Fighting Anxiety And Depression At Work

We live in a world that is very volatile, uncertain, complex and full of ambiguity. We live in an environment, particularly in the corporate world, where competition is increasing, where there is a 24/7 always-on mentality, and where people are expected to do more with less. This sort of environment is conducive to driving people to high levels of stress, which can evolve into depression and anxiety. And given that there's no indication that things are going to get any easier in the future, how can the corporate world better address depression and anxiety and break the stigma associated with those illnesses?

Here are four starting points:

1. Managers and leaders need to become better educated on the importance of a healthy mind. When we were in school, we were taught the importance of a healthy body through physical education and health classes, but we were never taught the importance of also keeping our minds healthy. There is a significant amount of work that needs to be done to educate managers and leaders on healthy minds. They should learn why a healthy mind is important; how to identify if someone might be moving from stress to distress to depression and anxiety; how stress and anxiety are illnesses, not weaknesses; and how to support someone who might be ill and reintegrate them back into the workplace.

2. We need corporate leaders to "come out of the closet" about their experiences with mental illness. When leaders rack up the courage to talk about personal experiences -- or those of a family member or close friend -- they help normalize mental illness and make it easier to talk

about these issues.

3. Put in place opportunities for employees to address their emotional and mental health. It's commonplace for companies to have gyms where people can improve their physical health. Mindfulness and meditation courses, quiet rooms and other opportunities for employees to

recover, recharge and reflect can help nurture employees' mental and emotional health. Oftentimes, the source of anxiety and depression can be factors in the workplace.

The simple act of not giving feedback to employees regarding their performance on a regular basis can be a real source of stress and distress, and can lead to depression and anxiety. When you combine already-existing stress and demands with technology and the need to cut costs, the pressures are even higher. In their New York Times article, "Why You Hate Work," Tony Schwartz and Christine Porath note that 87% of people today find their work disappointing, which leads to less productive work.

Therefore, the competitive edge in the future might be to ensure that employees are well in a holistic sense. In order to achieve this complete sense of well-being, corporations must focus more on enhancing the well-being of their people, and thus attend to not only their physical health, but also their mental well-being (i.e. ability to focus), emotional well-being (i.e. level of happiness), and spiritual well-being (i.e. sense of purpose).

4. Corporations need to become more purposeful in what they do so employees feel a sense of purpose. Giving people a sense of purpose at work is strongly linked to overall well-being. We need a more conscious form of capitalism, where organizations are driven by purpose, by addressing the social and environmental challenges the world faces and in doing so, grow and be profitable. This gives individuals in organizations a greater sense of purpose in what they

do and thus contributes to their overall well-being.

Overall, in wealthy countries, mental illness accounts for 40% of all ill health for people under 65. And as Richard Layard and David Clark write, " [I]t is terrible for those who experience it. But it is also bad for business, since it gives rise to nearly half of all days off sick. And it is bad for taxpayers, since mental illness accounts for nearly half of all the people who live on disability

benefits."

The last 50 years have seen enormous progress in advanced societies: less absolute poverty, better physical health, more education, among many other developments. Yet there is almost as much misery as there was 50 years ago. And the ever-increasing volatility, uncertainty, complexity and ambiguity is contributing to this. Businesses must now do their part to reduce this burden, and the four starting points above provide some guidance as to how to begin tackling these issues, to the benefit of their performance, their employees and society as a whole.

http://www.huffingtonpost.com/geoff-mcdonald/fighting-anxiety-and-depression-at-work_b_5718735.html?utm_hp_ref=healthy-living

Social Anxiety and Depression - Full Documentary

Professor Green: Men shouldn’t suffer in silence with depression and anxiety

My dad killed himself and, having struggled with feelings myself, I want to make sure I deal with them properly. You should too.

                                'Things always change, as long as you give them the chance to.' Photograph: Alamy

I was 24 when my dad, Peter Manderson, took his own life. We had a troubled relationship and hadn’t spoken to each other for about six years; for no real reason we just stopped. Then one day I got in touch to try and repair some of the damage. It was Boxing Day and we argued over the phone about where to meet. I got angry, and my dad, who was a gentle man, stammered and stuttered. The last words I said to him were: “If I ever see you again I’m going to knock you out.” It all seems so desperately trivial now.

The tragic last hours of Robin Williams’ life have been raked over in minute detail over the past week. Susan Schneider, his wife, has said he was battling depression and anxiety, as well as the early stages of Parkinson’s.

