Postnatal depression

Depression in a woman after childbirth. The cause is probably a combination of sudden hormonal changes and psychological and environmental factors. The depression ranges from an extremely common and mild, shortlived episode (“baby blues”) to a rare, severe depressive psychosis. Most mothers first get the “blues” 4–5 days after childbirth and may feel miserable, irritable, and tearful. The cause is hormonal changes, perhaps coupled with a sense of anticlimax or an overwhelming sense of responsibility for the baby. With reassurance and support, the depression usually passes in 2–3 days. In about 10–15 per cent of women, the depression lasts for weeks and causes a constant feeling of tiredness, difficulty in sleeping, loss of appetite, and restlessness. The condition usually clears up of its own accord or is treated with antidepressant drugs. Depressive psychosis usually starts 2–3 weeks after childbirth, causing severe mental confusion, feelings of worthlessness, threats of suicide or harm to the baby, and sometimes delusions. Hospital admission, ideally with the baby, and antidepressant drugs are often needed.