Signs of postnatal depression: when to seek help

Updated August 2023 | 6 min read
Contributors Terri Smith, CEO Perinatal Anxiety and Depression Australia; Jessica Rowe, journalist and Beyond Blue ambassador
Words by Natasha Phillimore

How to spot the signs of perinatal anxiety or depression, and when and how to get help.

Carrie* lives in Sydney’s Northern Beaches, has a growing young family and works full-time as a marketing executive. She also experienced signs of postnatal depression – also referred to as postpartum depression or perinatal anxiety and depression (PAND) – after the birth of her first child.

Carrie admits she’d had anxiety and bouts of depression before but was unprepared for her feeling of powerlessness with an unsettled newborn. The move from a world of structure and control to the opposite was overwhelming.

“There was one day about two weeks after Gracie* was born, when everyone had stopped visiting, my husband had gone back to work and I had severe sleep deprivation," she said.

"I was inconsolable. I spent the whole day sobbing, and when my husband came home from work I said to him, ‘We have to see someone.’ I just wanted the doctor to send me to a hospital so I wouldn’t have to take care of Gracie.”

“It doesn’t matter where you live, your culture, your socio-economic background – PAND doesn’t discriminate,” says Perinatal Anxiety and Depression Australia (PANDA) CEO Terri Smith. “We’ve spoken to doctors, midwives, neuroscientists … and every woman is really surprised that it happens to them.”

Signs of postnatal depression

Postnatal depression affects about one in five Aussie mums and one in 10 dads in the first year after they have a baby. Unlike 'baby blues' which is common in the first few weeks after birth, postnatal depression lasts longer and the symptoms may be more severe.

When you're recovering from birth and adjusting to looking after a newborn, it can be difficult to know what's 'normal' or what could be the start of something more serious. If you experience two or more of the following symptoms for longer than two weeks, you may have postnatal depression.

• Racing heart
• Palpitations
• Shortness of breath
• Shaking
• Feeling physically ‘detached’
• Obsessive or compulsive behaviours
• Abrupt mood swings
• Feeling constantly sad or low
• Crying for no obvious reason
• Persistent or generalised worry regarding the health or wellbeing of your baby
• Suicidal thoughts

What causes postnatal depression?

One of the risk factors for postnatal depression, Terri explains, is an earlier mental illness. “If, for example, someone has been treated for anxiety for their year 12 exams, it puts them at slightly higher risk,” she says.

Most new mothers experience some teariness, anxiety and irritability due to hormonal changes throughout pregnancy and birth – but with support and understanding this usually resolves in a few days or weeks. With postnatal depression, these feelings persist. Terri advises that anyone feeling mood swings for two weeks or longer should reach out to someone.

Journalist and Beyond Blue ambassador Jessica Rowe can relate. The mother of two often speaks out about her experiences with postnatal depression. “Despite the sleep deprivation, I couldn’t sleep. My waking hours were consumed by anxious thoughts,” she admits.

“Why couldn’t I breastfeed? Was my baby putting on enough weight? Did using formula mean I was setting my daughter up for a life of obesity and lowering her IQ? I wondered how I could feel so wretched when I finally had my darling girl. Wasn’t I meant to be the superwoman who could deal with anything life threw at me?”

Terri points out the realities of new motherhood. “There’s so much pressure even just planning for babies. A natural birth, where particular music is playing … then the baby comes three weeks early and it’s a caesarean. Basically, we feel like we’ve failed on day one.”

According to Terri, it’s a common journey. “Women tell us all the time that [the birth] didn’t happen the way they wanted it to. We have a very idealised view about bringing a new baby into the world, one that rarely addresses that it’s a time of extraordinary transition – the biggest many people will experience.

“Your life as a couple is turned on its ear. Your career is turned on its ear. And there you are, at home, looking at this lifelong decision you’ve made, wondering how you’re going to do it.”

Preventing postnatal depression

When Leah Williams and her partner Colin undertook IVF, they were both on the same page – they were focused on building a family. But when baby Eva arrived she turned out to be a "textbook difficult baby" and Leah experienced signs of postnatal depression and Colin struggled too. You can listen to their story in episode five, season one of our Navigating Parenthood podcast.

For anyone experiencing postnatal depression, including partners, there are ways to make the transition to parenthood easier.

Firstly, don’t expect too much of yourself. Make time to slow down, rest and relax. Leave the washing. Don’t put pressure on yourself to do anything more than care for yourself and your baby.

If you have a partner, talk about the difference a baby will make to your lives, both positive and negative. Arrange as much time as you can for both of you to be at home after the baby is born.

You may be eligible for government-funded Dad and Partner Pay, which provides up to two weeks’ paid leave, and you may be able to negotiate additional time off with your employer – it pays to ask.

Set up extra support for the first few weeks after the baby’s birth, both immediate (to help with night feeds) and long term. Your hospital, antenatal class or family health clinic will usually assign you a mother's group which can be a great source of support and information. If you're not assigned to one, the Australian Breastfeeding Association has a directory of local support groups you can contact.

One of the most important factors, and one that is hard to quantify, is sleep. According to the Division of Sleep Medicine at Harvard Medical School, scientists have found that just a small nightly decrease in sleep has serious cumulative effects. This is a tough hurdle for any new parent, making immediate support (from a grandparent or friend perhaps) even more important.

Getting help for postnatal depression

If you’re struggling, talk to someone: your GP, your mum, a fellow mum, your partner. You can also contact the PANDA hotline on 1300 726 306 to speak to a professional counsellor or volunteer with a lived experience of perinatal mental health issues. It’s about finding the best way to get help.

“Speaking to my husband was one of the hardest things I’ve ever had to do because for me to say, ‘I’m not coping and I need help’, is so difficult,” Jessica says.

Just reading about other people’s experiences of new parenthood – like those at Beyond Blue – “can help provide a language about what’s going on with you,” says Terri.

Other mothers, however, may require more substantial support. Medication, including antidepressants, may be prescribed in pregnancy or during breastfeeding. Cognitive behaviour therapy, counselling and psychotherapy are other possible solutions that can help ease the signs of postnatal depression.

“The most important thing is to get help, to speak up,” says Jessica, who wrote her memoir Is This My Beautiful Life? about her experience. “I know that made all the difference for me, and then I could focus on being a mum and getting to know my baby, which is what it’s all about.”

How to help someone with postnatal depression

If you know someone who is struggling with postnatal depression (it can also affect the father or partner too), Better Health offers these tips:

• be patient and encourage them to talk about their feelings
• try to empathise with their experience
• avoid being critical of their negative feelings, or taking them personally
• offer to babysit or help with housework
• encourage them to practise self-care as much as possible, like prioritising sleep and a healthy diet
• stay connected with them to prevent feelings of loneliness or isolation.

Mental health care that's got you covered

Everyone’s mental health journey is different, and often finding where to go for support for yourself or your loved ones can be challenging. That’s why we’ve developed a holistic mental health and wellbeing program with access to a range of options for all ages, and the freedom to choose what works for you.

If you prefer a self-help approach to online mental health support, This Way Up* is a not-for-profit hub offering a suite of interactive programs to help manage symptoms of a range of conditions like anxiety, depression and social anxiety. There are also coping and resilience resources, multilingual resources and self-led programs for peri and postnatal mental health.

The programs are available free of charge when prescribed by a clinician. Your provider will register with This Way Up and refer you to an appropriate online program under their supervision. Alternatively, you can access the programs without a supervising clinician for $59 per program. 

Learn more about our mental health services.

If you need to speak to someone now, call Lifeline on 13 11 14.