I still don’t know what was going through my dad’s mind when he killed himself in a park not far from where he lived in Brentwood, Essex, in April 2008. I’ll never know. The last time I saw him alive was my 18th birthday. He had been in and out of my life for years. I was brought up by my gran in Hackney, east London, because neither of my parents were capable of looking after me. I just wish that he could have reached out to someone, anyone.

The moment I found out my dad had killed himself is as clear today as it was when it happened. That morning I woke up with a sense of dread knowing that something was very wrong. My gran came into my room with tears in her eyes and said: “Stephen, your dad’s dead. He’s hanged himself.”

His death was a complete shock and it’s still a struggle to articulate how I felt. I went through so many emotions that day. At first I was angry with him for doing what he did. I kept thinking, how could he take himself away from me? Williams’ daughter Zelda said something similar about her dad: “I’ll never understand how he could be so loved and not find it in his heart to stay.”

I thought my dad was selfish for taking the easy way out. But then I quickly realised that I was the one who was being selfish for thinking he was selfish. For someone to be able to do that, I don’t think it is cowardice; it’s the only solution they think they have. The last thing I said to him kept replaying in my head – you have no idea how much I regret that the final words he heard from me were anger and hate. I would give anything to change that. I never got a chance to say a proper goodbye or tell him that I loved him.

Last year in Britain, almost 6,000 people killed themselves, leaving behind families struggling for answers. Men aged between 30 and 44 are most at risk. My dad was 43. I later found out that one of his brothers had killed himself two years before and that another brother, whom I am named after, is believed to have died after allowing himself to fall into a diabetic coma.

Communication is a big problem with us men. We don’t like to talk about our problems; we think it makes us look weak. There have been times when I’ve suffered from anxiety and depression. I even had cognitive behavioural therapy and although that didn’t work for me, I did find that talking about things to someone helped the problem seem smaller than it was in my head. It’s important to let things out and not bottle them up.

Society likes to tell you that you have to be happy all the time, and it’s easy to think that if you’re not happy then there’s something wrong with you. But happiness isn’t permanent, it’s not something you can feel all the time – and neither is sadness.

What happened to my dad and uncles makes me want to deal with things. As much as I love my dad, I don’t want to be the father to my child that he was to me. I wrote the song Lullaby about my experience of depression and how it has affected my life. The most important lyrics are the final two lines: “Things always change, as long as you give them the chance to.”

Know that is true. I just wish my dad did.

http://www.theguardian.com/commentisfree/2014/aug/20/men-suffer-depression-anxiety

Ashley James shares her advice on beating depression and anxiety in her latest Metro blog

Ashley James offers advice on overcoming depression and anxiety (Picture: Ashley James)

Ashley James is best known for starring in E4’s hit show Made In Chelsea when she joined the cast for a whirlwind two series, leaving in 2013. Aside from Chelsea, she’s also a model, TV presenter and blogger. After opening up on her battle with depression and anxiety in her blog last week, here she offers advice on how she overcame these issues. 

‘I have been overwhelmed by the support and positive comments I have received in their hundreds since publishing my blog post last Monday. Amazingly I haven’t come across one negative comment, which is quite surprising in our world of trolling. So firstly I want to thank each and every one of you who took the time to get in touch with me.

I talked in the post about the overwhelming feeling of isolation and loneliness I felt. What’s astonishing to see from those who got in touch is that nearly everybody either went through the same, or knew someone who was suffering and was struggling to understand their torment until they read my blog. So try not to feel lonely, as you are very much not alone.

I thought it might be useful in my next post to offer you advice on what helped me out of the darkness. Please take into account that this is my personal opinion based on my individual experience only.

Get into a routine

Implement structure and routine into your life. For me I found going for a run in the morning helped, as well as preparing and eating healthy food.

Act on what’s making you unhappy

Make a brainstorm of everything that’s troubling you or having a negative impact in your life. This could be an unhappy relationship, friendship, job, money…. Whatever it is make plans on how to change them. Don’t do anything too drastic as that might leave you feeling worse or lost. In my case, my relationship wasn’t making me happy, so I ended it. I had a friend who always brought me down so I distanced myself and focused my energy on friends who made me feel good. I was in a career I wasn’t passionate about, so I took holiday and did a presenting course to kick-start my presenting career. Small steps are fine, and remember that life is a journey not a destination so enjoy the steps you make that get you towards your goals.

