Quick answer
What is postnatal depression?
Postnatal depression (PND) affects about 1 in 10 women after childbirth — persistent low mood, exhaustion, guilt, anxiety, and difficulty bonding with the baby beyond the first 2 weeks. Baby blues — tearfulness days 3–10 — usually resolves alone. PND needs treatment — talking therapies (CBT, counselling) and antidepressants safe in breastfeeding when needed. Partners can develop depression too. Postpartum psychosis is rare emergency — confusion, hallucinations, rapid mood swings — phone 999. See a GP or health visitor if low mood persists over 2 weeks or you have thoughts of harming yourself or the baby.
Postnatal depression — more than tiredness
Postnatal depression (PND) is depressive episode in perinatal period — onset within first year — peak first 3 months.
~10–15% mothers — under-recognised — shame delays help
Baby blues vs PND vs psychosis
| Baby blues | PND | Postpartum psychosis | |
|---|---|---|---|
| Timing | Days 3–10 | >2 weeks | Days to weeks |
| Severity | Mild | Moderate–severe | Severe |
| Treatment | Support | Therapy ± meds | Emergency psychiatry |
| Psychosis | No | No (unless severe) | Yes |
Why it happens
Multifactorial:
- Hormonal crash — oestrogen, progesterone
- Sleep deprivation
- Birth trauma
- Previous mental health
- Isolation, financial stress
- Difficult feeding, colic
- NOT weakness or not loving baby
Symptoms to act on
Emotional:
- Anhedonia — nothing enjoyable
- Guilt — “bad mother”
- Intrusive thoughts — harm to baby — common, treatable, not acted on
Physical:
- Insomnia despite exhaustion
- Appetite loss
Bonding:
- Detached, going through motions
Partner PND — ~10% fathers/partners — also needs GP
Screening
EPDS at 6–8 week check
Score ≥13 — referral
Question 10 self-harm — any score >0 — urgent
Treatment
Mild-moderate:
- Listening visits, IAPT CBT
- Peer support — PANDAS, Netmums
Moderate-severe:
- SSRI — sertraline
- Perinatal psychiatry
Mother and baby units — keep dyad together
Safety planning
If intrusive harm thoughts:
- Tell GP — not child protection automatic if no intent/risk
- Support person, sleep blocks
Postpartum psychosis — 999 — do not leave alone with baby unsupervised if acutely unwell
Low mood 3 weeks after birth — not “normal new mum” if persistent — GP saves two lives. Some people find apps and online tools helpful alongside NHS care. brightloaf is a UK mental health app focused on practical support for anxiety, with check-ins, short educational tools, and access to counselling sessions.
Common questions about postnatal depression
- What is the difference between baby blues and postnatal depression?
- Baby blues — starts days 2–5 after birth, tearfulness, mood swings, anxiety — peaks day 5, resolves within 2 weeks — no treatment needed. Postnatal depression — persists beyond 2 weeks, more severe, affects daily function, bonding, and enjoyment — needs GP assessment and treatment.
- What are the symptoms of postnatal depression?
- Persistent sadness, hopelessness, exhaustion beyond normal new-parent tiredness, loss of interest, guilt about parenting, anxiety and panic, irritability, difficulty bonding with baby, concentration problems, appetite change, insomnia when opportunity exists, intrusive thoughts (common — distressing), social withdrawal. Can include suicidal ideation — medical emergency.
- How is postnatal depression treated?
- Guided self-help, CBT, interpersonal therapy via NHS talking therapies — IAPT perinatal priority. Antidepressants — sertraline often first choice if breastfeeding. Severe cases — specialist perinatal mental health team, day units, mother and baby unit if inpatient needed. Practical support — health visitor, family help with sleep.
- Can you take antidepressants while breastfeeding?
- Yes — several SSRIs pass minimally into breast milk — sertraline and paroxetine often preferred. Untreated PND harms mother and child — balance risks. Discuss with GP — monitor baby for sedation or feeding change. Breastfeeding not mandatory to receive medication if you choose not to.
- What is postpartum psychosis?
- Rare severe psychiatric illness — days to weeks postpartum — manic or mixed episodes, hallucinations, delusions, confusion, rapid deterioration. Medical emergency — mother and baby unit admission — antipsychotics, lithium. Higher risk if previous bipolar or postpartum psychosis. Different from PND though can coexist.