Postnatal depression therapyYou deserve support too.

Postnatal depression, also called postpartum depression, is a common mental health condition that can happen after having a baby, and it usually gets better with treatment¹. It can begin soon after birth or at any point in the first year¹. Research reviews estimate that around 13% of mothers experience postnatal depression in the first year after delivery².

Many factors can contribute: the enormous physical changes of pregnancy and birth, sleep deprivation, a difficult birth or feeding experience, previous depression or anxiety, relationship strain, financial worries, lack of support and the loss of a previous identity and routine. None of these mean you are a bad parent. Depression is an illness, not a verdict on your love for your child.

• Persistent sadness, emptiness or feeling numb.
• Loss of interest in things, including sometimes in the baby.
• Exhaustion, yet difficulty sleeping even when you can.
• Anxiety: constant worry about the baby's health or your ability to care for them.
• Guilt and feeling inadequate as a parent.
• Irritability and tension with your partner or family.
• Withdrawal from friends and social contact.
• Intrusive, frightening thoughts, for example about harm coming to the baby, which can be very distressing but are common in perinatal anxiety and depression.

Postnatal depression can also affect fathers and partners¹, and anxiety after birth can occur with or without depression.

A meta-analysis of psychological interventions for postnatal depression that could be delivered in primary care, including cognitive behavioural therapy, interpersonal therapy and counselling, found that they were associated with significant improvements in depressive symptoms immediately after treatment and up to six months later². Interpersonal psychotherapy, which focuses on role transitions and relationships, has been specifically adapted for postpartum depression³. The NICE guideline on antenatal and postnatal mental health covers recognising, assessing and treating mental health problems from pregnancy through the first year after birth⁴.

Our therapists work in an integrative, evidence-informed way. With new parents, sessions often include:

• Space to say the unsayable: guilt, ambivalence, anger, grief for your old life, without judgement.
• Understanding what is happening, so that symptoms feel less frightening and less like a personal failure.
• Techniques from cognitive behavioural therapy, where helpful, to ease harsh self-judgement and anxious thoughts, including intrusive thoughts.
• The transition to parenthood: changes in identity, work, your body and your relationship.
• Practical support planning: sleep, rest, help from others and realistic expectations.
• The relationship with your partner, which often comes under strain after a birth.
• Bonding, if you feel distant from your baby, which is common and can change.

Postpartum psychosis is rare, affecting around 1 in 1,000 mothers, but it is serious and should be treated as a medical emergency⁵. Symptoms usually start suddenly within the first two weeks after birth and can include hallucinations, delusions, confusion, very high or very low mood and behaving out of character. If you notice these signs in yourself or someone else, call 112 immediately.

Leaving the house with a newborn can be a major undertaking. Online sessions let you attend from home, with your baby nearby if needed. Video psychotherapy has shown outcomes broadly comparable to in-person therapy for depression and anxiety⁶. It is completely fine to pause for a feed or to settle the baby.