The first few weeks after having a baby can be really tough.

We spoke to Andrea Witt, a cognitive behavioural therapist specialising in postnatal mental health, about some of the challenges new parents can face once we bring our babies home.

Read on for Andrea’s advice on signs and symptoms to look out for. Andrea also provides tips to help alleviate any initial feelings of anxiety, and to help deal with the often overwhelming realisation that you are now a parent.

There are a number of factors which may mean you are at increased risk of postnatal mental health issues, these include:

• A previous history of depression or struggles with anxiety
• Family history of mental health problems
• A difficult pregnancy
• A traumatic labour
• Difficulty breast feeding
• Baby needing any special care post birth
• Other factors which contribute are all the things which come with being new parents like lack of sleep, adjusting to a new life, and feeling isolated

BABY BLUES

A few days after the birth around 70% of new mums will experience a few days of what we know as the ‘baby blues’. This will typically be a few days of low mood and perhaps feeling a bit tearful. This is typically mild and passes as the hormones begin to settle down.

PND

Between 10 and 20% of new mums will experience postnatal depression. Unlike the baby blues the symptoms will be stronger and persist. Symptoms usually begin to appear one to two months post birth, and may include feelings of sadness and hopelessness, feeling helpless and worthless, difficulty in sleeping (even when your baby is asleep), change in appetite and high levels of anxiety around the baby.  This is often coupled with feelings of guilt and thoughts such as ‘I have everything I have ever wanted so why do I feel sad?’.

PNA

Postnatal anxiety is very common and affects between 9-15% of new mums. As with postnatal depression, symptoms usually appear within 1-2 months of baby being born. Symptoms include feeling tense and on edge, always fearing the worst, having constant worries and difficulty concentrating.

OCD

A smaller number of women may experience OCD, typically around 3-5%, and symptoms would include upsetting intrusive thoughts such as harming your baby.

PUERPERAL PSYCHOSIS

Puerperal Psychosis is incredibly rare and affects between 1 to 3% of new mothers. Symptoms typically start a few days after baby is born and include things like vivid hallucinations. This is treatable but needs immediate medical attention.

PTSD

And finally, some women may experience Post Traumatic Stress Disorder after the birth of their baby. The symptoms of birth trauma would include flash backs, avoidance of any triggers which remind you of the birth or the trauma and hyper vigilance. If you feel as though there were areas of your delivery that are still troubling you after you come home, you can ask for some time with your midwife. This will allow you to go over your notes of the birth and ask questions which some women find incredibly helpful.

DADS

Dads are also susceptible to postnatal mental health issues with around 1 in 14 new dads suffering from postnatal depression. Dads are often forgotten in the excitement of the new baby being born as understandably everyone focuses on the mum and the baby. The symptoms are identical to those of new mums although obviously not caused by biological or hormonal factors. It can be triggered by feeling the pressure of now being the sole breadwinner and the pressure of having to provide for their new baby. The sudden change in the dynamic of their relationship with their partner can also lead to depression in new dads.

It’s important for dads if you are feeling anxious, a bit lost or overwhelmed to be open and to talk about these feelings either with your partner, a close friend or family member or your GP.

So what can we do in order to help in these early days?

SELF CARE

Self care is vital but often neglected.  When we bring our new baby home, it’s easy to become consumed with looking after the baby and we forget to look after ourselves. I often tell my clients to remember when you are on an aeroplane, cabin crew tell you to fit your own oxygen mask before that of a child so you can make sure you can help them. Well it’s the same in life. You can’t pour from an empty cup. Make sure you are eating properly. Try to get rest as and when you can. It may mean letting some household chores slide for a while.

EXERCISE

Try and be as active as you can. Getting out each day for a walk with your baby will be beneficial for you both. Fresh air and exercise release endorphins which is your brain’s way of giving you a natural high and raising your mood.

GOOD ENOUGH

Remember there is no such thing as perfect. It does not exist. Do not compare yourself to others. All babies are different, everyone’s family dynamic is different and everyone’s experience of parenthood will vastly differ. Delegate where you can, ask for help and take any help that is offered.

JOURNALLING

Writing things down at the end of each can be really helpful. Look back at the events of the day and focus on the things that went well even if they seem small.

It can be helpful to write yourself a compassionate letter whilst pregnant that you can get out and read on the days when it feels tough once the baby has arrived. Include things like ‘I know you are tired but you’re doing a great job.’

BREATHING

A breathing technique that can be helpful at times when you feel particularly overwhelmed or stressed is breathing to a count of four. So we breathe in for four, hold for four, breathe out for 4 hold for 4 and repeat until you feel calmer.

COMFORT ZONE

Build yourself a comfort zone in your home. Maybe a chair or a corner of the sofa that you keep a cosy blanket and anything else that calms your mind. It might be a picture, a book, listening to music or reading a magazine but that’s your space that you go to to feel calm.

ROUTINE/PRACTICAL TIPS

Get into some sort of a routine as this will make life easier on a daily basis but make sure you are not becoming too rigid about sticking to it. Plan in advance if you can to make sure you are prepared for each activity ie. have all things you need for bath time on hand in the bathroom. It’s helpful to have a box or bag of changing kit both upstairs and downstairs.

GP

If you do feel like you are struggling with anything described above, please make sure you chat with your GP or Health Visitor. They will understand and be able to talk through options with you.

Above all try and keep in mind that whilst the early weeks and months with a new baby are joyous, they are also tough, but these days will pass and whilst things will never be as they were you will find a new normal and become a family unit.

Andrea is a CBT therapist specialising in postnatal mental health – she runs The PND Coach and is a mental health contributor for Komu

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