There is rarely a single cause for a bout of depression and several factors usually work together. The drop in hormones that happens after childbirth has been blamed for PND. However, researchers haven't found any difference between the hormones of women who get PND and those who don't, and treatment with hormones isn't effective. It's more likely to be because of the combination of life changes associated with childbirth.
The adjustment to the extra responsibility of looking after a totally dependent infant can be demanding. All babies are different, for example some cry more than others, which can make them more difficult to look after.
You may find your relationship with your partner has changed as you focus your energy on childcare, or find that your partner is unsupportive. You may be less interested in sex for a time after childbirth, which may put an additional strain on your relationship. Giving birth can be disappointing or even traumatising, and you may feel out of control and frightened.
You may have stopped work and find that you have less social life, lower status and reduced income.
Depression tends to run in families and so it's likely that some genetic factors are important, although these aren't clearly understood.
Other factors include:
- depression or postnatal depression in the past
- depression in previous pregnancies
- having had the 'baby blues'
- your baby being premature or sick
- not getting much help from family or friends
- having had stressful life events recently, for example, bereavement
Some studies have also shown that you may be more likely to be affected by PND if:
- it took a long time to conceive
- the father is depressed
- your pregnancy wasn't planned
- you're not breastfeeding
- you have two or more children
- you're unemployed
- you or your partner were stressed when you were pregnant
- you had a problem with thyroid levels when you were pregnant
It's possible that your risk of PND is greater if you had to have an emergency operation to deliver your baby, such as a caesarean. However, the evidence for this varies and more research is needed.
Awareness of PND is increasing so midwives, doctors and health visitors are often alert to the symptoms. They should ask you specific questions during routine health checks before, during and after the birth of your baby to detect signs of depression and follow them up as appropriate.
See a doctor if you think you may have PND. You will be asked about your mood, health and your baby. If this and any treatments your doctor prescribes don't help, you may be referred to a specialist health professional.