Cognitive Behavioural Therapy (CBT) is often recommended for people suffering from depression, but there are many different types of depression, so figuring out if it’s the best type of therapy for you can be tricky.

Postnatal depression is a unique type of depression that may require a specific therapeutic approach. In this article, we will take a closer look at what postnatal depression really is, the causes, signs and symptoms, risk factors, treatments, and whether or not CBT could be a viable treatment option.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about postnatal depression, we’re here to help.

What is postnatal depression?

Postnatal depression is a specific type of depression that occurs when someone has recently had a baby. Although it primarily affects new mothers who have recently given birth, it is also thought to affect those who have not directly given birth, such as partners. Postnatal depression is as serious as any other subtype of depression, and can impact the person suffering as well as their partner, new baby, and wider family.

Postnatal depression is reported to affect as many as 10-20% of mothers, and can be present from the moment of birth, or can develop over time.

What causes postnatal depression?

Postnatal depression is often thought to be caused by our body’s hormones following childbirth, and although this is true, many other factors can contribute to the cause of postnatal depression. Studies have suggested that genetics, psychological factors and social life stress could all be involved in its development.

One of the most prominent causes remains to be hormones, with much research to show that reproductive hormones during and after pregnancy can become dysregulated in those with a sensitivity to hormonal changes. Hormones tend to fluctuate during pregnancy and remain this way for up to 12 weeks after giving birth.

There are also alterations to a number of biological and endocrine systems within the body, for example, the hypothalamic-pituitary-adrenal axis, which is involved in releasing cortisol when experiencing stress. When this is not functioning as it should, it could lead to a poor stress response. Hormones such as oxytocin and prolactin, which typically help to regulate the synthesis of breast milk, are also involved in the pathogenesis of postnatal depression.

Is postnatal depression different from the “baby blues”?

You may have heard of the “baby blues”, which is the mind’s very normal reaction to giving birth. In the first week after childbirth you may experience symptoms such as low mood, anxiety, emotional outbursts, crying, being irritable, and more. This is all down to your body’s hormones balancing out after the birth, and these symptoms should only last a few days.

Postnatal depression is different from the baby blues, as it is more severe and doesn’t lift after only a few days. Postnatal depression can stick around for months if left untreated, and can sometimes become a long-term issue for new parents. Studies have distinguished between the two, and you may have heard a number of different names for mood changes during and after pregnancy:

• Baby blues: Mild mood changes that last a few days, and feeling worried, unhappy and exhausted in the first couple of weeks after having a baby.
• Postnatal depression: More severe depression experienced after having a baby, that doesn’t tend to go away on its own without treatment.
• Postpartum depression: An alternative name for postnatal depression.
• Perinatal depression: Depression that can occur from the moment of conception until after giving birth.
• Antenatal depression: Depression experienced during pregnancy. This is a common type of depression affecting more than 1 in 10 women.

What are the symptoms of postnatal depression?

Postnatal depression can be officially diagnosed when a patient meets at least five of the depression symptoms listed below, and in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), it is defined as a “major depressive episode with the onset of pregnancy or within 4 weeks of delivery”.

The symptoms of postnatal depression include things like:

• Low mood for most of the day
• A loss of interest in things and not being able to enjoy activities you normally would
• Insomnia or hypersomnia
• Feelings of being worthless
• Feelings of guilt
• Loss of energy
• Lack of concentration
• Weight changes
• Suicidal ideation
• …and more

In the case of postnatal depression, these symptoms will not have been brought on by a previous mental health condition.

What are the risk factors for developing postnatal depression?

Studies show that there are a range of potential risk factors for postnatal depression, including socio-demographic factors, family dynamics, antenatal factors, other health conditions, pregnancy-related outcomes, and health sector systems.

One study noted that in a new mother’s wider social group, things such as myths about being the ‘perfect mother’, or the relationship with their significant other can also play a part in the occurrence of postnatal depression.

Other risk factors include having had a prior episode of postnatal depression in the past, and having a family history of postnatal depression.

Is CBT a good treatment option for postnatal depression?

Cognitive behavioural therapy (CBT) is a specific type of psychotherapy focused on offering patients alternative ways of thinking, and challenging their behaviours and reactions to stressful situations. It is often recommended as a therapy for people suffering from depression and anxiety, and can be done either individually or in a group setting.

CBT is also recommended to those suffering from postnatal depression, with a review of studies citing CBT as one of the main ways to tackle the issue. Many patients have seen success with psychological therapies like cognitive behavioural therapy, psychodynamic therapy, interpersonal therapy and other types of counselling, with one study finding patients with postnatal depression saw significant improvements after 13 CBT sessions.

At Augmentive we recommend trying our free 15 minute consultation where a qualified professional will help guide you to the most relevant therapists and types of therapy for you.

Another factor to consider is that CBT (a non-pharmacological therapy) is often preferred by new parents over medication, since some medicines may not be safe for breastfeeding.

Other types of therapy and treatment could be more beneficial depending on your specific situation, but ultimately, CBT can be an effective treatment option. One study of CBT found that, although further clinical trials are needed to figure out just how effective it is over other therapies, CBT is thought to be sufficient in relieving the psychological symptoms of postnatal depression and improving quality of life for new mothers.

What can I expect in CBT for postnatal depression?

Each practitioner will likely approach CBT in a slightly different way, and will edit their approach to fit your specific needs. One study suggests that CBT for postnatal depression is an effective form of treatment when delivered both on an individual basis or within a group setting, and can be effective both in the short-term, and for up to six months after the intervention takes place.

The main components of CBT that were found to be most effective for postnatal depression include psychoeducation, cognitive restructuring and goal setting, but again, your sessions will be structured based on the expertise of your practitioner.

How to spot the signs of postnatal depression

Sometimes it can be difficult for new parents to identify postnatal depression in themselves, but you may notice signs of this in your partner.

If you believe your partner has had symptoms of depression such as low mood, loss of interest in things, insomnia, low self-worth, feelings of guilt, and more, then they could be suffering from postnatal depression.

Family and friends can help to support someone with postnatal depression by encouraging them to pursue treatment and speak to their healthcare provider, offering emotional support, and helping with tasks that they may be finding difficult such as looking after the newborn or cooking healthy meals.

What other treatment options are there for postnatal depression?

The NHS recommends a number of treatment options for postnatal depression, all of which could be worth trying if you have been feeling symptoms for a while. Some of these include:

• Self-care: It may be helpful to try things like speaking to family and friends about how you are feeling, delegating childcare and other responsibilities to lighten your load, finding time for yourself to do things you enjoy, resting often and getting as much sleep as you can, moving your body, and eating healthy meals.
• Medication: You can speak to your GP or psychiatrist about going on medication to help with symptoms of postnatal depression, but remember if you are breastfeeding you will need to be prescribed a safe medication.
• Opening up: You could join a group, therapy-focused or otherwise. Group therapy could help to improve symptoms, but also chatting to a group of fellow new parents may be a safe space for you to discuss your feelings with others.
• Therapy: The most effective form of treatment is to speak to your GP about getting cognitive behavioural therapy (CBT) or another type of therapy, or reach out to another service (such as ours) for a personalised consultation and introduction to the right therapist for your needs.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to broader mental health care: join us today.

If you have a question about postnatal depression, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.