Pregnancy health centre

If you have just had a baby and have felt low and sad for more than a couple of weeks, you may have postnatal depression. This illness is quite common, especially in the first few weeks after giving birth.

You may think it is up to you to 'pull yourself together'. You may even worry that you're a bad mother. But having postnatal depression is not your fault.

Postnatal depression usually goes away on its own. But it can last for a while. That can be harmful for you, your baby, and your partner. The good news is that there are treatments that can help you feel better sooner.

Key messages about treating postnatal depression

• There are several treatments to choose from. Talk to your doctor about which ones are right for you.

• Some antidepressant drugs are likely to help get rid of your depression. But they get into your breast milk. You may wish to discuss with your doctor whether they are safe to take if you are breastfeeding.

• Talking treatments, such as cognitive behaviour therapy, are likely to work. But there hasn't been much research on these.

• St. John's wort, a herbal treatment, may be used to treat depression at other times in your life. But herbal treatments are not recommended if you're breastfeeding.^[56] That's because we don't know if they are safe for babies.

The National Institute for Health and Clinical Excellence (NICE) is the government body that advises doctors about treatments. NICE has issued some guidance about how doctors should treat women with mental health problems, including depression, during pregnancy or in the year after giving birth.^[57] To learn more, see NICE guidance on postnatal depression.

NICE guidance on postnatal depression

If you get depression after having a baby, you will probably be cared for by a variety of people. These might include your midwife, health visitor, GP, mental health nurse, psychologist, or hospital doctor (such as a psychiatrist). We can't tell you exactly how you will be treated. But we can give you some idea about how postnatal depression is treated in general:^[57]

• Your doctor might advise you to try some things yourself first. For example, you might be given some books to read or advised to take some regular exercise. Or you might be asked to follow a course of cognitive behaviour therapy (CBT) on a computer

• You might be offered some form of talking therapy (psychological treatment). This might be non-directive counselling, CBT, or interpersonal psychotherapy

• If your doctor has recommended a talking treatment, this should start within one month

• If talking treatments don't help, or you would rather have drug treatment, your doctor might prescribe an antidepressant

• If one antidepressant doesn't help, your doctor may try a different one

• If neither antidepressants nor talking treatments work very well, your doctor might try using both of these approaches together

• If you need to be cared for in hospital, you should be able to be treated in a mother and baby unit, unless there are reasons for not doing this

• If you have very bad depression that doesn't get better with talking treatments and antidepressants, your doctor might consider electroconvulsive therapy (ECT).