The experience of post-natal distress will be at least slightly different for everyone. PND is the many forms of ongoing distress/depression that may affect mums or dads before or after the birth of their baby. It affects at least 1 in 5 post-natal women and their families. PND varies in severity, when it begins (usually the 1st year) and can affect any mum or dad.

A woman with postnatal distress may lose interest in previously enjoyed activities, she may have negative and/or obsessive thoughts, be extremely tired but unable to fall asleep when baby is asleep, be distressed, angry and upset at times when there’s no reason, feel overwhelmed and unable to cope. A mum or dad with PND may feel like they are having real difficulty adjusting to parenthood.

It has long been recognized that not all women are fortunate enough to make a smooth transition to contented parenting, but until relatively recently, any form of post-natal distress was most often called post-natal depression or PND. We have come to realize, however, that many different things may underlie and trigger ‘PND’, that it is not necessarily depression (or even post-natal for some), and that there is value in recognizing these differences when trying to explain and address their effects.

The Wellington Post and Ante-Natal Distress Support Group network uses the term post and ante-natal distress to refer to the many forms of distress that may affect women at this time in their lives. Although not everyone finds it helpful to ‘label’ their experience, finding a name for it that makes sense to you, may help to understand and explain it to yourself and others. Some of the other terms you may hear about or see include:

+The Baby Blues
A normal and short-lived experience of feeling low, moody, anxious or tearful within the first few days after birth (about the same time as the milk comes in), and thought to be related to hormonal variations. Some women also experience the pinks – a brief period of post-natal elation. Both of these may be forerunners to depression or other forms of distress if they continue for longer than several days, and become more extreme over time.

+Ante-natal depression
Some women become depressed during pregnancy. Others may have a depression which predates pregnancy, and which may not have been recognized up to that point. Some women have other pre-existing mental health issues that are influenced by, and influence the events and experience of pregnancy, labour and delivery, and parenting. Perhaps the most commonly recognized forms of post-natal distress are post-natal depression (PND) and post-natal psychosis (PNP), also called puerperal psychosis.

+Post-natal depression
Post-natal depression has been estimated to affect between 8 and 20% of post-natal women. Actual numbers are hard to determine because it varies so much in terms of severity, when it begins, how long it lasts, and its features, and is often not reported. It may begin suddenly or gradually at any time within the first year of giving birth, and be relatively short-lived or more enduring. Because it coincides with a time of great physical, psycho-emotional, and social upheaval and adjustment, and often has features such as anxiety and anger not usually associated with depression, it may be hard to identify.
+Post-natal psychosis
Post-natal psychosis (PNP) is much less common, affecting about 1 in 1000 women after giving birth. PNP usually begins suddenly, is more extreme, and more obvious to others, but also has a much shorter duration if professional help is sought quickly. There is usually marked disorganization in speech, thinking, and behaviour at the time, but a complete return to usual patterns once treated. For some women who have experienced post-natal psychosis, depression may follow in its wake, as they deal with the significant upheaval it has caused in their lives and relationships. Once you have experienced a post-natal psychosis, there is a chance of recurrence with subsequent pregnancies. It is important to seek out some form of support during pregnancy to help reduce both the chances and possible effects of this.

Another extreme form of post-natal distress is post-natal mania – characterized by irritability, enormous (and unusual) energy, busyness, grand plans, and marked inability to relax or sleep, which become increasingly problematic for others, but may not be recognized by the woman herself.

Other common mental health diagnoses such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, anxiety disorder, and adjustment disorder, can also be used to refer to post-natal experiences, as can the processes of grief, loss, trauma, and stress.

+Post and Antenatal Anxiety
Some increase in anxiety is common and seen as a normal part of becoming a parent.  Naturally you’re concerned for the safety and welfare of your baby.

But it becomes problematic when its starts to interfere with your sense of wellbeing and confidence. Constant worry, difficulty sleeping, racing thoughts, feeling nervous,  inability to sit still, concentrate or remember?

You may also experience panic attacks.

Another form of anxiety is postnatal OCD.

 

Post and Antenatal anxiety can be experienced on its own or in addition to depression.