Widespread lack of awareness of postnatal depression signs and symptoms results in 35,000 untreated mothers suffering in silence each year in the United Kingdom, national charity 4Children revealed in a new report. The authors wrote that the consequences for the mothers and their families can be devastating.

Half of all women across the country with postnatal depression do not see a healthcare professional about their problem, the charity revealed. Serious faults in the National Health Services mean thousands more are not being treated properly or promptly – shortcomings in the system listed by the authors include an over-reliance on antidepressant usage, and inadequate screening and referral. In a significant number of cases, the stigma surrounding mental illness discourages women from being forthcoming about their symptoms.

This report is the first of three that explores how family crises can be prevented, and forms part of 4Children’s “Give Me Strength” campaign. It explains how postnatal depression can burden families with enormous relationship problems and breakdowns, placing pressure on older brothers and sisters to take over the care of babies and children. Postnatal depression can undermine early bonding between mother and child, which can have long-term consequences.

The authors add that GPs (general practitioners, primary care physicians) and other health care professionals need to do more to diagnose the condition early on so that mothers may be treated properly and promptly.

The report found that among the mothers with postnatal depression who were not treated (49% of all cases):

  • 29% did not know they had postnatal depression
  • 60% did not believe their symptoms were severe enough to merit treatment
  • 33% kept quiet about their condition for fear of what might happen to them or their child

There is a serious lack of data and hunger for knowledge among postnatal depression sufferers, the report explained. Dissatisfaction with treatment is common.

The authors wrote that:

  • 65% of the women interviewed said they wanted more information about available support groups
  • 52% want information on counseling and other talking therapies
  • 46% found the information they were given on postnatal depression symptoms unsatisfactory

Even though the guidelines issued by the National Institute for Clinical Excellence (NICE) include “the effective and timely treatment of postnatal depression . . . . which stipulates that talking therapies should be offered to patients with a mild or moderate diagnosis”, what really happens to a considerable number of women is very different, the report shows.

Postnatal depression can interfere with the bonding between mother and baby

Only 41% of diagnosed women were referred to talking therapies and 70% were prescribed antidepressants by their GPs. Talking therapies form an important part of effective and long-lasting treatment.

The report highlighted some disturbing facts regarding postnatal depression surveillance in the UK:

  • Most Primary Care Trusts do not gather data on postnatal depression rates, or on severity or treatments at local levels.
  • Two trusts reported just one diagnosis of postnatal depression during the whole year
  • The Department of Health, by its own admission, has no national data on postnatal depression rates or treatment
  • Inpatient care for mothers with severe symptoms is described as a “postcode lottery” – with a lack of provision of Mother and Baby Units in Cornwall, Devon, East Anglia, and Cumbria, as well as vast pasts of Scotland and Wales. There are no Mother and Baby Units in Northern Ireland.

Chief Executive of 4Children, Anne Longfield OBE, said:

“Postnatal depression is a problem that with the right help, early on, can be treated successfully avoiding long-term impact on the rest of the family. However, many families are suffering the consequences of postnatal depression in silence, and even when they do seek help they all too often encounter a wall of indifference and a lack of empathy from medical professionals with an over reliance on antidepressants for treatment.

The best ways to treat maternal depression are set out clearly in the NICE guidelines, but all too often there is a shocking lack of awareness. So many women have to rely on luck to come across a sympathetic GP or health visitor who will lead them to the right course of treatment. This report calls for an end to the neglect of this destructive and prevalent illness to ensure that every mother is guaranteed the practical and emotional support she needs to avoid her unnecessary suffering and that of her family.”

Postnatal depression (PND), also called postpartum depression (PPD) is a type of depression that a mother can develop after childbirth, and requires treatment. Onset of symptoms may develop from a few days to several months after giving birth. PND should not be confused with baby blues which lasts for a short time after childbirth. Postnatal depression has more severe symptoms and can seriously undermine the woman’s ability to go about her daily duties. If the mother is not treated, there is a serious risk that her condition becomes long-lasting with worsening symptoms. Experts say that treatment today is effective, especially if the patient is diagnosed early on.

The signs and symptoms of PND may be different from patient to patient, and usually include some of those listed below:

  • A low mood that prevails for long periods
  • A constant feeling of irritation
  • Tearfulness
  • A feeling of being trapped
  • Panic attacks
  • Concentration problems
  • Lack of motivation
  • Lack of interest in the baby
  • Lack of interest in herself
  • A feeling of loneliness
  • Feeling inadequate
  • Feeling guilty
  • Feeling rejected
  • Feeling overwhelmed
  • A feeling that it is impossible to cope
  • Insomnia
  • Constant fatigue
  • Headaches
  • Stomachaches
  • Loss of libido
  • Loss of appetite

Some mothers with postnatal depression may have frightening thoughts, some of them about harming their baby – experts say that approximately half of all women with PND have such thoughts. Some may have thoughts about harming themselves. It is rare for a mother with these symptoms to harm either her baby or herself.

Some mothers may not be aware that they have postnatal depression, while others might not talk to friends and family about how they feel. It is helpful if partners, family members and friends recognize PND signs, especially at an early stage, and to seek professional advice.

Written by Christian Nordqvist