Postnatal Depression

Almost every parent who reaches us with postnatal depression says a version of the same thing first. They tell us they should be happy, and then they apologise.

We are Richard and Helena Boyd, and we have practised in Perth since 2005. Postnatal depression is common, it is not a failure of love or character, and it responds well to treatment. This covers how to tell it apart from the baby blues, what to watch for, what causes it and where to get help.

If there is immediate danger, or you are having suicidal thoughts or thoughts of harming your baby, call 000 now. For urgent help, Lifeline is on 13 11 14 and PANDA, the perinatal anxiety and depression helpline, is on 1300 726 306.

Baby Blues Or Postnatal Depression?

The first thing to sort out is which one you have, because they are different.

The baby blues affect around 80 per cent of new mothers and usually arrive three to five days after giving birth. You feel sad, teary and raw. It is a response to a sudden hormonal shift and it passes within a few days with rest, reassurance and emotional support.

Postnatal depression lasts longer and cuts deeper. If low mood, hopelessness or anxiety have run for two weeks or more after your baby’s birth and are affecting daily life, that is no longer the baby blues. It can develop gradually over weeks or arrive suddenly, and it can begin any time in the first year.

How Common Is Postnatal Depression?

More common than most parents realise, which matters when you are convinced you are the only one.

Perinatal depression and anxiety affect around one in five mothers and one in ten fathers in Australia, which is almost 100,000 parents every year. Postnatal depression affects a substantial share of that group. These are not rare mental health problems, and the reason it feels rare is that almost nobody talks about it while it is happening.

Perinatal means pregnancy and the first year after birth. Depression starting during pregnancy is part of the same picture rather than a separate thing.

Signs And Symptoms Of Postnatal Depression

Symptoms vary and rarely arrive at once. These are the ones we see most.

• Persistent low mood, numbness or a depressed mood most of the day
• Feeling hopeless about the future, or that things will not improve
• Difficulty bonding with your new baby, or feeling detached from them
• Trouble sleeping even when the baby sleeps
• Constant worry about the baby, or checking on them repeatedly
• Guilt, shame and a strong sense of failing at something everyone else manages
• Irritability and resentment, often followed by more guilt
• Loss of appetite, weight loss, or feeling tired beyond ordinary exhaustion
• Withdrawing from family and friends
• Panic attacks, or physical symptoms with no medical cause

You may have several of these, only a few, or other symptoms not listed. These are the symptoms of depression as they present after the birth of a baby. Two weeks is the marker worth using, since the first week home is chaotic for everyone.

Intrusive Thoughts, And What They Are Not

This section exists because nobody says it out loud, and the silence causes real harm.

Unwanted intrusive thoughts about something bad happening to your baby are extremely common in new parents. Images that arrive uninvited and horrify you. They are distressing precisely because they are the opposite of what you want, and having them does not mean you will act on them. Tell your GP, your child and family health nurse or your midwife. They have heard it before and will not take your baby away.

What is different, and is a medical emergency, is postpartum psychosis. That involves confusion, not sleeping at all, beliefs other people do not share, or seeing and hearing things. It is rare and it is treatable, and it needs help immediately. Call 000.

What Causes Postnatal Depression?

There is no single cause. It is biological, psychological and social factors landing at once.

Physical. Hormone levels drop sharply after birth and that shift affects mood regulation directly. Add sleep deprivation, a recovering body and the demands of feeding, and the load on your physical health alone is substantial.

Emotional. A new baby reorganises your identity, independence and relationship in the space of a week. For some that adjustment is smooth and for many it is not, and neither says anything about how much you love your child.

Social. Isolation is the factor we see most, particularly in Perth where many parents have their mother and closest friends five hours away by plane. Add the expectation that you should be visibly grateful, and family members stop being told anything is wrong.

Risk Factors Worth Knowing

Some things raise the risk, and knowing them early helps.

A personal or family history of depression or anxiety is the strongest single predictor of developing depression after birth. A difficult pregnancy, a traumatic birth, a premature or unwell baby and feeding difficulties all increase it, as do relationship strain, financial stress, other health problems, and caring for other children at the same time.

Lack of practical support is the one most amenable to change. If no close family member can hold the baby while you sleep, that is a health issue rather than a lifestyle preference.

Postnatal Anxiety

Postnatal anxiety often travels with depression and sometimes arrives alone.

It looks like constant vigilance rather than sadness. Checking the baby is breathing through the night, an inability to rest even when someone else is holding them, and racing thoughts about everything that could go wrong. Perinatal anxiety is as common as perinatal depression and gets diagnosed less often, partly because worrying about a newborn looks reasonable from the outside.

The distinction that matters is whether the worry is proportionate and whether you can put it down.

Postnatal Depression In Fathers

Up to one in ten fathers experience it, and it does not depend on how their partner is going.