Ashley, pictured here with friends, says it’s important to reflect on your life and work out what’s making you unhappy (Picture: Ashley James)

Read

Obviously if you hate reading then look at something else – audiobooks, films etc. For me, reading kept my mind focused on something other than my own thoughts. Sometimes I’d read a book a day. Crime thrillers are my favourite as I get totally enraptured in the world and become desperate to uncover the story.

Take up a hobby

Sometimes anxiety or depression can be amplified when you have too much time to sit and over-think. Learning something new occupies your mind, gives you something to look forward to and learn, and also opens your horizons to new people. Perhaps you’d want to start writing, start a YouTube channel, take up dance classes, go on a photography or make-up course…. The list of things you could do is endless, and a hobby may turn into a career.

We weren’t made to sleep; we were made to rest

If you can’t sleep, don’t stress about it as you’ll work yourself up more. Listen to music or an audiobook, and just relax. Harry Potter audiobooks are the best because you can listen to the sweet sweet sound of Stephen Fry’s voice. When I was 8 years old at boarding school I couldn’t sleep one night and got so upset. My dorm captain, a twelve year old girl, told me: we weren’t made to sleep we were made to rest. That’s stuck with me ever since. Think of times when you’ve stayed up late partying, chatting, or watching back to back episodes of 24 – you got through the next day then, and lying in bed is much more relaxing.

Ashley says try not to stress out unnecessarily (Picture: Ashley James)

See a psychic

You may be cynical, and I was too, but a friend recommended I go see a lady called Katy Winterbourne. She pinpointed things that were troubling me, and left me feeling focused on an exciting future. I still go see a lady called Elizabeth Caroline who incorporates facials with chakra and aura readings – she offers me a wonderful sense of insight and clarity.

Don’t expect other people to help you

It can be easy to blame your friends or partner for not supporting or helping you out of your torment. Don’t. You have to understand that dealing with someone with anxiety or depression can be draining and exhausting, it doesn’t mean they don’t love you. Source your own happiness.

Write a memory book

Everyday write down the three most positive things about the day. It could be something minor like a stranger saying bless you, or your friend telling you you look beautiful. When you’re feeling low, read through it.

I’m sure there are a million other ways that can get you through your depression, and I’d love you to share them in the comments below. As I’ve learnt, you are very much not alone, so let’s all help each other.

http://metro.co.uk/2014/08/04/ashley-james-throws-open-the-doors-to-her-battle-with-depression-and-anxiety-in-her-next-metro-blog-4820219/

'Luckily depression never lasts long with me': Robert Pattinson opens his heart about his ongoing anxiety issues

Brooding heart-throb Robert Pattinson has spoken out about his ongoing battle with anxiety and depression – and surprisingly he's not unhappy about either issue. 

'I kind of like my anxiety in a funny sort of way and I like my peaks and troughs,' he reveals. 'Luckily depression never lasts long with me.

'I would love to go into therapy but it makes me too anxious,' the Twilight star jokingly adds in an interview with The Daily Telegraph.

Home again: Robert pictured arriving at LAX airport in June

Coping with the mania surrounding Twilight was especially challenging for the notoriously private star, who's now based in Los Angeles.

'I had a bit of a struggle at first because my life really contracted and I couldn't do a lot of the stuff I used to be able to do. 

'But once I got through that a year or two ago I just accepted my life is something else and now I can't really remember what it was like before. So it's much easier to deal with.' 

Happy now: Robert looking chirpy after filming Good Morning America in New York yesterday

His high-profile split from co-star Kristen Stewart was especially painful for Robert, though he hasn't had much time to dwell on things of late as he's been so busy working.

Forthcoming releases include Hold on to Me, a thriller co-starring Carey Mulligan, and crime drama Idol's Eye with Robert De Niro and Rachel Weisz.

Old flame: Robert pictured as Edward Cullen alongside his Twilight co-star and former girlfriend, Kristen Stewart, who played Bella

Happy days: Robert and Kristen at the premiere of the Twilight Saga: Breaking Dawn – Part 2

First comes The Rover however, a gritty drama filmed in the Australian outback.

Robert plays a simple lad named Rey, who forms an unlikely alliance with angry loner, Eric, played by Guy Pearce. 

The film has received warm reviews from critics, and fans will be able to decide for themselves in August when it arrives in cinemas. 

Trailer for The Rover starring Robert Pattinson and Guy Pearce

Robert's taking all of this in his stride however, saying his biggest issue at present is his lack of suitable attire, after most of his clothing went missing when he recently moved house. 

'It's ridiculous,' he says. 'I don't understand how I don't have any clothes. I've basically stolen every item of clothing that anyone's ever given me for a premiere but in my closet there are literally about three things. I'm sure there's some kind of random storage box full of them somewhere.'

