Post-natal depression: are you at risk?

It is generally agreed that depression during the post-natal period falls into three categories: ‘the blues’, depression and psychosis. In general, the first two can be successfully treated without in-patient treatment.

Post-natal depression affects about ten per cent of women in the early weeks after the birth, with episodes typically lasting two to six months. There has been a lot of research trying to prove a biological basis for post-natal depression. Inadequate hormones, thyroid dysfunction and immune changes brought on by stress are examples of the most popular theories.

If one tries to find a predictor for post-natal depression, the presence of ‘the blues’ in the period immediately after birth may be related to the subsequent development of post-natal depression. Obstetric factors are also important in a vulnerable subgroup of women — those with a history of depressive disorder or experiencing complications during delivery are associated with an increased rate of post-natal depression. Furthermore, the occurrence of stressful events in general, such as unemployment, marital conflict and the absence of personal support have all consistently been found to raise the risk. Often women with post-natal depression have described resentment that their lives have changed so drastically compared with that of their partners.

Women have unrealistically high expectations of themselves. The belief that they should manage all the physical chores and emotional demands of a family is a dominant one in our society. When they feel they fall short of expectations about maternal abilities to ‘take care of everything’, new mothers may become overwhelmed and feel defeated. Everyone has a mental image of the ‘perfect baby’, the ‘perfect mate’ and the ‘perfect family’. Seldom are these fantasies fulfilled.

The odds are that you will not suffer from post-natal depression; however, thinking about these issues and discussing them with your partner now will give you an added advantage. Having a plan in place to help both partners adjust to the new baby can help offset some but not all of the risk.