HOW IS POST-NATAL DEPRESSION (PND) DIAGNOSED?

Generally speaking, the time frame that certain symptoms last is what enables your healthcare team to diagnose whether you (or your partner) has post-natal depression.

If you have any or all of the symptoms listed below for a period of 2 WEEKS OR MORE, then this can be a helpful guide as to whether you need to speak with your GP, obstetrician, midwife or child health nurse.

The ‘Baby Blues’ is having similar symptoms that can arrive at the onset of milk supply production around day 3 to day 5, but the time duration is short-lived compared to PND. This is a key differentiating factor that can help initiate a diagnosis and treatment plan to move forward.

The symptoms can vary from woman to woman, vary in severity and when exactly they appear; for me it was on day 5 post-birth, for others it may occur later and others may be during the weaning process of breastfeeding. There is no ‘one-size fits all’ approach as to what it looks like per se, with various shades of grey in between… (which makes knowing ‘definitive’ and black/white statements of what will make and when you will recover so tricky!)

However, symptoms that you may be experiencing include;

• Inability to concentrate or make decisions
• Anger or frustration
• Feeling no emotion or low and numb
• Feeling teary or sad all the time
• Lack of interest or pleasure in things normally enjoyable; even time with your baby
• No motivation, no energy
• Changes in sleep; sleeping too much or not able to sleep at all
• Changes in eating; eating more or less than usual
• No hope for the future
• Feeling like you are unable to cope and things are too overwhelming
• Feeling very teary or emotional
• Feeling isolated, alone and disconnected from others
• Having thoughts of self-harming or harming your baby
• Anxiety
• Heavy and clouded feeling in the head; cannot think clearly
• Losing confidence
• Fears of being alone or fear of being around people
• Feeling like your baby does not love you or that you don’t love your baby
• Inability to do regular everyday tasks
• Disconnection from your baby and children; lack of connection and emotion
• Inability to function which makes everything feel difficult and overwhelming
• Feeling like there is no way out, stuck, no hope or nothing will get you out
• Loss of joy, emotion and pleasure in things you normally love

In my book Shining The Light On PND – A Journey From Darkness To Healing From Post-Natal Depression, I write about my daily experience; what it can look and feel like to have the condition. I wanted to do this, as I felt like I did not know if what I was going through was ‘normal’, so being transparent in my experience was designed to help others not feel alone or confused like I was.

It was one thing to know the symptoms in a dot-point article; but reading about articulate feelings of someone’s experience leaves nothing to the imagination…so if you are sitting on the fence unsure whether you or your partner has PND, then it can hopefully make it crystal clear.

The support team of your GP, obstetrician, midwife or child health nurse may give you a screening tool called the EPDS, or the Edinburgh Postnatal Depression Scale. This is not a diagnostic tool per se, but is a helpful screening tool to gauge how you are feeling in a measurable and quantifiable way. This can be useful considering that the symptoms can be hard to quantify without a scale or if you are having trouble articulating exactly what you are feeling.

I would encourage you to visit the COPE website (Centre of Perinatal Excellence) that has the full EPDS resource there and a lot of pertinent information about it. If you do feel like you may have PND then ask your provider to give you the EPDS if they have not done so already. Remove any fear of judgement when completing the form and be entirely honest with how you are feeling.

Whilst I have not included a copy of the EPDS here, however as a guide, the questions that are included on the tool have a range of answer scales and marking as to how you have felt in the previous 7 days and are listed below for your reference:

• I have been able to laugh and see the funny side of things
• I have looked forward with enjoyment to things
• I have blamed myself unnecessarily when things have gone wrong
• I have been anxious or worried for no good reason
• I have felt scared or panicky for no good reason
• Things have been getting on top of me
• I have been so unhappy that I have had difficulty sleeping
• I have felt sad or miserable
• I have been so unhappy that I have been crying
• The thought of harming myself has occurred to me

Doctors can also rule out other underlying conditions that may be causing your anxiety and depression symptoms by doing blood tests or using other differential diagnostic tools. They can review your medications and past medical history and make a diagnosis from all of this information provided to them.

We are so blessed here in Australia to have access to high quality healthcare and this would be the time to access it and utilise it to your advantage.

There is an opportunity to speak up to your child health nurse when they come to visit you at home post-delivery, which whilst I felt so scared to do because I did not know them, this is a wonderful opportunity to chat about how you are feeling.

Call your obstetrician at any time if you are feeling any of the symptoms above and they will make it a priority to see and listen to you.
Remember, that by taking action and speaking up…this in and of itself will allow you to step into your recovery (that is and will be possible for you too).

Hold on beautiful Mama (and Papa)…you’ve got this!