Post Natal Depression
Having a baby is usually a positive experience for mothers and fathers; society expects us to feel happy and fulfilled as we welcome a new life into our world. Yet parents have a major readjustment to deal with, these include the loss of independence, changes in financial status or security, and sometimes changes in relationships with those in different circumstances. Although you may feel prepared for these changes, having a baby can still be a shock for many people.
It is perfectly normal to feel emotional, vulnerable and sensitive after your baby is born. Some mothers may feel confused about their feelings – that they should be overjoyed and instantly fall in love with their baby. This is not always the case and there are understandable reasons why you may not feel like this. For example you may have had a difficult labour or a traumatic delivery which has left you feeling exhausted and possibly unfulfilled of the expectations you may have had. Don’t forget we are not taught how to be mothers; it is something we need to learn for ourselves, and at this time of our lives we sometimes need to be mothered ourselves.
Approximately one in two mothers experience baby blues after the birth of their child. These typically occur between three to five days after the birth. One theory is that they coincide with the hormonal changes that occur as the breast milk starts to come in. Other theories are that the baby blues are due to the ‘come down’ after the effects of endorphins, or that they are a sort of physical shock reaction after the upheaval of birth. You may feel weepy, irritable, have a low mood and feel that you lack confidence in caring for your baby. This is very normal and these feelings usually subside after a week or so. It is perfectly acceptable to have a good cry and to talk to someone about how you are feeling.
Postnatal depression is a recognized and treatable condition that affects approximately 15 – 20% of new mothers and 10% of fathers experience depression and or anxiety after the birth of their child. It can affect anyone irrespective of background. Although it can occur straight after the birth it often does not get acknowledged or recognised until later on. However, for some women it may come on later in the year – some women get depressed after a few months. The most common signs and symptoms of postnatal depression are low mood, anxiety, inability to look forward to anything, lack of motivation and extreme tiredness. Some mothers may not actually feel depressed but may feel far more anxious or agitated which is a common symptom of PND. They may not know what they are feeling anxious about and may experience panic attacks due to their anxiety. These feelings can be very frightening; however they are very normal and symptomatic of PND and will decrease and eventually disappear with recovery. Some mothers may be feeling overwhelmed by the responsibility of having a baby and may become anxious about the baby’s health and sometimes their own health.
This is a totally different condition to postnatal depression. It affects approximately one in five hundred to a thousand new mothers and usually occurs within the first six weeks after birth. The mother may experience delusions, hallucinations and erratic behaviour; family members commonly notice these first. This condition is considered a medical emergency so it is very important for family members or friends to contact the woman’s GP if they are concerned. Usually this condition is treated in hospital, preferably in a mother and baby unit, where, if appropriate, the mother can have her baby with her.
As with all the conditions above there are a number of things that can be done to help. It is very important to contact your GP or health visitor to find out about the options and choices available. Remember that different options suit different people and their varying symptoms and circumstances.
The Health Visitor
Your health visitor can be extremely helpful in helping you acknowledge your depression and by getting treatment and support for your postnatal depression, initially by using a tool known as the Edinburgh Postnatal Depression Scale( EPDS) or a mood assessment tool. This is a questionnaire designed to focus solely on the mother not the baby. It is a self-report questionnaire that the mother fills in on her own while the health visitor is present. It should be used routinely with all new mothers, not just the women that health visitors think might be suffering from postnatal depression. It consists of ten short statements about how she has been feeling in the last seven days which the mother has to grade. It is usually used between six and eight weeks after the baby’s birth and gives the mother an opportunity to talk about her feelings. Some women may feel assessed or judged by this tool; however it should not be seen as threatening but as a useful tool to identify how she is feeling. Health visitors can offer support to mothers, for example by visiting them in their own home on a regular basis, so allowing them to talk about their feelings.
Some women may not feel comfortable talking to health professionals about their negative feelings and thoughts, and may mistakenly believe that that their child might be taken away from them if they do share how they are really feeling. This is not the case, health professionals are there to help.
If you think you have postnatal depression, it is important to speak to your GP. For some women, just the consultation and the acknowledgement between the GP and the woman that there is a depressive illness, possibly mild, are enough and they may not require any other treatment. However, your GP may suggest anti-depressants which can be extremely useful in aiding recovery. Some women may be anxious about taking medication while breastfeeding; however there are some anti-depressants that are considered safe for use by breastfeeding mothers. It is important to discuss this with your GP.
Your GP may suggest counselling or a referral to the Community Mental Health team who should have expertise in this area. Postnatal depression support groups can also be extremely helpful as you will be with other mothers who are experiencing similar feelings. Your GP or health visitor should know of postnatal depression support groups in your area. These can help to reduce feelings of isolation as being aware that other women have had similar thoughts and feelings can be hugely reassuring.
Having postnatal depression can be frightening and distressing, sometimes you may feel like you are going mad and will never feel normal again. It is important to remember that with the right support and treatment you will recover and enjoy life again.
- If possible try to rest as tiredness may make your symptoms worse. Don’t feel that you have to get the housework done first, you are more important.
- Try to eat small regular meals especially if your appetite is poor. This helps to keep the blood sugar level constant which otherwise makes the depression and anxiety worse.
- If feeling up to it, try to take some exercise. This doesn’t need to be as vigorous as a work out; a steady walk in the fresh air every day can do a lot to ease irritability and tension.
- It may help to keep a diary of your feelings so you can look back and see your progress.
- Don’t force yourself to do things you don’t want to do and try to avoid the things that cause extra stress.
- Try to confide in someone you trust who won’t pass opinion or judge you.
Liz Wise is a specialist postnatal depression counsellor who offers one to one counselling and facilitates PND support groups in Surrey.
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