Sharp (stolen?) suit: Robert on Late Night with Seth Meyers in June

http://www.dailymail.co.uk/tvshowbiz/article-2710679/Robert-Pattinson-opens-anxiety-depression.html

How practicing mindfulness can help with depression and anxiety

Smoking cannabis DOES increase the risk of anxiety and depression

• Brains of users were less able to react to feel-good chemical dopamine
• Adds to past research linking marijuana to lethargy and apathy

Smoking cannabis does increase the risk of depression and anxiety, a new study has concluded.

U.S. researchers found the brains of users were less able to react to dopamine - the feel-good chemical that inspires a spirit of get-up-and-go.

The study adds to previous research suggesting marijuana can lead to people becoming withdrawn, lethargic and apathetic.

Danger: The brains of cannabis users were less able to react to the feel-good chemical dopamine 

Psychiatrist Dr Nora Volkow, of the National Institute on Drug Abuse in the U.S., used the stimulant Ritalin to see the effect cannabis had on the brain.

Like cocaine, Ritalin raises levels of dopamine in the brain.This made it ideal for the study, published in the journal Proceedings of the National Academy of Sciences.

Of the 48 people in the study, half received the drug - while the other half acted as a control group.

Personality and brain scans showed the cannabis users had significantly blunted dopamine responses compared with the controls who had never taken the drug.

Previous research has suggested a lack of dopamine makes people lazy

This could contribute to drug-craving and negative emotions, a tendency towards depression and anxiety which are hallmarks of cannabis addiction.

Dr Volkow said the phenomenon cannot be unequivocally attributed to reductions in dopamine release.

They believe there is a downstream effect later in the process in an area of the brain called the striatum - the reward and motivation region.

Indeed, last year a study from Imperial College London found that long-term use of cannabis destroys dopamine.

Levels in the striatum - found towards the side of the brain - were lower in regular cannabis users.

Dr Michael Bloomfield, of Imperial College London, said: 'Dopamine is involved in telling the brain when something exciting is about to happen - be it sex, drugs or rock ‘n roll.

'Our findings explain why cannabis has a tendency to make people sit around doing nothing'

Commenting on the new study, the U.S. researchers said: 'Moves to legalise marijuana highlight the urgency to investigate effects of chronic marijuana in the human brain.'

http://www.dailymail.co.uk/health/article-2691837/Smoking-cannabis-DOES-increase-risk-anxiety-depression.html

Various Anxiety vs. Depressive Disorders

Anxiety and depression is rising among teenagers - and girls are suffering most, new study reveals

• The review looked at 19 studies conducted across 12 countries
• It found an increase in anxiety and depression in teenagers across Northern Europe, the UK and China
• The number of older adolescent girls suffering from mental health problems was double that off boys

Older adolescent girls across the world are increasingly experiencing severe anxiety and depression, a new Australian study has found.

The review, which has been published in the in the Australian and New Zealand Journal of Psychiatry, looked at 19 extensive studies conducted across 12 countries and found that teenage girls in Northern Europe, the UK and China are specifically experiencing an increase in mental health problems.

The studies leader, Dr William Bor from the University of Queensland, told the Daily Mail Australia that a combination of cultural, schooling and economic factors are most likely to be leading to the growing problem.

The review looked at 19 studies conducted across 12 countries and found that teenage girls in Australia, Northern Europe, the UK and China are experiencing an increase in anxiety and depression

'There appears to be increasing school distress amongst girls as they negotiate their way through the last parts of their school careers,' Dr Bor said. 

'They face difficult choices and pressures and the modern education system appears to be more problematic for girls – so the issue there is the stress of making future decisions and how they cope with them.'

However culture is also believed to have a significant impact on mental health issues within young women, who are well known to struggle with identity and appearance issues.

'Culture has high expectation on girls in terms of appearance and weight,' Dr Bor said.

'There's a lot of speculation about the pressure on girls in terms of early sexualization and concerns they have about body image.

'However, there is also  a third factor around increasing economic inequality, and that may be increasing pressures at school as well.'

The studies leader, Dr William Bor from the University of Queensland said that a combination of cultural, schooling and economic factors are most likely to be the cause for the growing trend.

Due to the data coming from an array of countries, Dr Bor said the exact reasons for the difference in results across genders was not entirely clear, but are most likely tied in with education and cultural pressures.

'Boys are also affected but they're not as affected,' he said.