Fathers experiencing depression present differently, though many of the similar symptoms are there underneath. Irritability, anger, working longer hours, withdrawal and increased drinking are more common than visible sadness. Because nobody screens fathers routinely, most go unidentified for a long time.

If you are a father reading this and recognising yourself, that counts. You do not need to be the one who gave birth to be affected by this.

How Postnatal Depression Is Diagnosed

Only a doctor or mental health professional can diagnose it, and the process is simple.

Most Australian services use the Edinburgh Postnatal Depression Scale, a short ten question screening tool given routinely at antenatal and postnatal checks by GPs, midwives and women’s health services. It is a screen rather than a diagnosis. A raised score prompts a proper conversation with your GP or child and family health nurse.

Answer it honestly. The most common reason postnatal depression goes untreated is parents answering the questionnaire the way they think a good parent should.

Treatment Options

Postnatal depression is one of the more treatable conditions in mental health, and full recovery is the usual outcome.

For mild depression and mild symptoms, practical support, sleep and psychological therapies are often the first treatment and frequently enough on their own. Cognitive behavioural therapy and interpersonal therapy both have strong evidence in the perinatal period, and interpersonal therapy targets the relationship and role changes driving much of this. Finding the right treatment usually takes one honest conversation rather than a long search.

For moderate to severe symptoms, antidepressant treatment may be recommended alongside therapy to treat depression directly. Several antidepressants are considered compatible with breastfeeding, and the amount reaching breast milk is generally very small, but that is a conversation for your GP rather than a decision to make from a website. Older tricyclic antidepressants are still used occasionally. Electroconvulsive therapy exists for rare, severe cases where a fast response is needed, and it is far less alarming in practice than its reputation suggests.

Where To Get Support In Australia

You do not have to find this on your own.

PANDA on 1300 726 306 runs a national perinatal helpline staffed by people who understand this specifically.

Gidget Foundation Australia provides free perinatal counselling.

Beyond Blue offers online support services.

The Centre of Perinatal Excellence publishes reliable, plain English and genuinely helpful information for parents and clinicians.

Locally, your child and family health nurse is one of the most useful people you will meet, and Ngala provides parenting support across Western Australia. A new parent group helps more than people expect, mostly by proving you are not the only one.

How We Help

Our approach is Integrative Body Mind Psychotherapy, and postnatal depression is a place where working with the body matters.

Parents experiencing postnatal depression are often running on a nervous system that has not stood down since the birth, sometimes since a birth that was frightening. Talking about it while the body stays braced changes very little, and it does nothing for emotional wellbeing that has been flat for months. We work with the physical state directly, and where the birth itself was traumatic, Richard’s Sensorimotor Psychotherapy training is the relevant piece.

We work alongside your GP and child health nurse rather than instead of them. Postnatal depression is a team situation, and we are one part of it.

What This Looks Like In Practice

These are composite examples drawn from our clinical work, with identifying details changed.

A first time mother could not say she was struggling because her pregnancy had taken four years to achieve. The gratitude and the flatness were both real, and she had decided only one of them was allowed.

A father in his thirties came in for anger. His son was seven months old, he was working sixty hour weeks and had stopped coming home for dinner. Nobody had asked how he was going, including himself.

A mother of two described intrusive images that frightened her badly enough that she had stopped being alone with her baby. Naming them as a common symptom rather than a warning changed the trajectory of her recovery.

Frequently Asked Questions

The questions parents ask us most often, and our honest answers.

How Long Does Postnatal Depression Last?

With treatment most people improve substantially within a few months. Without it, it can persist for a year or longer. The biggest factor in how long it lasts is how early someone asks for help.

Does Postnatal Depression Mean You Will Not Bond With Your Baby?

No. Difficulty bonding is a symptom rather than a verdict, and it resolves as the depression lifts. Plenty of parents who felt nothing for months describe an ordinary attachment afterwards.

Can You Get It After A Second Or Third Baby?

Yes. Having been fine previously does not protect you, and having had it once raises the risk next time. Tell your GP before the birth rather than after.

Will Anyone Take Your Baby Away If You Speak Up?

No. This is the fear that keeps parents silent and it is not how the system works. Health professionals are trying to get you support, and asking for help is evidence of care rather than the opposite.

Where To Go From Here

Postnatal depression is common, it is nobody’s fault, and it is treatable. It is a mental illness in the way a chest infection is a physical one, meaning it responds to treatment and says nothing about you. What makes the difference is naming it early, because parents routinely wait months while telling themselves this is simply what having a baby is like.

If the signs of postnatal depression here sound like your last few weeks, start with your GP or child health nurse. If you want counselling alongside that, we see parents individually and as couples at our Inglewood rooms and online. Book a session with us or read more about our depression counselling.