Postnatal depression – A conspiracy of silence

It’s Mental Health Awareness month and my Twitter feed is flooded with acknowledgments of the disease model of depression (largely due to Redi Thlabi’s show yesterday on Cape Talk/702). I’ve recently seen a mom in therapy who is struggling with depression and anxiety following the birth of her child a few weeks ago. A mom who feels alone, inadequate and overwhelmed. The good news is that she recognised that she needed help, phoned her gynaecologist and was referred to see me for therapy for postnatal depression.

Most moms experiencing postnatal depression do not seek help early. They’ve heard about the “baby blues” and perhaps find it hard to acknowledge that they’re not coping. Their mothers may be from the generation of “pull yourself together” and they are bombarded with perfect pictures of motherhood on Facebook. No one posts a status “Motherhood is not for me” or “I find it hard to bond with my baby.” Rather posts are all about the “perfect moments” and being #BLESSED.

One of the greatest resources we have in South Africa is the Post Natal Depression Support Association (PNDSA), a non-profit organisation supporting women with ante- and postnatal depression. Below are some guidelines from their website:


  • They hide their real feelings because they feel ashamed and guilty.
  • They may feel more anxious about the baby than depressed.
  • They may receive help for the physical symptoms of depression, like insomnia or tiredness, without examining the underlying causes.
  • Society expects women to be happy during pregnancy and after the birth of a baby, and it’s hard to admit to being miserable especially when everything has gone smoothly and you have a perfectly healthy baby.
  • Health professionals may not recognise the depression, or may not take it seriously.
  • Partners and families may not understand how the mother is feeling, and may try to tell her to, “Pull yourself together” or “count your blessings”.postnatal depression


Being pregnant and having a baby is exhausting and disorientating, but you may have depression or anxiety.

Get help immediately or have yourself assessed by an expert if you feel:

  • that things are getting worse rather than better,
  • that you are a changed person to who you normally are
  • very anxious, panicky, irritable, angry, withdrawn, forgetful, tearful, indecisive
  • that the baby would do better without you.


  • Previous history of depression and/or anxiety
  • Depression during pregnancy
  • Previous postnatal depression
  • Stress
  • Attitude to labour and delivery
  • Lack of support
  • Difficult relationship with baby’s father
  • Personality factors
  • Abuse


The PNDSA recommends a combination of three approaches for the treatment of postnatal depression:

  • Medication
  • Psychotherapy
  • Support Groups

For signs and symptoms of postnatal depression, take a look at the PNDSA website which has great resources. Don’t forget that dads can be affected too!