As this story indicates, post-natal depression is a significant problem which affects many thousands of families and where there is a major impact upon every family member.
While this may seem difficult to believe I assure you that what I am about to say is true:
In women who come to see me before their baby is born and where I continue to care for the child in the first few months of life I have never had a woman develop significant postnatal depression that I am aware of. The exception to this is where they have had a history of depression. A small number of my patients have been on some form of psychoactive drug or needed professional care for a period of years.
My key point here is that in women who have not previously had depression I am not aware of patients developing it under my care. This is not because I have particular skills in mental health. I have no training in mental health and do not claim abilities in that area.
In my experience, successful parenting and in particular becoming a skilled and insightful mother has a positive impact upon mental health.
My experience is that supporting a mother in the early weeks and months of pregnancy and teaching her skills, giving her insight and practical strategies which work effectively supports her emotional well-being.
Allowing a woman to experience the joy of being a successful parent is associated with high quality mental health.
It is my experience that with appropriate care it is possible to protect the very large majority of women from developing postnatal depression.
In 2012 I undertook a study of patients visiting our surgery and we assessed their emotional well-being. The results of this study were published in the BMJ open.
We assessed 100 patients using a recognised survey tool called DASS 21. This is a questionnaire designed to assess depression, anxiety and stress. The scores reflected the impact of coping with disturbed sleep for between six and 12 months:
- Depression (any severity) 32.5%
- Anxiety (any severity) 25%
- Stress (any severity) 48.8%
The patients returned approximately 2 weeks later and were resurveyed. At this point the only intervention which the parents had received was basic guidance on the physiology of infant sleep and advice on how to resolve the overnight sleep problems.
Scores for the second survey were as follows.
- Depression (any severity) 5%. Improvement of 85%
- Anxiety (any severity) 15%. Improvement of 40%
- Stress (any severity) 20%. Improvement of 59%
These results are consistent with my clinical observations. It is self-evident, in a clinical sense, and this is now supported by the above evidence, that once sleep disruption is resolved, the well-being of the mother improves dramatically.
Postnatal depression is a condition of significance which must be treated with respect and sympathy. It is common in our culture and is associated with significant consequences for families. It is my experience, both clinically and through my peer reviewed published research that we can decrease post natal depression, anxiety and stress.