Uticopa Blog

I've been diagnosed with post-natal depression - why me?

It's not clear exactly what causes PND, although there are things that seem to increase the risk.

Like depression which occurs at any other time, PND doesn't have one definite cause - but it's likely to result from a combination of factors. A mixture of physical, biological and hormonal factors seem to put women at risk of experiencing depression following the birth of a baby including:

• a past history of depression and/or anxiety
• a stressful pregnancy
• depression during the current pregnancy
• a family history of mental disorders
• experiencing severe 'baby blues'
• a prolonged labour and/or delivery complications
• problems with the baby's health
• difficulty breastfeeding.

New research
Some doctors think that hormone levels also play a part in increasing a woman's risk of postnatal depression. During pregnancy, the placenta makes a hormone called corticotrophin releasing hormone (CRH). Because the placenta is delivered along with the baby, levels of this hormone drop suddenly after a woman gives birth. One theory says that these hormone changes may be responsible for postnatal depression.

To find out more about the effects of CRH, researchers followed 100 women throughout their pregnancies. The women gave blood samples every few weeks, which were tested for CRH. The researchers then followed the women to see whether they got postnatal depression.

What does the new study say?
Out of the 100 women, 16 got symptoms of postnatal depression. High levels of CRH didn't always mean women went on to become depressed, but having lots of this hormone at around week 25 of pregnancy did seem to put women at risk.

The test wasn't perfect. It only spotted three quarters of the women who later got post-natal depression. And in about one quarter of the women who didn't get depression, the test predicted they would have got symptoms.
Women who felt depressed during their pregnancy were also likely to get depression after they gave birth.

How reliable are the findings?
One problem with the study is that depression was diagnosed using a questionnaire. The women weren't examined by a doctor.
The hormone test predicted postnatal depression reliably only when done around the 25th week of pregnancy. Even then, it didn't predict depression correctly for everyone, and incorrectly labelled some healthy women as likely to get depression.

Who did the study?
Most of the researchers were based at the University of California. The study appeared in a journal called Archives of General Psychiatry, which is published by the American Medical Association*.

The study was funded by the National Institute of Child Health and Human Development, a US organisation that supports health research.
What does this mean for me?

Tests for CRH aren't likely to be used routinely to predict whether women will get postnatal depression. Although the new study found some promising results, overall the evidence is mixed.

However, this study also found that feeling depressed during pregnancy is linked to postnatal depression. Other research shows that getting plenty of support cuts the risk of depression, so it makes sense to talk to your doctor and make the most of any help you can get from your family and friends.
After I did the on-line test, I have now been diagnosed with PND. What should I do now?

Although PND can be a serious illness, there are treatments that can help. Antidepressant drugs may be helpful, although some women prefer to avoid these if they're breastfeeding. Talking treatments, such as cognitive behaviour therapy, can help too. One recent study found that simply having someone to talk to on the telephone cut women's chances of becoming depressed. So, if you're pregnant and are worried about any thoughts or feelings you've been having, talk to your midwife, doctor, health visitor or a mental health therapist as soon as you can.

This is my first baby. I haven't the time to bother with myself at such an important time in my baby's life. People say I will get better if I just wait awhile..

If symptoms of postnatal depression are left untreated, it can have a big impact on the lives of people with the illness, their families, friends and the baby. Untreated depression can lead to:

• marriage problems
• family problems
• financial problems
• difficulties becoming and staying employed
• drug and alcohol use
• anger management problems
• difficulties bonding with children

Sometimes the reality of motherhood doesn't match the 'warm and fuzzy' images often portrayed in the media. Unfortunately, for many women, the early weeks and months of motherhood is a constant, tiring and demanding job.

But, a brand-new person in the world is now totally dependent on you.  Don't let him or her down.

LOOK AFTER YOURSELF!

*Yim IS, Glynn LM, Schetter CD, et al. Risk of postpartum depressive symptoms with elevated corticotropin-releasing hormone in human pregnancy. Archives of General Psychiatry. 2009; 66: 162-169.