Perinatal depression: the questions you really want to ask

What is perinatal depression?

Depression is the most common perinatal mental health disorder women experience in pregnancy and the first year after having a baby (NICE, 2014). Depression in pregnancy is seen in 7-12% of women, (Bennett et al., 2004; Gavin et al., 2005) with postnatal depression rates of around 10-15% reported. 

Around 10% of fathers have depression in the perinatal period (Beszlag & Hopkinson, 2020) and it is common for both parents to experience mental health problems at the same time (Anding et al., 2016). Depression is a mental health illness which, with treatment, will get better in time.

Depression in pregnancy can start at any time, although the severity may be different in each trimester. Postnatal depression usually comes on within six weeks of giving birth, although it can emerge up to a year after your baby is born (MIND, 2017). While postnatal depression should dissipate within a few months, 3 in 10 people with PND will still be ill after the first year (NICE, 2014).

Watch our video below where three mums talk about what it feels like to experience postnatal mental health issues. 

What are the symptoms of depression?

Like depression at other times in life, it can be mild, moderate or severe. It can come on gradually or suddenly (NICE, 2014). The main difference though is that it can be a lot trickier to recognise. That's because your mental state is likely to change in the weeks and months after you have a baby anyway (NICE, 2014). You will also have such a lot going on around you.

Symptoms of depression can include:

• feeling down and teary
• an inability to concentrate
• low sex drive
• feeling worthless
• inability to feel happiness
• sleep problems
• anger
• finding it difficult to leave the house
• overeating
• problems bonding with your baby
• suicidal thoughts

(Boots Family Trust Alliance, 2013)

A depression and anxiety self-assessment quiz is available here.

You can also seek information and support through NHS 111 or via your GP.

If you feel at risk of harming yourself or others then call 999, attend an emergency health care setting, or call the Samaritans on 116 123.

What causes depression in parents?

The exact cause of postnatal depression is not clear, although in women it doesn't seem to be due to hormonal changes (Patient, 2017). Some factors are known to increase the chance of becoming depressed in pregnancy and after birth. These include:

• having a previous mental health problem
• experiencing a traumatic birth experience or loss of a baby through stillbirth
• living in a violent social situation
• being a refugee or asylum seeker
• having a history of childhood or adulthood abuse
• having poor social support.

(RCOG, 2011; NICE, 2014; Ayers and Delicate, 2016)

Speak to your GP or midwife if you think you are at risk of depression so that you can get support.

What is the effect of having depression?

It is important to get help for depression so that you can access the right treatment and support to enable you to get better (Shakespeare, 2015). If not, it can have major consequences for your mental health, your relationship, your partner’s mental health and the development of your baby (Fatherhood Institute, 2010; Howard et al, 2014; Ayers and Delicate, 2016).

It is common to have depression along with other perinatal mental health conditions such as anxiety, birth trauma and PTSD (Dikmen-Yildiz et al., 2017).

Support and treatment for depression

Treatments for depression include talking therapies like cognitive behavioural therapy (CBT) or anti-depressants (talk to your GP for advice if you’re breastfeeding) (NICE, 2014; NHS 2018). If depression becomes severe, you might need a stay in hospital or mother and baby unit (RCOG, 2011; NHS Choices, 2018).

You can access treatment for depression via your GP or you can find out more about NHS psychological services here.

There are self-care tips that may help with mild to moderate depression:

1. Build a support network and make time to meet friends and other mums for a much-needed cup of tea and a chat (NEF, 2008).
2. Accept offers of help. It might be your mum dusting your living room or your best friend walking your newborn around the block so you can lie down. Whatever it is, take it (Boots Family Trust Alliance, 2013).
3. Exercise can work wonders for the way you feel (Cooney et al, 2013). It is also a great long-term practice for safeguarding your mental health (NEF, 2008; NHS, 2018). If you have recently given birth, it is important to give your body a chance to physically recover. The NHS provides some guidance which is suitable for pregnancy and after birth.
4. Try to eat healthily and regularly, and cut back on caffeine and alcohol (NHS, 2018).
5. Get showered and dressed, even if your plan for today is to go no further than the back door to put some nappies in the bin (MIND, 2017).
6. Be mindful – apps like Headspace can help improve your mental wellbeing and help you to deal with daily challenges (NEF, 2008). You can even practice mindfulness on the sofa while your newborn is feeding.
7. Keep a mood diary. It can help you notice how people, places and activities affect your mood (MIND, 2020).
8. Sign up to a baby massage class at NCT or with your local children’s centre through a referral from your health visitor (NHS, 2018).
9. Contact local or national specialist organisations – they may offer the opportunity to talk to other women who are going through the same thing. Services available might include a dedicated telephone helpline, a buddy service, online support, support groups, counselling and wellbeing sessions.

This page was last reviewed in February 2022

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our NCT New Baby courses helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Contact specialist organisations like PANDAS for more help and support with postnatal depression including a FREE helpline number on 0808 1961776.

Experiencing mental health symptoms can be overwhelming but help is available, so speak to a trusted health care professional such as a midwife, health visitor, or GP. If you feel at risk of harming yourself or others then call 999, attend an emergency department, or call the Samaritans on 116 123.