How does it feel to have this disorder?
10-15 in every 100 women become depressed after having a baby. This means you have a low mood and other symptoms for at least 2 weeks, and may last for weeks or months. These may include:
- feeling anxious or irritable
- not sleeping even when your baby sleeps
- poor appetite (or comfort eating)
- guilty and negative thoughts
- being unable to enjoy things
- feeling that life just isn’t worth living
- finding it hard to look after yourself and the baby.
PND often starts within 1-2 months of giving birth, but can develop later in some women. In many ways it feels similar to depression at other times of life (and depression in pregnancy can continue after birth). The difference in PND is that, understandably, there is often a great deal of focus on the baby and in being a mother. For example, it can be difficult to bond with your baby which can lead to worries about the baby’s welfare or anxiety about your qualities as a mother.
It is important for you and those around you to be aware of these feelings persisting, because PND is a very treatable condition, and the risks of missing it can be very distressing.
What causes Postnatal Depression?
Many causes have been suggested. It is more likely if you have:
- had depression or other mental health problems before
- had depression or anxiety in pregnancy
- no support
- had a recent stressful event, such as a relationship ending.
Treatments that can help
Why is treatment important?
Most women will get better without treatment in 3 to 6 months. 1 in 4 mothers with PND are still depressed when their child is one-year-old. Depression can affect your relationship with your baby and partner. It can also affect your child’s development. So the shorter it last, the better.
Where to get help for Postnatal Depression
Talk to your GP or Health Visitor. For urgent help, go to the Accident and Emergency Department or contact your GP or your mental health service.
The help you need depends on how severe your depression is. Everyone can try the self-help suggestions below. If this is not enough, you might benefit from a talking therapy. For more severe depression, you may need medication, with or without talking therapy.
Talking helps. Your GP can refer you for counselling. Cognitive Behavioural Therapy helps you to see how some of your ways of thinking and behaving may be making you depressed. Other therapies can help you understand the depression in terms of what has happened to you in the past.
What about antidepressants?
These may help if your depression is severe or not improving. There are several types ofantidepressants. They all work equally well, but have different side-effects. They are not addictive. They can all be used in PND, but some are safer than others if you are breastfeeding.
Antidepressants take at least 2 weeks to start working. You need to take them for around 6 months after you start to feel better.
Are there alternatives?
Hormones probably don’t work well and they may have their own dangers, particularly if you have had thrombosis (blood clots in the veins).
St John’s Wort is a herbal remedy. There is evidence that it is effective in mild to moderate depression. There is not enough information to say that it is definitely safe in breastfeeding.
St John’s Wort can interact with other medicines. Check with your doctor before you take it. This is very important if you are taking the oral contraceptive pill. St John’s Wort might stop your pill working. This can lead to an unplanned pregnancy.
Even if you have been depressed for a while, support, counselling and medication can all help. It’s never too late.
How to help yourself
- Do tell someone how you feel – your partner, a relative, a friend, your health visitor or your GP.
- Do sleep or rest during the day or night when you can.
- Do try and eat regularly.
- Do find time to do things you enjoy or help you relax.
- Do go to local groups for new mothers or postnatal support groups.
- Do let others help with housework, shopping and looking after other children.
- Do exercise.
- Do use self-help books and websites.
- Do contact organisations that support women with Postnatal Depression.
- Don’t blame yourself, your partner or close friends or relatives.
- Don’t use alcohol or drugs.
Can Postnatal Depression be prevented?
We don’t know enough about PND to prevent it. These things make sense:
- Don’t try to be ‘superwoman’ – do less and try not to get over-tired.
- Make friends with other pregnant women or new mums.
- Find someone you can talk to.
- Go to antenatal classes.
- Don’t stop antidepressant medication in pregnancy without advice. Discuss this with your GP. Around 7 out of 10 women who stop antidepressants in pregnancy relapse.
- Keep in touch with your doctor if you have had depression before. They can recognise any signs of depression early.
- Make sure you have treatment for depression in pregnancy.
- Accept offers of help from friends and family.
How can partner, family or friends help?
- Take time to listen.
- Try not to be shocked or disappointed by the diagnosis – it can be treated.
- Encourage your partner, relative or friend to get the help and treatment she needs.
- Give practical help like shopping, feeding, changing the baby, or housework.
How and where to seek help in the Maldives?
If you’re concerned about your mental health, please consultant a doctor or your primary health care worker. A doctor or a primary health care worker could recommend a consultation with a psychiatrist should you require one.
Psychiatric consultations are available at:
- Indhira Gandhi Memorial Hospital, Kan’baa Aisaa Rani Hingun, Male’, Maldives
Telephone: 333 5335
- Psychiatrists are also available at some regional hospitals in the Maldives though this may vary in availability and thus their details are not included in this list as these are not permanent posts.
For any reason, should you wish to seek private psychiatric consultations, they are available at:
- ADK Hospital, Sosun Magu, Male’, Maldives
- Medica Hospital, Faamudheyri Magu, Male’, Maldives
- Family Care Clinic and Scan Centre, H. Azum, Ameenee Magu, Male’, Maldives
- Advanced Medical Clinic, G. Rocketge, Lonuziyaaraiy Magu, Male’, Maldives
Telephone: 3007788, Email: firstname.lastname@example.org
Talking/psychological therapies in the Maldives:
Free counselling services including face to face and telephone counselling services are available at:
- Society for Health Education (SHE):
Psychosocial Counselling Services, SHE, M. Kulunu Vehi, Buruzu Magu, Male’, Maldives
Telephone: 3318804/ 7976325
For any reason, should you wish to seek private psychological therapy provided by clinical psychologists and/or counsellors, they are available at:
- Maldives Institute of Psychological Services, Training and Research (MIPSTAR)
Ma. Kinaara House, Iskandharu Magu, Male’, Maldives
- Lifeline Multispeciality Clinics, M.Chambeyleege, Shaariuvarudhee Magu, Male’, Maldives
- Alive Medicals, Sandhubaraka Goalhi, Male’, Maldives
- Primax Medi-care, Carnation Magu, Male’, Maldives
- Institute of Mental Well-Being, Ma Noomas (1st Floor), Chaandhaneemagu, Male’, Maldives
Telephone: 3337892/ 7897892
If you feel this list of where to seek help in the Maldives for mental health is inaccurate or incomplete, or if you are a new institution providing any of the above services, do kindly inform us at email@example.com and we can confirm and make the necessary amendments.
This leaflet is based on material produced by the Royal College of
Psychiatrists (www.rcpsych.ac.uk/info). © February 2014
The Royal College of Psychiatrists. Reproduced by permission.
MHAF would like to thank the Royal College of Psychiatrists, United Kingdom, for kindly granting permission to use this leaflet based on material produced by the Royal College of Psychiatrists (www.rcpsych.ac.uk/info). © February 2014