Post Natal Depression (PND)
What is Post Natal Depression?
Symptoms
Causes
Treatment
Men are affected too
Further Help
What is Post Natal Depression?
Society expects mothers - and fathers - to be happy, to be enjoying life with their adorable baby. Yet 10-15% of new/recent mothers have Post Natal Depression, which blights their lives and ruins their time of getting to know and enjoy their child in these early and important developmental months.
Post Natal Depression is sometimes described as the ‘smiling’ depression. This is not because it is an ‘easier’ kind of depression, but rather because the person affected feels she MUST be happy because everyone else is telling her that she should.
“You think you should be happy because you’ve got a baby and everyone else is happy but you’re not coping” - Mother with PND
At Depression Alliance Scotland, we often hear from mothers who have been diagnosed with PND who believe they are bad parents; that any problems are their fault; that other parents they meet are all coping and don’t have fractious babies. We hear from mothers who feel guilty and ashamed at feeling like this; frightened to mention it to anyone, especially health professionals, fearing they might even have their child taken away. However the simple facts are that mums with PND and some new dads who develop depression in the first 15 months of parenthood, are just as good and loving and caring as any other parent and do not need to feel guilty in having an illness which can and does happen to anyone.
Symptoms
PND includes the symptoms of depression in general, such as low mood; constant sadness without reason, appetite problems and general neglect of self and weeping. Tiredness can be a problem. Babies usually wake in the night, tiring any mum and in addition depression often causes difficulty in sleeping leaving the mum even more exhausted. They may lack interest in the baby – again adding to the guilt. Some mothers fear they may harm their baby, but do not want to do so and it’s important to reassure the mothers on this and encourage them to discuss this with their health visitor or other local healthcare staff.
Post Natal Depression should not be confused with the ‘baby blues’ where a mother may feel tearful in the first few days after the birth (though those having the baby blues may be at more risk of developing PND later).
About 2-3 mothers in every 100 may develop the very serious puerperal psychosis in the first few days after birth and treatment for this may mean admission to hospital.
Having PND after the first baby does not necessarily mean it will recur with subsequent births (though extra support should be available). Indeed the mum may not have PND with the first baby but it may happen after a subsequent birth when extra pressures to ensure care of all children is given.
Causes of PND
Changes in hormones can contribute towards PND in some mothers but the illness can also arise because of various ‘losses’ when becoming a parent:
- Loss of confidence – looking after your baby can be a very steep learning curve involving the baby’s character too! A mother may have been skilled in her job of work and it is not easy to adapt to this completely different role.
- Loss of identity – we all carry and are seen to have various roles in our lives from daughter to friend to worker to partner – the role of motherhood is perhaps the most powerful role away from self.
- There can be financial loss from leaving work and from costs of the child’s needs.
- Loss of time and space, including during the night are not easy (depression can in itself be a major cause of sleeplessness making for sheer exhaustion).
Other contributing factors can include:
- A difficult pregnancy.
- Body image changes both during and after pregnancy.
- A difficult labour.
- Perhaps, for some mothers, problems in trying to breast feed when it isn’t being established easily and feeling she MUST be able to breastfeed or she will be failing her baby because of pressure, adding to her feelings of being a bad mother.
- A crying baby –the baby may have colic – it can always seem that the baby seems to stop crying if someone else picks the baby up.
- Unresolved issues or childhood trauma.
- Family, friends telling you how lucky you are and to pull yourself together and count your blessings.
- The ultimate fear of not being a good mother and having your baby taken into care.
- Poor relationship.
- Other unresolved problems.
“I spent the first few months feeling disappointed and guilty and felt frustrated by the demands of my baby. I had turned into a person I barely recognised. I kept telling myself I should just get over it. This was how it was going to be, and yet that made me feel worse.”
Treatments for PND
Post Natal Depression is a very treatable illness. Treatment(s) may or may not include antidepressants (taking into account if the person is pregnant or breastfeeding) and may or may not include counselling. It may also help to find extra child care for the child to give the mum a break
Some areas of Scotland screen newly pregnant mothers for depression and have a debriefing session after the birth in case the mother has concerns. The Post Natal Depression Project based in Edinburgh provides individual counselling, therapy groups and crèche facilities. These are in addition to access to art therapy, infant massage and telephone support, all of which can be a lifeline as well as helping the often isolated mum to know she is not alone in having the illness. Groups also run in the Borders and Linlithgow. Mothers can self-refer or are referred by professionals.
It is common for mothers with Post Natal Depression to be put off seeking help for fear of having their child taken into care. However, these are irrational thoughts typical of depression. If you are concerned about PND do not be afraid to speak to your health visitor about it.
“Slowly things began to get better. I found myself crying less and beginning to enjoy life again. It was such a relief to find that life could be different and that I was going to get through this.”
Men are affected too
It is an issue that is often neglected but a study published in the Lancet in 2005 found that up to one in twenty five men also suffers from postnatal depression. The study examined parents taking part in the Children of the Nineties project in Bristol, which is following the fortunes of thousands of families. It examined more than 8,000 fathers and found that eight weeks after the birth of their child, 3.6 per cent appeared to be suffering from depression. This shows that after the birth of a baby, depression in fathers, as well as depression in mothers, should be considered.
Further information
Bluebell at Parentline Scotland Helpline for Post Natal Depression.
Freephone: 0800 3457 457 (free from landlines). Lines are open from 9am to 5pm Monday, Wednesday and Friday and from 9am to 9pm on Tuesdays and Thursdays.
Edinburgh Post Natal Depression Project
0131 220 3547 or 0131 538 7288
Bluebell Day
An annual awareness raising day for Post Natal Depression usually in June http://www.bluebellday.org.uk/
SIGN guidelines on Post Natal Depression and Post-puerperal Pyschosis
http://www.sign.ac.uk/guidelines/fulltext/60/
The Associaton for Post Natal Illness
145 Dawes Road, Fulham, London, UK, SW6 7EE
020 7386 0868
info@apni.org
http://www.apni.org/