Postnatal Depression (PND)

Condition

Postnatal depression is a condition that affects over 1 in 10 women within a year of having a baby. 

Many women experience the ‘baby blues’ in the first week after giving birth. This normally passes within 2 weeks of the birth as hormones settle down and the mother adjusts to new routines.

Where symptoms last longer, then it could be postnatal depression. Postnatal depression can start at any time in the first year after giving birth and can become a long term problem.

It’s important to seek help for postnatal depression and not dismiss it as the ‘baby blues’ or something that will pass. Untreated, symptoms can last for months/years or get worse. The condition also makes bonding with baby difficult and has an enormous impact on family life.

Symptoms

Symptoms of postnatal depression may include:

  • Persistent feeling down or sad
  • Lack of enjoyment
  • Loss of interest in the wider world
  • Lack of energy, feeling tired all the time
  • Trouble sleeping

Problems

Problems caused by postnatal depression may include:

  • Difficulty bonding with baby
  • Preferring isolation to seeing other people
  • Difficulties thinking, concentrating or making decisions
  • Feelings of worthlessness, hopelessness, helplessness, or guilt
  • Thoughts of death or harming baby

Causes/Triggers

While the exact cause of depression is not known, it is generally believed to be due to a combination of factors. There are significant hormonal changes during pregnancy, childbirth and recovery which can affect some women more than others; but other factors are social, emotional and psychological.

Adjusting to motherhood and a more domestic lifestyle instead of work can be a big change and relationships can change when a baby comes along. Premature or traumatic birth are also issues which raise the likelihood of postnatal depression and issues with breastfeeding, health problems (baby or Mum), sleeping problems are also known to be linked to PND. A history of depression means that postnatal depression is more likely.

Are you suffering from Postnatal Depression?

The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire for diagnosing postnatal depression, which is often used by General Practitioners and Health Visitors in the UK to indicate how a person is feeling. Mothers who score above 13 are likely to be suffering from a depressive illness of varying severity. This is an indicator based on a snapshot of how you are feeling when you answer the test – you should always seek medical advice for a proper diagnosis. The Edinburgh Postnatal Depression Scale (EPDS) can be downloaded using the button below:

Conventional Treatments

Conventional approaches to treating postnatal depression include:

  • Counselling and therapy
  • Medication
  • Cognitive behavioural therapy (CBT)
  • Peer support groups

These can be very effective with the right group, but may not suit everyone.

Taking antidepressants is not usually recommended while breastfeeding as there is a risk that the drugs may contaminate the mother’s milk and pass to the baby. There can also be unpleasant side effects, such as feeling detached or sleepiness, which can cause further difficulties when trying to bond and care for a baby.

Group therapies and counselling can also be a challenging prospect for many patients.

rTMS Treatment for Postnatal Depression

TMS may be a suitable treatment for postnatal depression, particularly while breast-feeding  as it is a safe, medication free treatment.

NICE Approved Treatment of Depression with rTMS

NICE approved rTMS as a safe and effective treatment for depression in December 2015 (NICE Guidelines, 2015).

The rTMS treatment for depression stimulates the prefrontal cortex area of the brain, which controls mood, motivation, social skills and positive feelings.  Stimulation of the prefrontal cortex by rTMS in depressed patients can lead to complete remission from depression with patients reporting that they feel much more positive; they are more sociable, motivated and talkative.

References:

NICE Guidelines (2015) https://www.nice.org.uk/guidance/ipg542.

Further Evidence, Research and Studies rTMS Treatment for Depression

Depression During Pregnancy

There are potentially harmful effects from drugs crossing the placenta during pregnancy. Avoiding the use of drugs in the treatment of depression in pregnancy is desirable because of the risk to the developing and growing foetus.

For these reasons TMS may be a suitable treatment for depression during pregnancy, which you can discuss with your doctor.

rTMS at The Smart Clinics in London

Transcranial Magnetic Stimulation therapy treatment for postnatal depression is available at Smart TMS, based at The Smart Clinics, Brompton Cross, London.

Treatment Protocol

At Smart TMS we provide the standard rTMS depression treatment. Each treatment session takes 40 minutes.  We also provide Theta Burst rTMS treatment for depression, if preferred, which takes 6 minutes per session.

The treatment protocol as outlined by NICE is typically 2-6 weeks.  Patients will receive five treatment sessions per week and progress will be assessed over the course of treatment to monitor the effect.  The actual length of the treatment will vary dependent on how quickly a reduction in depression level is seen.