Post Natal Depression
The first thing that must be pointed out is that post natal depression (PND) is not a sign of failure as a parent, nor does it mean you are going mad and ought to be locked up. It is an illness that can be cured and is not forever - although for many sufferers, it may feel like there is no end to it.
Post natal depression is unique to new mothers - it usually manifests itself after about one month from the birth of the baby and if left untreated, it can carry on for some months or in rare cases, even years. As many as 1 in 10 women suffer from post natal depression in one form or another and there are many varied ways of dealing with it, so don't think that pills are the only answer. Your health visitor is your first port of call as she will be already looking out for signs that you may not be yourself and will often be able to offer you immediate advice and support. If she feels you need to see a doctor or counsellor, she will have the information to hand and can often register you on any waiting lists there and then, as many help and support groups tend to prefer the recommendation of a health visitor or midwife, seeing as they spend so much time with the mother and child. Half of all women develop what is called "baby blues" for a few days after the birth of their child which is not the same as post natal depression and disappears after a few days. You may feel unsure, scared and more prone to crying than usual - but it will pass, so please don't panic. If in doubt, speak to your midwife or health visitor and they can reassure you of your feelings.
Symptoms of post natal depression
- Feeling low/down/unhappy. This may or may not be due to any one single cause and you may not be able to define it at all.
- Loss of appetite.
- Tired. You may find yourself almost permanently exhausted and seeming to be constantly lacking in energy.
- Irritability. You might start snapping at people, losing you temper more easily and feeling grumpy.
- Sleeplessness. Although you may be shattered, you struggle to sleep and find yourself waking up early in the mornings and unable to get back to sleep at night.
- Unable to enjoy anything.
- Loss of interest in sex. This one can be extremely difficult for partners to understand as they will want to reaffirm the intimacy you shared prior to the birth. Sex after birth can be uncomfortable - even painful - but if lack of interest carries on for some months, you may wish to speak to someone about it.
- Feelings of despair, guilt and hopelessness. You may think you will never get better and may never be happy again. You could also be feeling guilty for lack of intimacy with your partner, lack of feeling towards the baby and even start thinking you are a bad mother and shouldn't be allowed to keep your child.
- Anxiousness. You may find yourself constantly wanting reassurance from doctors, health visitors, your partner and other people because you are convinced something may happen to the baby. You might find yourself panicking that your baby may stop breathing, choke, become ill or even hate you and this can make some women prone to panic attacks and periods of intense worry.
There are no hard and fast rules concerning how you may feel with post natal depression and you may find some women seem to suffer more with it than others. However, if you should start to experience any of the following, it is vital that you contact your health visitor as soon as possible:
- Feelings of suicide or self harm
- Wanting to harm the baby in any way
- Neglecting the baby's basic care needs such as feeding, changing and bathing
- Hitting, shaking or throwing the baby
But won't they take the baby away from me?
Contrary to popular belief, it is not always the first step to call in Social Services and take the baby away - many healthcare professionals nowadays are trying to keep families together as much as possible and if they can help you before the baby comes to harm, then they will do everything in their power to ensure that happens. Remember, if you are honest with them they can help you. If you hide anything, they cannot. It is more likely you will have a crippling worry that you could harm the baby rather than actually hurting your child, but please speak to someone as this will help alleviate your worries and release some tension as well as give you the opportunity to work out some practical guidelines for when those feelings start to creep up again. You are not a monster and no one will judge you for being honest.
I've been diagnosed, so how do I deal with it?
Recognising that you have post natal depression is the first step - dealing with it is the next. There are different ways of handling post natal depression and one of them is, of course, a period of taking antidepressants. You may see this as a sign of weakness or an indication that you've gone crazy but this is simply not the case. There are many different types of antidepressants available and the doctor will work with you to find a combination that suits you and it is nothing to be ashamed of - and to be honest, if it helps you feel like getting up in the morning or holding your baby for the first time in three days, it really is worth a shot. They don't have to be long-term and you can couple taking medication with group therapy, mother and baby clubs or one-on-one counselling sessions if you find any of these helpful. Obviously, as with any medication, you need to make sure you take them on time and don't mix them with other pills unless the doctor says it's ok - but otherwise, just see it as part of your daily routine just like brushing your teeth or having a shower. The less you stigmatise it in your head, the less frightening and damning it will become to you.
Another route to dealing with post natal depression is by meeting with other women who are going through the same experiences as you are. Now whilst this may initially sound like some kind of bizarre nutter's club, be assured that it won't be full of women giving each other group hugs and chanting weird mantras. More often than not it will be a group run by someone who is trained in mental health and possibly childcare who will sit with you all and discuss how you've all been coping recently. Other options are family centres which are run by Social Services and provide a safe environment for you and your child to bond, play and meet other parents and children whilst under the care of a key worker who will record your activities and encourage you to interact as much as possible. Sounds scary, but don't panic - they don't follow you with a clipboard and a stern look on their face; in fact, they will be alongside you as a confidante and friend rather than a big bad reporting machine just waiting for you to slip up and give them a reason to snatch your child away from you. Their primary goal is to support you, not condemn you. Again, be honest and open otherwise they cannot help you as much as you may need.
