Signs and symptoms of antenatal and postnatal depression

A woman experiencing a perinatal mood and/or anxiety disorder may have a variety of symptoms, including:

• Feeling overwhelmed. Thinking “I can’t do this and I’m never going to be able to do this” or “I can’t cope, it’s all too much” or “Maybe I shouldn’t have had a baby”.
• Feelings of guilt because she believes she should be coping better (negatively comparing herself to other new mothers). She may feel she is letting her baby down. She may start to wonder if her baby would be better off without her.
• She may feel that she isn’t “in love” with her baby (some people use the word bonded) or connected to her baby.
• She might feel confused or scared about what is happening to her.
• Some women find their thoughts are racing and that they can’t quiet their minds, reporting that “my head is full of ‘shoulds’ and ‘have to’s’”.
• Some women start to feel constant worry. If pregnant, they worry that something might go wrong and ask themselves: “Am I doing the right thing?”, “Will I be good mother" or "What if I can’t cope?”
•  Reassurance doesn’t seem to help; in fact, for some it appears to make the worry worse.
• Some women report a sense of dread, as though something terrible is going to happen.
• Some will experience panic symptoms or full-blown panic attacks.
• She may notice that she is feeling irritated or angry, with little or no patience. Everything starts to annoy her. She may start to resent her baby, or her partner, or her friends who don’t have babies.
• Some women may report that they feel nothing and describe a sense of emptiness and numbness, as though they are just “going through the motions”.
• Some women will describe feeling very sad and tearful and report that they can’t stop crying, even when there’s no real reason to cry. This may lead to feeling of hopelessness. They may start to have thoughts that “things will never get any better”. This in turn can lead to the woman feeling desperate. 
• She may find that she can’t sleep. Some will wake up in the early hours and be unable to get back to sleep, and will describe lying awake, feeling alone, desperate to sleep but unable to do so. However, a few will find that all they can do is sleep and struggle to get the most basic things done.
• A woman may find that she has lost her appetite and finds eating a chore, while others will report comfort eating.
• Some woman will tell you that they  know something is wrong, but don’t want to tell anyone in case they are judged. They may start to worry that they are “going to lose their mind” or that if others “knew how bad she felt, that they would take her baby away from her”. 
•  Some women will find that they start to have disturbing and intrusive thoughts: these thoughts might frighten them and they may start to question and doubt themselves. These thoughts often start may start with the words “What if …”
• Sometimes they start to have thoughts about harming their baby and they become afraid to be alone with their baby.
• Some women may find they start having physical symptoms like stomach cramps or headaches, shakiness or nausea.
• Some women will note they have previously had depression and/or an anxiety disorder and that this feels different, while others will recognise it and report that they are having a relapse.

Information above provided by Dr Mark Huthwaite Senior Lecture for the Department of Psychological Medicine and Perinatal Psychiatrist (Otago and Wellington) and Perinatal Psychologist.