Firstly I would say that the fact you have come to this page is a sign of the first steps of recovery. Accepting you have a problem is actually encouraging.
I remember in the first few months after baby Dominic was born that I felt my life was unravelling. I hardly slept; I was so irrational about many things, such as worrying all day what to cook for the evening meal. I was snappy to all my loved ones and pushed away all offers of help. I put on a mask of ‘I’m fine’ to the health professionals around me. I felt being a mother was not the euphoric state I had always dreamed of. I was exhausted. My breasts hurt. I felt the old me had simply gone. I had no notion of who I was anymore, but felt ashamed and embarrassed to admit any of this.
When my GP gently said that she felt that I was suffering from postnatal depression I felt a sense of relief. For several months the ‘blame’ had been on a traumatic birth; Dominic slept for no longer than 2 hours at a time; the week I was due back at work he was rushed into hospital with suspected meningitis. It was hardly the rosy picture I was had read about in all the magazines. The diagnosis I felt gave me a reason, a label, a possible solution to all my strange feelings and behaviours. I remember reading a magazine article a day or two before my diagnosis about postnatal depression and the truth dawning on me that I was suffering from it! So even ‘Miss Perfects’ like me can get it!
So what can I do about it?
On reflection I wish I had opened up much, much earlier on about how I was feeling. We tend to have this in-built ‘coping’ mechanism and few of us like to feel we are ‘failing’, so we keep quiet about what is going through our head. Yet it really can help if you tell others how you are feeling.
If you had been given a diagnosis of appendicitis would you feel ashamed or guilty? I guess not, so why do we tend to feel we have done something wrong if we have a diagnosis of mental illness?
Find out about your diagnosis. The hundreds of people who have told me their stories have shown me that postnatal depression is a unique illness – your symptoms, personality, circumstances, can all affect your actual condition.
This varies widely across the country.
Initially you should get help on the maternity ward if signs are immediate, e.g. you do not feel that the baby is yours or you do not want to acknowledge their existent. However, stays on the ward are often so short that such things may get missed.
If you have a homebirth or once discharged, a midwife should visit every day or two until your baby is ten days old. In some areas midwives run postnatal clinics instead of doing home visits, and in other areas they run drop-in breastfeeding clinics. Ask your midwife what happens locally.
After that your health visitor and GP should be in regular touch with you. They may recognise the early signs but if you are worried please let them know.
If postnatal depression is diagnosed you may be prescribed medication (see below). Also appointments with a counsellor or specialist perinatal mental health nurse, if there is one in your area.
In extreme cases of puerperal psychosis you may need to be admitted to hospital – ideally a mother and baby unit. Sadly there are a lack of these beds in the UK.
I did take a variety of anti-depressants and felt that they helped me. My emotions were on a huge roller coaster and it felt that the medication lessened the troughs and peaks. We tend to take medication for physically conditions and are not too concerned about it yet there is often a stigma and worry that once started on anti-depressants you will never come off them. If mental distress is caused by a chemical and hormonal imbalance then it make sense that medication is likely to be very helpful.
So I would say take your GP’s advice BUT do not just expect that the tablets themselves will miraculously make you feel better! I know that I wanted this to happen so badly and the tendency was just to sit there and wait for instant recovery! They can take weeks to work and it may take several attempts to find one that suits.
Mums and Tots groups
So many ladies tell me that a huge factor in their recovery is contact with others. It was suggested that I attended a six week support group at my local health centre after I was diagnosed. When I walked in for the first session the first lady I spotted was one who I had spent hours with at ‘Mums and Tots’ groups – neither of us had admitted to each other how we had REALLY been feeling! You can sit there in ‘ordinary’ mother and baby groups and feel worse – I did! My perception was that all these other mothers were fantastic! Their babies slept for 16 hours a night; never dirtied their nappies and drank and ate everything they prepared for their baby! So you just withdraw more and more. I suggest that you be honest! I don’t me that you declare loudly that you want to jump in front of a bus, but’ drop gentle hints that you find some days tough … you may just give others permission to admit the same.
One simple example of this ‘honesty’ did stop three ladies from sinking further. I was asked to visit a Mums and Tots group as the leader said she felt some ladies were struggling but would not admit it to anyone. I dropped in on a session and spoke about my experiences. Almost immediately I could see who the ladies were as their expressions changed instantly! They could not believe that I had been so poorly yet now was great. All three admitted that the days they had no group to attend were awful as they were on their own from 8 am to 7 pm with their baby. After talking we came up with the idea that they all met up for an afternoon or morning on those days at one of their houses, or appropriate venue (e.g. play place.) They took it in turns to be hostess and that gave them their own free time to shop, pamper, sleep, etc. leaving baby with the other two mums who had each other to chat too. Within three weeks all of them felt much better. No need for medication – just being together and offering mutual support.
Specific support groups
Find out if there is one in your area. Please let me know about it and we can add it here.
Find a friend and support – internet groups
Ladies who are isolated can find some great support on the internet with forums www.pni.org.uk
Phone a friend!
I pushed away many offers of help initially as I felt it showed how useless I was!
