1. WHAT IS POSTNATAL DEPRESSION?
First, I believe it is important to establish what is normal and what is not! I was absolutely terrified when I initially came home from hospital with my first baby. I was suddenly responsible for keeping a tiny, helpless human alive! Now, on my second child, I am far more accustomed to this idea, but now overwhelmed with trying to re-balance my life. I am blessed with a 3 year old and a 9 month baby, but now I am plagued with the guilt of having to share out my time and love between my two boys!
These kinds of feelings are completely NORMAL. Even feeling anxious, irritable or weepy are common symptoms of the “baby blues”! Between 40-80% of women experience this after giving birth. It is not surprising considering the massive shift in hormones a woman has to deal with! “Baby blues” should not last more then a couple of weeks. In my case however, things got progressively worse over time until my ability to cope or function was severely impaired.
The sooner the symptoms of postnatal depression (PND) are recognised and treated, the more likely it is to have a speedy recovery. In my mind, I visualise depression as a sort of repugnant weed. The longer it is allowed to cultivate, the more expansive and tenacious its roots become. It can feel like an insurmountable and extremely painful challenge to eventually dig it out! My hope is, that via my posts someone might recognise PND in themselves or a loved one early enough to weed it out quickly, to perhaps even save a life.
Here’s a list of the main symptoms of PND:
- feeling very low or sad and lacking energy
- extreme guilt and self-loathing
- an inability to take joy or pleasure from anything in your life (including your new baba which adds extra feelings of guilt!)
- intense fears that you cannot care properly for your baby/ children
- feeling that you are not bonding with your baby
- changes in appetite
- lowered sex drive
- trouble sleeping
- confusion and difficulty concentrating
- irritability or apathy (“couldn’t be bothered”)
- thoughts of suicide or self harm
- feelings of guilt, hopelessness and self-blame
- unsettling or scary thoughts –even thoughts of harming the infant (please note this is very rarely acted upon)
Be mindful that PND usually progresses slowly over time and may kick in any time in the year after giving birth. It may also begin during pregnancy!
A rare but extremely dangerous form of PND is called postnatal psychosis.
POSTNATAL PHSYCHOSIS: This is a very rare and very extreme form of PND. It usually becomes apparent very quickly in the first couple of weeks, but sometimes later on. The symptoms are very like that of bi-polar disorder and but is considered a medical emergency as the mother often rapidly deteriorates . These are the most common symptoms:
- sudden thoughts or beliefs that are unlikely to be true
- hallucinations (visual and /or audio)
- a manic “high” mood – talking and thinking too much or too quickly
- a “low” mood – showing signs of depression sudden being withdrawn or tearful, lacking energy, having a loss of appetite, anxiety
- trouble sleeping
- loss of inhibitions
- severe paranoia
Postnatal psychosis is classed as a medical emergency! If you or someone you know has some of these symptoms (not necessarily all of them) it is important to contact a medical professional immediately!
Unfortunately, there are many desperately sad stories of mothers not being diagnosed in time. I read in the Belfast Telegraph about a woman from Northern Ireland who smothered her baby. She was treated for postnatal depression on her first child and completely recovered. On her second, she deteriorated dramatically. In court, he barrister said, “She felt she couldn’t go on any longer. The only way was to finish it. It was automatic that (her son) had to die too.” This thought process, that she would kill herself and take her son along with her is a theme that comes up repeatedly. In the mothers warped state of mind she does not want to leave her baby behind.
2. WHO CAN GET PND?
Anyone…. Even Men!
10%-15% of women are known to suffer from some form of PND, but due to the stigma associated with the disease those figures are probably significantly higher. Those with an increased risk would included women with a history of mental illness, particularly bipolar disorder. Women who have suffered a severe episode of illness after a past delivery were found to be particularly at risk.
PND IN MEN:
Before you roll your eyes, like I did as vague memories of “man flu” and the likes came to mind, please hear me out! Obviously it is also completely life altering it is to become a father. Our rolls and difficulties as men and women may differ, but at the core, our feelings are the same. Sleep depravation has actually been shown to alter hormones and neurochemicals in the brains of some men, contributing to depression. Younger men (especially those struggling financially) and those with a history of depression were found to be high risk with partners of women with PND twice as likely to develop it.
3. ARE ANTIDEPRESSANTS OK DURING PREGNANCY?
PND can start during pregnancy, in which case it is called prenatal depression. In my previous blog I described how during my first pregnancy my doctor drastically reduced my antidepressant meds, resulting finally in a total breakdown!
As soon as I became pregnant with number 2 , I signed to see an antenatal psychiatrist. He was FANTASTIC and took the time to discuss the risks and necessities of meds during pregnancy. His main points were as follows:
- You wouldn’t stop taking epilepsy medication while pregnant as it would have detrimental consequences. Depression is also a very serious condition and therefore if there is very little or limited risk of harm to the unborn baby, the medication should not me tampered with.
- There is growing evidence to suggest that poorly treated mood disorders can actually have severe consequences to the unborn baby’s emotional and cognitive development!
- Although there is evidence that some medications may be detrimental, there are a vast number of them which have never been shown to be harmful.
- As with any medical treatment, the benefits must outweigh the risks in order t0 proceed.
A NOTE ON BREASTFEEDING: Again, there may be risks associated with certain medications, but for many there has been no evidence that the meds have ever caused harm.
4. WHAT ARE THE TREATMENT OPTIONS?
Depending on the severity of the case, medication may be extremely useful. Often, this may only have to be used short term until you are better.
Psychotherapy is almost always extremely useful, especially the likes of cognitive behavioural therapy which I found to be instrumental in my recovery. In brief, it helped me to identify harmful thought processes and replace them with a more realistic and optimistic mind-set. I also found grounding meditation to be wonderful!
Exercise, good nutrition and sufficient sleep are unbelievably important, however, as I’m well aware, often almost impossible for a new mom to obtain.
Support is critical! Family, friends, church members, mother and baby groups, online support groups, mommy blog communities…… There are so many people in the same boat. We need to all support each other!
Thanks for reading,