is normal and useful — it is what keeps small humans alive. It is worth telling someone when it stops being useful and starts costing you: when you cannot sleep because of the checking, cannot leave the house, or cannot let anyone else hold your baby without dread.
Partners and fathers
The NHS is unambiguous: fathers and partners can also have depression after having a baby. It is not a lesser version and it is not sympathy pains.
It tends to be spotted even later than in mothers, for two reasons. Partners are rarely asked — the health visitor's questions are usually pointed at the person who gave birth — and it more often shows up as irritability, working late, drinking more, or withdrawing, none of which look like the picture people have of depression.
If that is you: you can go to your own GP about this. You do not need permission, and you are not taking attention away from anyone.
Postpartum psychosis — the emergency
This one is urgent, and it is different
Postpartum psychosis is a serious illness affecting around 1 in 1,000 mothers after giving birth. Symptoms usually start suddenly within the first 2 weeks, often within hours or days. It can involve hallucinations, delusions, mania, severe mood swings or confusion.
It can get worse rapidly. The NHS says to see a GP immediately and request an urgent assessment the same day; to call 111 if you cannot reach a GP; to call your crisis team if you already have a care plan; and to go to A&E or call 999 if you or someone you know may be in danger of imminent harm.
If you are reading this about someone rather than for yourself: you do not need their agreement to get advice. Ring 111 and describe what you are seeing. People experiencing psychosis often do not recognise that they are unwell, which is precisely why the responsibility tends to fall to whoever noticed.
“Will they take my baby away?”
This is the fear that keeps people silent, so it is worth answering directly.
Postnatal depression and anxiety are common, expected illnesses that the health service is set up to treat. Telling a midwife, health visitor or GP that you are struggling is an ordinary conversation for them — they ask about it precisely because they expect to find it. The overwhelming, everyday outcome of that conversation is support: a follow-up appointment, a referral to talking therapy, a discussion about medication.
Professionals are far more concerned about a parent who is struggling in silence and unsupported than one who has said so and is getting help. Asking for help is evidence of you looking after your child, not evidence against you.
What help actually looks like
Any of the three is a legitimate front door. Health visitors in particular are trained in this and can usually see you sooner than a GP.
Cognitive behavioural therapy (CBT) is a standard NHS treatment for this. In England you can also refer yourself for talking therapies without going through a GP at all.
Antidepressants are commonly used, and many are safe to take while breastfeeding. If that is your worry, say so out loud — it changes which one you are offered, not whether you are offered anything.
For more severe illness there are specialist NHS teams, and mother and baby units where you are admitted with your baby rather than separated from them.
Most people get better. The NHS expects postnatal depression to improve in 3 to 6 months with treatment, though it can sometimes last longer. Slower than that does not mean it is not working.
What to say, if you cannot find the words
The hardest part is often the first sentence. You do not need a diagnosis or a tidy explanation. Any of these is enough to start:
Enough to open the conversation
- “I don’t think I’m coping and it’s been more than two weeks.”
- “I’m not enjoying anything, including the baby, and it frightens me.”
- “I can’t stop worrying and I can’t sleep even when I get the chance.”
- “I’m angry all the time and it isn’t like me.”
- “I’m having thoughts that scare me and I need to tell someone.”
If saying it out loud is too much, write it down and hand it over. That counts. So does asking someone else to make the call for you.