Instead of snapping ‘no, I can do it myself’ say ‘yes please, that would be great’! So accept offers of meals at friends and relatives. If they offer to babysit; do your ironing; pamper you, etc, accept it graciously. They will feel that they have done something useful and you will benefit too. Being a new mother doesn’t mean that you have to be Superwoman! If you had a broken leg would you let them help? I am guessing you would. So why should this brokenness be any different?
On good days or hours do you worry about the bad time that will inevitably follow? I did and I spoilt the good times because of it. Picture yourself on a rollercoaster. You know the up follows and down and vice versa. Occasionally it flattens off so you get your breath back, then whoosh, off you go again. Think of your moods like this. Make the most of the ups and deal with the down when it comes, and hold on to the fact that you will rise back again.
Remember too that it is good to laugh and cry!
Some ladies tell me that they feel guilty if they smile, especially f they are an inpatient. It is almost like with a diagnosis of postnatal depression you are barred from happiness! Like when you were a child and you persuaded your parents you were too ill for school After lunch you begin to feel better so you get out of bed and are found playing on the bedroom floor! What was the response? Back to school tomorrow! That childhood guilt stays with us but we have to remember the chemical swings in our head and mood so banish the guilt and enjoy the ‘ups’. Those around you will be genuinely pleased and relieved!
Having a good cry is also good. By putting on a brave face and bottling up all your emotions it can make the situation worse in the long run. Use a film or song to help spark it off if it doesn’t come naturally. And if a well-wisher tells you not to, then suggest that it is actually good for you – or do it in private. When you’ve had a good sob go and does something off your feel good list to celebrate!
When I taught children with severe learning difficulties we used sensory stimulation a great deal. We often overlook the importance of the senses and I know they can have a fantastic effect on mental health.
Look – what makes you smile? A favourite film? A special view?
Touch – what makes you go ‘ooo’? A particular jumper or blanket? Stroking a pet?
Taste – what do you just fancy to eat? Galai melon? Banana milkshake? Grandma’s apple pie?
Smell – which aroma reminds you of a happy time and place?
Sound – which music makes you emotional, happy or sad? Gloria Gaynor ‘I will survive’?
Why not make a feel good list for yourself? When you need a boost it will be there to refer to.
When I was suffering with postnatal illness no-one stressed the importance of a good diet. When you feel low you often go for the ‘comfort’ foods of cakes, biscuits, etc. Yet it is vital that you do make sure you have fresh fruits, vegetables and all the usual healthy eating suggestions. Make sure you have little and often meals. Remember that your body has had a terrific change due to pregnancy and it needs care even if you do not have postnatal depression!
Weight loss? Forget it when you are really poorly – you have enough to deal with. As your mood lifts then by all means try to do this if it is important to you but otherwise take it off your worry list for the time being.
Treats? I am all for them! If you fancy a bit of chocolate then go for it and don’t beat yourself up about it!
Some ladies may turn to alcohol or other forms of substance abuse in order to mask their postnatal depression. If this is you PLEASE seek professional help as there are other, less harmful, ways to deal with it.
When I was a patient in the psychiatric hospital, the occupational therapist prescribed me some gym sessions. At first I hated it but gradually the natural raising of serotonin, ‘the feel good’ chemical, began to lift my mood. I would pedal away on the gym bike but close my eyes and think of bike rides in happier times. In Australia they have pram walking groups for ladies suffering with postnatal depression.
Make a start with simple things like walking a few more times up and down stairs an extra couple of times. Sit on a gym ball whilst you are at the computer. Get an exercise video and do it in the lounge or bedroom.
Put the baby in the pram and get out of the house! Arrange to meet a friend to do so many laps of the neighbourhood. Go to the Mums and Tots swimming sessions.
I feel this is very under-rated as a wonderful technique for both mum and baby.
I remember all the advice of ‘when baby rests you should’ but I did not take it! If Dominic did sleep in the day I used that time to catch up on housework; sort out the post, do the ironing. It always seemed that just as I decided to sit down then he would wake up again and the feed, change, entertain routine would start all over again! So my question to you – does it REALLY matter if the cushions aren’t plumped up? That the lounge hasn’t been dusted for weeks? Does anyone ever say on their death bed ‘I wish I’d done more house work’. I do not think so!
We are so good at trying to be everything to everyone and feeling we have to achieve such high standards in everything we do, that we can lose ourselves in it all. The important thing is your health and it is vital you DO rest when baby does. This is a phase – it won’t be like this forever, so be good to yourself.
Night time sleeping. What was that? We got very little. Time and time again I told my health visitor that we were not sleeping but the months rolled by and circumstances deteriorated. I reached a point of not sleeping as I couldn’t see the point. My baby would wake me as soon as I did. I feel this was the biggest factor in my complete breakdown. So please take sleep seriously!
In retrospect I feel that my mood was rubbing off on baby Dominic – he did not sleep well due to being anxious about me and so the vicious circle began. When I was in hospital he did sleep far better for Nick. Maybe because Nick did not breast feed like I could or just because he was much calmer than I was? Who knows but it did make me feel even more hopeless at the time.
Take all suggestions of getting a baby to sleep through but fundamentally do what suits you and your family. Professionals and well meaning friends can sometimes make you feel worse about your techniques but if they work for you then go for it!
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