According to studies, around 15% of women will suffer from postnatal depression. This figure is very likely to be an underestimate as there is evidence that postnatal depression is under reported, and that as only around 15% of women with symptoms of post-natal depression seek medical advice.

When you combine this with the fact that postnatal depression is the most common, but certainly not the only mental health problem that can occur during pregnancy and in the first year after giving birth (others include a range of anxiety disorders, such as generalised anxiety disorder, obsessive-compulsive disorder, panic disorder, phobias, post‑traumatic stress disorder and social anxiety disorder), that’s a huge number of women that might be able to benefit from help but aren’t currently accessing it.

Why is this? Honestly, there are probably as many answers to that as there are people in that group

Firstly, I think its important to see all of the symptoms that feature in these conditions as a spectrum from very mild to incredibly debilitating, and that most people will only seek help when they (or other around them feel) that it is having a significant impact on their ability to function in everyday life.

Some people may be unwilling to disclose symptoms of depression and other mental health problems or due to fear of stigma, fear the baby may be taken into care (this is incredibly rare and always done when all the other options haven’t worked; the main aim is to support families and not to remove babies), concern that they will be perceived as a poor mother, the nature of the condition or problems with alcohol or substance dependence. Your GP will never judge you. We’re a tough bunch to shock, we’ve seen and heard most things before, so please try to be honest with us.

As a GP I see lots of women every week experiencing a whole range of emotions and physical and mental symptoms after having a baby; the whole spectrum, and I’d like to see more. I’d like to see those parents who don’t know whether what they are feeling is normal, those who are feeling like they aren’t coping, those who feel suicidal, and everything in between. Its really important to seek help early, even if you’re not sure what you need (or whether you need anything at all). Part of our job is to help assess things and to work with you on a plan to help improve your mental wellbeing. This is such a crucial time for parents, especially mums, and also for the babies. We know that when post-natal mental illness is untreated there are adverse impacts on the babies, the mums and the wider family. There are minimised by getting the right support and treatment early.

So, what to expect when you see your GP? The first thing, and the most important, will be to be listened to, so be honest and tell us how you are feeling. The GP’s initial job will be to find out as much as they can about how you are feeling, what you are experiencing and how this is affecting you.

They may then ask more questions and sometimes use screening tools or questionnaires. They are likely to ask about sleep, appetite, low mood, anxiety, concentration, whether you are still getting enjoyment from things you used to, energy levels, your relationships and support networks, any
previous physical and mental health problems, and any thoughts or plans you’ve had around harm to yourself or
others.

The GP will ask these questions in order to better understand the problem and is impact on your life, and to assess any risks to you or to others. The GP will then discuss the options most appropriate to you and involve you in planning the next steps.

This may involve signposting to resources or self-help. It may involve support from other health professionals (often Health Visitors). It can involve connecting you with other groups or professionals in your local community. Depending on the assessment that the GP makes they might offer to refer you for psychological therapy. There are various different types, and there is excellent evidence for the effectiveness of some of these. Pregnant women and those within a year of giving birth are usually a priority group for accessing these therapies so generally you shouldn’t be waiting long for this to start. In some instances, medications are offered, often alongside psychological therapies. On some occasions your GP may refer you to a specialist mental health team. Your GP can talk you through all of the options and help you to make informed choices about your management plan. This is your management plan and it is important that you are happy with it and that you are able to ask questions.

Some tips that might help you when you see your GP:

  • If you have something that you really want to say, a question you want to ask, or an idea about what you think you would like to happen next then don’t be afraid to say it. Some people find it helpful to write down a couple of pointers in advance so that
    they don’t forget.
  • However, don’t feel you need to do this. Many people come to see me and say “I don’t know why I’m here or what you’re going to do, but I just don’t feel right”, and that’s absolutely fine too, we’ll ask some questions to help. The important thing is
    still to come.
  • If you think it might help, feel free to bring someone with you (conversely, some people prefer to come alone).
  • Remember that this is about you and you share the power in the consultation, so don’t be afraid to ask questions, seek clarity, share the decision-making.
  • Everything you tell your GP is confidential. The only time that the GP (or any other health professional) will share information about you with anyone else is either with your consent, or if they feel that there is a high risk of harm to someone if they don ’t share information (this is very rare, and your GP would always still aim to tell you that they are going to do this and explain their reasons first).
  • Most standard GP appointments are only 10 minutes. If you think you might need longer ask when you book the appointment if you can get a double appointment.
  • Before you leave clarify any next steps and follow up arrangements.

Not every GP can be everything to everyone (as much as we really want to be), so if you come away from your GP appointment and feel that you haven’t been listened to, or even just that you didn’t click with, or feel comfortable talking to that GP then see another GP at your practice, or talk to another health professional. We won’t take it personally, and we would much rather that you get the help you need in a way that
works for you.

And finally, but really importantly, don’t put off coming if you are concerned about how you are feeling. Your wellbeing is far too precious to be an after-thought. You are important.
Take Care, Louise.