Depression after delivery: recognising when you need help

It can begin during pregnancy or after birth and may affect sleep, appetite, energy, concentration, confidence and connection with the baby. It is a health condition, not evidence that someone is an uncaring parent.

Brief tearfulness and emotional sensitivity can occur soon after birth as hormones, sleep and routines change. Depression is more persistent or severe and interferes with daily functioning, relationships, self-care or caring for the baby.

Possible experiences include emptiness, hopelessness, guilt, irritability, anxiety, difficulty enjoying anything, withdrawing from others, poor concentration and feeling unable to cope. Sleep loss can intensify distress, but depression can remain even when there is an opportunity to rest.

Tell a trusted person and contact your obstetric, primary-care or mental-health clinician. Treatment may include talking therapy, practical support, help with sleep and, when appropriate, medication selected around breastfeeding, other medicines and personal preferences.

Reduce isolation by arranging specific help with meals, household tasks or baby care. Keep appointments even if explaining your feelings seems difficult; writing symptoms down or taking a support person can make the conversation easier. Partners can also report changes they have noticed.

Seek emergency help now if you might harm yourself or the baby, cannot keep either of you safe, hear or see things others do not, hold unusual fixed beliefs, feel extremely confused, or become severely agitated with little need for sleep. Do not stay alone while arranging help.

Prompt clinical contact is also needed when sadness, fear, guilt or loss of interest is worsening, makes basic care difficult, or leads you to avoid the baby. A clinician can assess depression, anxiety, trauma, thyroid problems, anaemia, infection, medicine effects and severe postnatal mental illness.

Ask what treatment choices are available, how feeding preferences affect medication decisions, and who to contact if symptoms worsen outside clinic hours. Describe intrusive thoughts honestly, including whether they are unwanted and frightening or feel like urges you may act on.