'You can see in the results that the trend in boys and girls is going up, but what is very clear is that girls have almost double the anxiety and worries as boys.

'We don't yet know all the answers here – each country has different pressures on their young people – and one of the odd things is that America isn't showing this increasing trend.

'We also have to account for why we are seeing a rise in China –so it's clearly not just a western phenomenon.'

Dr Bor recommended that parents, peers and medical professionals receive more education about depression and anxiety, including prevention programs being placed in high schools.

'The school factor is the common denominator and the most likely factor across the multiple countries.'

Dr Bor recommended that parents, peers and medical professionals receive more education about depression and anxiety, including prevention programs being placed in high schools, to increase the chances of successful prevention and early intervention.

'One of the greatest issues is that it could lead to higher rates of attempted and successful suicide - that's the greatest risk with anxiety and depression,' Dr Bor said.

'But having severe depression and anxiety in adolescence is also a predictor of having it in future life – about a quarter of kids go on to get the illnesses as adults so it is a risk factor for the future, and it also increases the likelihood of drug and alcohol abuse in adulthood.'

Although the study has no conclusive figures on the number of youth suffering from anxiety and depression in Australia, a population survey will be releases in 2015 with extensive figures.

http://www.dailymail.co.uk/news/article-2689466/Anxiety-depression-rising-teenagers-Australian-study-shows.html

This Morning - Postnatal Depression

Five Shocking Celebrities Who Suffer From Anxiety and Depression

Anxiety and depression are silent illnesses that people all over the world suffer from. You may look at someone with anxiety and depression and think they are perfectly fine, while inside, they may feel like they are dying or losing their minds. Anxiety and depression are among the most common diseases suffered by Americans, so it doesn't come as any surprise that celebrities suffer too. Here are five shocking celebrities who suffer from anxiety and depression.

Emma Stone

Who would have thought that this amazingly talented actress with the bubbly personality that makes us love her suffered from a major anxiety disorder? In an interview with Vogue, Stone opened up about suffering from crippling panic attacks starting at the young age of eight. She recalled feeling “immobilized by it.” As so many people with these disorders do, Stone felt that no one understood her or what she was going through. She began isolating herself at a young age to avoid having to answer the impossible question, “what’s wrong?” Eventually, she developed agoraphobia as well. When someone is suffering with these diseases, often times there is nothing  that can be perceived as wrong on the outside, but on the inside, they can feel like they’re falling apart. Luckily, Stone got the help she needed and after years of therapy that provided her with the tools she needed to overcome her attacks, she began her acting career at age 23.

Vinny Guadagnino

Better known as the fist-pumping cutie on the Jersey Shore, Vinny came out in the past few years about his major battle with anxiety. Vinny was forced to temporarily leave the Jersey Shore house during season five of the show after he reached his breaking point. He told MTV he needed to “leave to recharge.” Though he may have hit his breaking point on the show, Vinny has suffered from clinical anxiety his entire life. In 2012, Vinny wrote a book about his lifelong struggle with anxiety, called Control the Crazy: My Plan to Stop Stressing, Avoid Drama, and Maintain Inner Cool. The book tells about his journey, and gives others tips and strategies to help them through their own struggle.

LeAnn Rimes

In 2012 country singer LeAnna Rimes voluntarily checked herself into a 30 day inpatient clinic when her anxiety and stress got out of control. While at the clinic she learned various coping mechanisms that have enabled her to keep her anxiety and stress level under control. For those fighting these illnesses, learning coping skills is imperative. While it doesn’t put an end to anxiety and depression, these skills can be extremely helpful during the more difficult times.

Adele

Adele, the woman with the gorgeous voice and strong lyrics is yet another one of the five shocking celebrities who suffer from anxiety and depression. Adele has had a lifelong problem with anxiety, and is often plagued with severe panic attacks. She also claims to have social anxiety disorder, a disease which makes it difficult for people to go into public situations, and also severe stage fright. While she still suffers, she has obviously learned some amazing coping skills to be able to battle her disease and perform in front of thousands.

Fred Durst

Who remembers Fred Durst from the wildly popular 90’s band, Limp Bizkit? Durst has had a lifelong problem with OCD and other anxiety disorders, which made performing in front of crowds for him nearly impossible at times. Durst doesn’t open up much about his struggles with OCD, but claims he has sought out therapy and help for years, and still hasn’t found the tools to help him cope on a daily basis. Sadly, this is often the case for many.

