What causes postnatal depression still remains unclear. At present, it is thought to be a result of a combination of many factors, (physical, psychological and social) rather than stemming from one single cause. Postnatal depression does not discriminate, and can affect women from all walks of life and from all social and economic backgrounds. It can happen after a first baby, or a subsequent birth. It can happen to women who have babies as teenagers, or in their early forties. There is no difference in the amount of women who experience postnatal depression from western and non-western countries, or indigenous cultures. However, postnatal depression can be under-reported in some cultures, if it is not officially recognised, and/or the woman is too ashamed, or afraid to seek help.
For many women, having a baby will be the biggest physical, emotional and social upheaval they will ever experience. Preparing adequately for this event can be difficult and is often laced with unrealistic expectations held by the woman's society. If a woman's expectations are not met and/or caring for her new baby proves to be difficult, most women will tend to blame themselves, rather than acknowledge that mothering can be a stressful job, often performed with little (or no) help or support.
Self-blame can also be compounded by the many opinions of others, and myths surrounding motherhood, that often only serve to set women up for feeling guilty and/or inadequate about being a 'good mother'. If a woman feels inadequate, guilty or ashamed about how she is feeling, it makes it harder for her to ask for help, ironically at a time when she is truly having difficulty coping, and really needs support.
The following are some possible risk factors that have been associated with an increased likelihood that a woman may experience postnatal depression. However, they are not in themselves direct causes of postnatal depression. They can include the woman:
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Having experienced depression at some time before she was pregnant, or during the pregnancy. |
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Experiencing severe 'baby blues'. |
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Having difficulties in her relationship with her partner, and/or lack of practical and emotional support, or being a single parent. |
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Dealing with an accumulation of stressful life events, such as financial difficulties, moving house, conflict in the relationship, the death of a close relative, changing jobs, pressure with leaving or returning to work. |
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Having unrealistic expectations about being the 'perfect mother' and being ill prepared for the reality of parenting. |
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Having a negative birth experience, experiencing unexpected complications, the baby being born premature and/or becoming unwell. |
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The baby being demanding, having difficulties feeding, experiencing colic and/or being frequently unsettled. |
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Having a partner who is depressed. |
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Being a person who tends to have a negative outlook on life. |
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Being a person who is used to having alot of 'control' and 'order' or 'power' and 'authority' in their lives. Possibly because parenting a new baby means losing 'control' of many daily activities. |
Other issues can include the pregnancy being unplanned, the baby being adopted and the woman requiring extensive fertility treatments to conceive her baby(s). Women, who have experienced postnatal depression during one pregnancy, are at increased risk of experiencing depression again at some stage later in their lives, particularly with subsequent pregnancies.
The combination of many factors will vary from woman to woman, as each individual has her own life experiences, support networks and ways of dealing with stressful events in her life.
Aspects that are believed to be 'protective' for women against postnatal depression can include the woman:
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Being a person who tends to be optimistic, having good self-esteem. |
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Having a good relationship with her partner, who provides emotional and practical support. |
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Having increased access to support from family and friends. |
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Having realistic expectations and being adequately prepared for the physical and psychosocial changes of parenting. |