One-on-one counselling is another choice you may wish to go for. You can find out a list of counsellors from your doctor or you can hunt one down for yourself - but be aware that these services are rarely free. A counselling session will often last for an hour and be once a week with the same counsellor. Be aware, however, that not all counselling services offer a creche or baby care facilities so you may need to ensure you have a babysitter before committing to a course of therapy. Counselling is not there to "fix" you or to make your decisions for you - the mark of a good counsellor is one who does more listening than talking and allows you the freedom to express your feelings without interrupting. A good counsellor shouldn't tell you what to do but let you talk through your feelings and issues until you find the answer or conclusion by yourself - anyone who railroads you into making certain decisions or belittles your feelings is not the person for you.
If all this group therapy and face-to-face talk seems daunting to you - and if you have post natal depression you may well find this sort of thing terrifying even if it didn't faze you before - how about joining an online community of like-minded people and talking about your experiences? It can be a good starting point before you feel ready to see someone in person or join a group - plus there are no babysitting problems or closing times. Many, if not all, communities are now 24 hours a day, seven days a week and you will find yourself interacting with people from all over the world. A couple of words of warning though - internet activity can be very addictive and in a vulnerable state you may find yourself spending more time with those who understand you than those who need you, like your partner and family. If you should find yourself ignoring your baby or locking yourself away for hours to speak to your virtual friends, you may need to stop using online communities as an option for dealing with post natal depression and try something else instead. Of course, you can make many good friends online and some may even live nearby so you can meet up for coffee - but as ever, the usual online safety rules apply and you must never give out personal details over the internet unless you are absolutely sure of the situation. Always protect your identity and that of your family.
Some other things that can help on a more practical scale are eating well (plenty of fruit and vegetables!) and getting sleep whenever you can. Regular, gentle exercise can also boost your feel-good factor but check with your doctor as to what you can and can't do depending on the type of birth you had and whether you have any other health concerns restricting you from certain types of exercise. If you don't fancy sex - and let's face it, after pushing something the size of a bowling ball out of you the chances are you won't be feeling like having anything else in there for a while - try cuddling, stroking, kissing and other forms of intimate contact that will not only reassure your partner but will go a long way to restoring and sparking up those old feelings of sexual desire again. You may find it also helps you feel more like the woman you were before the pregnancy and be more inclined to want to try sex again sooner rather than later. Again, don't rush yourself and don't feel guilty if this takes longer than you anticipated.
Keep the flow of communication between you and your partner as much as possible and remember that none of this is your fault or theirs - no one is guilty for your having post natal depression and having a go at each other helps no one. Try, if possible, to go out together alone as often as is feasible and leave all baby talk behind. If you have other children, try to include them in the care of the baby if they are able and if other people offer to help, take it! If you have a partner or family member suffering from post natal depression, listening to them is the best thing you can do for them. Telling them to "pull themselves together" is both insensitive and impossible - they simply cannot do it. Encourage them to spend time with the baby but if they really cannot face it, then calmly and lovingly remove them from the situation without judging them and suggest an alternative activity such as a hot bath, watching a film on TV together or for her to go out and see a friend. If you have any concerns about the safety of your child and you can't speak to your partner about it, try talking to the health visitor or doctor and ask for help - if the mother has not yet been diagnosed, they will regularly ask her questions to ensure that her mental health is well cared for. It is hard to cope with a new baby and a depressed partner at this time but they both need your support and if you feel overwhelmed, do not think it a weakness to seek support for yourself. You are not meant to be a super hero so don't try to force yourself to be strong when you really cannot cope either.
There are lots of organisations dedicated to helping new parents - even if this is the second, third or fourth time you are "new" at all this! - and it's worth looking into all your options carefully. The charity Home Start, based in the UK, is an incredible support network of volunteers who can come and help you in your own home each week, listen to you, support you and also bring you to their support group which consists of other families just like yours who need a bit of "me" time whilst the children are cared for in a creche. You can remain part of the group until your child reaches school age and they often have regular outings to parks, zoos and farms. Many of the volunteers have been post natal depression sufferers themselves so it can be very reassuring to see that there is a light at the end of the tunnel and people who truly know what it feels like. For more information on Home Start, speak to your health visitor or check out their website: Home Start UK. There are also international versions of the charity based in Australia, Canada, Czech Republic, France, Greece, Hungary, Republic of Ireland, Israel, Kenya, Lithuania, Malta, The Netherlands, Norway, South Africa, Sri Lanka and Uganda.
Remember - you're not crazy, you're not a failure and you will get better. Just keep talking and don't forget that we here at My Stopgap are always ready to listen.
To read a first-hand account of one person's experience of post natal depression, check out Angel's Blog.