Of course, these are only five shocking celebrities who suffer from anxiety and depression. Many more have come forward to share their stories and journeys and offer help to their fans who may be battling the same demons. The important thing to remember with these illnesses is that there is always help available, and always support to get you through the toughest times.

http://www.viralglobalnews.com/entertainment/five-shocking-celebrities-suffer-anxiety-depression/10602/

Isolation - A short documentary on Depression & Anxiety

Depression affects mothers most when child is four years old

Doctors urged to be aware postnatal depression can occur much later than thought, prompting calls for change in care for women.

Four in ten of those suffering depression when their child was older had not previously had any problems Photo: Alamy

Mothers are more likely to suffer depression when their child is four years old than when they are babies, according to a study that has led to calls for a change in the way women are cared for.

Four in ten of those suffering depression when their child was older had not previously had any problems, the study found.

Researchers have now urged doctors to be aware that postnatal depression can first occur much later than thought.

Women who only had one baby were twice as likely to suffer postnatal depression when their child was four years old, than those who had subsequent children, it was found.

The study, which was conducted by Australian researchers, found more than 14 per cent of women suffered depression when their child was four years old.

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Fewer than one in ten at 12 months and eight per cent of women three months after giving birth.

Almost one in three first-time mothers reported suffering depressive symptoms at least once between pregnancy and four years after birth, the study found.

Postnatal depression is thought to affect up to 15 per cent of women in the UK in the first year after having a child and experts said this may now need to be revised.

Dr Hannah Woolhouse, psychologist and senior research officer, from the Murdoch Children's Research Institute, in Victoria, Australia and co-author of the report, said: "It is likely that current systems of maternal mental health surveillance in Australia and the UK will miss more than half the women experiencing depression in the early years of parenting.

"In particular, women who do not have subsequent children may be especially vulnerable to falling through the gaps as they will not be reconnected back into primary care services.

"There also needs to be a focus on social health and relationships as we have found a strong link between depressive symptoms and intimate partner violence."

Dr Carmine Pariante, of the Institute of Psychiatry at King's College London, said nurses and doctors should ask mothers how they are coping whenever they bring their child in for routine vaccinations and other appointments and be aware that depression can hit women at any point.

He said: "Mothers should be encouraged to seek help if they need help.

"This paper is not saying depression in the first few months after the baby is born is not important, it is. But it is also the case that women are vulnerable to depression as their children get older.

"That is due to the stressors to having a child and raising a child. The sooner we can help those women and put them on the right trajectory the better."

The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, used data from 1,507 first time mothers registered to give birth at six hospitals in Melbourne, Australia, who completed questionnaires at three, six, 12, 18 months and four years after giving birth.

The strongest predictor of depressive symptoms at four years post birth were having previously reported depressive symptoms either in early pregnancy or in the first 12 months after childbirth.

Other factors associated with depressive symptoms were being young – 18 to 24 years old – stressful life events in the year before the four year follow-up, violence from a partner or a low income.

The authors of the report said the findings presented a "compelling" case for a rethink on approaches to monitoring maternal mental health where policies focus on pregnancy and the early months after birth.

Dr Woolhouse wrote in the paper: "The fact that one in three first-time mothers reported depressive symptoms on at least one occasion from early pregnancy to four years postpartum, coupled with the finding that the prevalence of depressive symptoms was highest at four years postpartum, provide a compelling case for rethinking current policy frameworks for maternal mental health surveillance.

John Thorp, BJOG editor in chief, said: "Much research has been conducted around maternal mental health during the perinatal period, however, we know very little about the prevalence of maternal depression after the first 12 months of giving birth.

"The findings of this study reinforce the need for an increased focus on maternal health, particularly in the long term, as current guidance for professionals focuses on pregnancy and the early months after birth, and the need to take into account factors linked to the mother's life."

Prof Ian Jones, Professor of Psychiatry at Cardiff University, said: "Clearly services must be aware that mothers remain at risk of depression and that risk does not go away after the postpartum period.

"For more severe episodes of mood disorder - severe postpartum depression and postpartum psychosis - there is no doubt at all that the period after having a baby is associated with very high risk. For example, women are 23 times more likely to be admitted to psychiatric hospital in the weeks following having a baby than at any other time in their life. This study does not change these facts. The more severe episode of depression or mood disorder the more clear it is that childbirth is an important trigger.

"The importance of postpartum depression is not due merely to it being more or less common than depression at any other time.

"Depression at this time has enormous implications for women, their babies and their wider families. Women are in contact with many health professionals through this period and its vital that depression is picked up and treated to prevent the negative outcomes we know are associated with depression at this time."