Caitlin Goodwin
Is a certified nurse midwife with 15+ years of experience in labor and delivery.
Forword: Postnatal depression is a serious condition that should be managed with professional help. If you are experiencing thoughts of harming yourself or someone else, seek immediate support by calling 111, visiting your GP, or attending your local A&E department.
Childbirth is a transformative experience. As part of this natural transition, you may find yourself unexpectedly tearful or unusually irritable. These emotions, often referred to as the baby blues, are common and influenced by rapidly changing hormones. The baby blues usually begin shortly after birth and last for up to two weeks. If these emotions feel more intense or persist beyond this time, you may need additional support and medical care.
Mild mood changes during pregnancy or the postnatal period are common, but around 15 to 20% of women experience more significant symptoms of anxiety or depression. Since suicide is one of the leading causes of maternal death during the first year after giving birth, recognising and seeking care for postnatal depression (PND) can be life-saving.
This article offers advice on how to recognise and manage postnatal depression. By combining realistic lifestyle changes with mental health support, new families can thrive in their evolving dynamic.
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Understanding Postnatal Depression
Postnatal depression (PND) affects individuals in different ways. Because of this, a full assessment of your physical and mental health is essential. In some cases, PND may be mistaken for other medical conditions such as vitamin D deficiency or thyroid problems.
Parents with a prior history of depression, anxiety, or trauma are more likely to experience a postnatal mood disorder. You may also be at greater risk if you’re going through stressful life events, relationship difficulties, or lack a reliable support system.
Common signs of PND include:
- Low mood, sadness, or irritability
- Difficulty sleeping, or sleeping too much
- Loss of appetite or overeating
- Feeling constantly tired or lacking energy
- Disturbing or intrusive thoughts
- Difficulty bonding with your baby
- Withdrawing from loved ones
- Losing interest in things you usually enjoy
- Unexplained physical aches and pains
Postnatal Hormones
Ever blamed your mood on hormones? You’re not wrong—hormonal changes can have a significant impact. After childbirth, the placenta detaches from the uterus, causing a rapid drop in hormone levels, which can deeply affect your emotions and mental wellbeing.
Oestrogen and progesterone - are two key hormones in pregnancy, decrease dramatically after birth. Oestrogen can plummet within 24 hours, often contributing to feelings of sadness or irritability. Progesterone, which has a calming effect during pregnancy, also drops, leading to emotional fluctuations and heightened anxiety.
Oxytocin - known as the “love hormone”, rises during labour and breastfeeding, encouraging bonding and lowering stress. Prolactin, which supports milk production, also helps create nurturing feelings. When these hormones fluctuate, your mood may shift as well.
Cortisol -the stress hormone, tends to rise after birth—especially when sleep-deprived or struggling with infant feeding. This can amplify feelings of anxiety and overwhelm.
Some mood disorders may make exclusive breastfeeding more difficult. In such cases, combination feeding (breast and formula) can reduce stress. This approach may also help those experiencing Dysphoric Milk Ejection Reflex (D-MER), a condition marked by negative emotions during milk letdown.
Postnatal Depression Screening
There are opportunities throughout the postnatal journey to identify early signs of PND. During postnatal check-ups and baby health visits, GPs, midwives, and health visitors often screen for mental health concerns. These routine checks can catch PND early, before it becomes more severe. It’s important to be honest during these assessments.
Screening is not a judgment of your parenting ability—it simply helps identify if extra support is needed.
Note that many people who are diagnosed with postnatal depression also experience anxiety. If you have any concerns, speak with a licensed therapist, GP, or perinatal mental health specialist who can support diagnosis and treatment.
Speaking Honestly - "Although nearly one in five new parents experience postnatal depression, it can still be difficult to talk about. Many feel ashamed of the numbness or negative feelings they may have after birth. But asking for help doesn’t make you a bad parent. And expressing your intrusive thoughts won’t make them real."
Practical Strategies for Postnatal Wellbeing
Friends and family often rush to visit when your baby arrives. But with everything going on, entertaining guests might feel overwhelming. You are allowed to say no.
Asking for help is vital. Let people support you—whether that’s tidying up, preparing a meal, or watching the baby while you rest. Set clear boundaries and prioritise your mental health, rest, and recovery.
It can feel daunting to discuss how you’re feeling with loved ones.
Postnatal groups like mother-and-baby meetups or breastfeeding support circles can be empowering and help you feel less alone. Others may prefer to speak with a spiritual advisor or counsellor.
As you return to work, you may need to request adjustments such as flexible hours, working from home, or longer breaks. It’s OK to advocate for yourself—mental wellbeing is as important as physical recovery.
Healing and Recovery
While lifestyle changes are important, therapy and mindfulness can play a vital role in managing PND. Speaking to a therapist can help you process major life changes, reframe unhelpful thoughts, and strengthen your relationships. Mindfulness practices can help ground you in the present and reduce anxiety.
Medication for PND can be extremely effective. There are different types, and your GP or specialist can help tailor treatment to your individual needs. Many antidepressants are safe to take while breastfeeding—just be sure to work with someone experienced in perinatal care.
Some people may also benefit from hormonal treatments like progesterone, although evidence around its effectiveness is still emerging. The best outcomes usually come from a combination of therapy, lifestyle adjustments, and, where appropriate, medication.
My Story...
"When I gave birth to my fourth child, I didn’t feel the same immediate desire to nurture my baby as I had previously. By the second week, I felt foggy, disconnected, and unsure of my ability to care for this tiny, fragile being.
Thankfully, I recognised the signs—I’d seen many patients with PND—and I reached out to my midwife and therapist for support.
With therapy and antidepressants, things gradually got better. Small tasks like getting dressed, going food shopping, or leaving the house with the baby became manageable again. But it took time. Even now, six years later, I still prioritise sleep, nutrition, and hydration to stay balanced."
Final Thoughts
One of the most important lessons I’ve learned is this: if we don’t look after ourselves, we can’t give our best to others. Above all else, be kind to yourself. You are exactly the parent your baby needs. Reach out for help—your wellbeing matters. The world is a better place with you in it.