There is no single cause of postnatal depression, and it can develop due to a combination of factors, including hormonal changes, psychological and social factors, and genetics. Let us examine these causes in detail.

Hormonal changes are a significant contributor to postnatal depression. During pregnancy, the levels of hormones such as estrogen and progesterone increase significantly. After delivery, these hormone levels drop dramatically, affecting a woman’s mood, energy, and sleep patterns. The thyroid gland also plays an essential role in regulating mood, and some women may develop postpartum thyroiditis, which can also contribute to PND.

Psychological and social factors such as stress, anxiety, lack of social support, and financial difficulties can contribute to PND. The transition to motherhood can be overwhelming, and new mothers may feel that they are not coping well, leading to guilt and shame. Sleep deprivation is also common in new mothers, making it challenging to cope with the demands of caring for a new baby.

Genetics can also play a role in the development of PND. Women with a family history of depression are more likely to experience PND. However, having a genetic predisposition to depression does not mean that a woman will necessarily develop PND.

Psychologists play a critical role in the treatment of PND. They work with women to develop strategies to manage their symptoms and improve their mental health. Several evidence-based treatments for PND include cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT). In some cases where mood symptoms are more severe, your psychologist may suggest involving a doctor or psychiatrist to consider adding medication to your treatment plan.

CBT is a talk therapy focusing on changing negative thought patterns and behaviours. In the context of PND, CBT aims to help women identify and challenge negative thoughts about themselves or their babies. For example, a mother may believe that she cannot cope with the demands of motherhood. The psychologist would help the mother explore the evidence for this assumption and then identify counter-evidence that contradicts her negative thoughts. The mother may be encouraged to focus on her strengths as a mother and to practice self-compassion.

IPT is a form of therapy that focuses on improving interpersonal relationships. IPT aims to help women identify and address relationship problems that may contribute to their depression. For example, a mother may struggle to adjust to changes in her relationship with her partner or be experiencing conflict with her family members. The psychologist would help the mother to develop more effective communication skills and set boundaries. This may involve role-playing exercises or other interactive techniques to help the mother practice these skills.

Antidepressant medication may be prescribed to women with severe PND. Antidepressants work by altering the levels of neurotransmitters in the brain that regulate mood. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for PND, as they are safe and effective for use during breastfeeding. However, consulting with a doctor or psychiatrist before taking any medication during breastfeeding is essential. The decision to take medication during breastfeeding is complex and requires careful consideration and guidance. Many women are concerned about the safety of psychiatric medication during breastfeeding, and it is essential to understand the risks and benefits of medication before making a decision.