Reflections on postnatal depression

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L ike many adults, I seem to spend much of my time trying to remember things – you know, remembering to collect the dry-cleaning before they auction it off to the highest bidder, remembering where I put my keys (in my bag, apart from that time when the dog was sleeping on them), remembering not to leave it until the day before camping to buy a tent…Then there’s the other smaller portion of my life that’s concerned with things I’m actively trying to forget.

I never thought I’d be someone who wanted to forget things but being able to compartmentalise and mothball difficult things is, I feel, crucial to keeping sane. In the mental health world, I guess they call these things ‘triggers’ and it’s part of self-care to learn how to handle – even avoid – them.

But though parts of my life are now packaged up in metaphorical boxes to be rummaged through only when I feel strong enough, outside events occasionally force me to prise them open when I’m least expecting it. Sometimes conspiring to forget is not an option.

Two things have had me rubbing up against one of my biggest triggers recently – memories of childbirth. Firstly, new research by the Maternal Mental Health Alliance (MMHA) has revealed ‘shocking gaps in the UK maternal mental health services’ for the one in 10 women who experience postnatal depression or other childbirth-related mental problems.

Secondly, a story in the Daily Mail by the husband of Kate Chetwynd, a mother-of-two who committed suicide in 2008 suffering from post-natal depression, got me thinking, ‘That could so easily have been me.’ (Suicide is, according to the MMHA, one of the leading causes of death for women during pregnancy and one year afer birth)

The reason these have forced me to remember is that, eight years ago, I was one of those women who was so unwell that, in those early days, I often wished I could no longer be around.

Twenty weeks into a twin pregnancy my then husband and I were told one of the babies had severe brain damage and wouldn’t survive. I had a history of depression anyway and from that point onwards, all I could think was, ‘How can I look after one whilst grieving for another? How can I carry on living? But how do I go about dying?’

After a terrifying crash Caesarean at 30wks, I woke up in recovery where my first mothering experience was holding a son who I’d never see grow up. My surviving son was already up in special care, fighting for his place in the world, while I was downstairs thinking, ‘It was never meant to be like this.’ The bitter-sweetness felt irreconcilable.

Mental health-wise, I desperately tried to be a good mother whilst harbouring daily catastrophic thoughts. One particular low point was when relatives told me (after hearing about a mother who died during childbirth in the same hospital), ‘You are so lucky – imagine, you might have died’, and all I could think was, ‘If only that window could open a bit more, I would jump out of it.’

But during that time, apart from close friends and family, three things were my saving grace. One was a health visitor who encouraged me to go to a baby massage class where – despite my intention to keep myself to myself – I met some friends who are still amongst my closest today.

Then there was an amazing clinical psychologist at the hospital who allowed me to talk through everything that had happened as many times as I needed to and, eventually, to get used to my ‘new kind of normal’. Thirdly, a befriender from the TAMBA Bereavement Support Group listened to me for many months and allowed me to go places that I thought other people would never understand.

Together, these people helped to ensure I didn’t fall off the page…

It was only 18 months later that I realised I was seeing light at the end of the tunnel – I was smiling and laughing without feeling it was a mask. Tornado-like, my son had managed to pull me back into life and living. And he’s done so ever since. I’m glad I stuck around.

Recently, I’ve thought about what I might liked to have known in those early days. PND blogger Rosey Wren (Twitter @PNDandMe) has also given me the benefit of her wisdom. Below are some of our reflections on PND and what might help (incidentally, we’d love to hear what you wish you’d known at the time – please tweet us @martharoberts01 and @PNDandMe).

Now it’s time to return thoughts of my birth experience back into their loosely-lidded box. After all, I’ve got keys to find and a tent to buy. And, of course, an amazing son to love and care for.

 

POSTNATAL REFLECTIONS

Reflection one: It may not feel like the happiest time of your life
Everyone is so happy about the new arrival that it may be hard for them to imagine the new mum is anything but joyful, too. ‘But you’ve got a lovely baby! You should be happy!’ was said to me SO many times I lost count. But postnatal depression can make you feel all kinds of things you might not associate with motherhood – numb, anxious, despondent, inadequate, panicky, to name but a few. If you or someone you know is experiencing these, seek help as this may indicate PND. Rosey says it’s important to be honest about how you are feeling, “with others but importantly yourself – there is no weakness in telling the truth, only strength.”

Reflection two:  Even ‘happy births’ can leave you feeling shocked
You don’t need a catastrophic birth to end up depressed. Even the aftermath of a fabulous birth can be ‘shocking’ – after all, a birth is an utterly life-changing event and many deliriously happy women will find themselves suddenly thinking, ‘My world has changed forever, what if I can’t handle it?’ Don’t discount PND if you’ve had an idyllic time. It’s still possible, so seek help.

Reflection three: The ‘right’ help is out there.
Don’t be scared to ask for help – and if you are, get someone to ask for you. There are some people out there who actually ‘get it’. Psychologist and parenting expert Anna Hamer (@AnnaRHamer) tells me: “Ask for help. Historically women were not left on their own to look after young children; mothers, aunts, neighbours, or members of the community were all on hand to give support, advice or physical assistance. Having an extra pair or eyes and ears around will enable you to sleep, eat, and get some encouragement.” Rosey adds: “Seek support and know that it’s OK to ask for an accept help, whether it’s from mum and baby groups, online friends or people like Homestart.”

Reflection four: Help can come from unexpected places
After the birth, I was terrified at the thought of everything, including meeting other mums. Who’d want me at their coffee mornings with my hideous birth story raining on their parades? But the other new mums I met were, for the most part, kind, sympathetic and happy to ‘go there’ with me. I’m eternally grateful to them.

Reflection five: ‘Baby blues’ and postnatal depression aren’t the same
Around 85 per cent of new mothers have the ‘baby blues’ starting around 3-10 days after giving birth. Although it may be distressing, it’s important to be aware that it doesn’t last long – usually only a few days – and is generally quite manageable. However, around 10-15 per cent of new mothers develop a much more severe and longer-term depression – postnatal depression. This usually develops within six weeks of giving birth and can come on gradually or suddenly and can range from relatively mild to very severe. If you or someone you know is depressed weeks after the birth, it may be more than just the ‘baby blues’ and it needs to be taken seriously.

Reflection six: It’s important to flag up previous mental health issues
It may be that you experience postnatal depression having never had depression or any other mental illness before. But Mind says that some situations are considered to put you at particular risk of developing PND, namely:

  • previous mental health problems
  • lack of support
  • experience of abuse
  • low self-esteem
  • poverty and poor living conditions
  • major life events

If any of these pertains to you, flag it up to your GP, consultant or midwife who should then offer you extra support. I often wonder if I’d done this whether my antenatal and postnatal care may have been different in some way.

Reflection seven: Having hope can help pull you through
Rosey says: “It’s not always about the light at the end of the tunnel, it’s about the glimmers of hope along the way that give you the strength to keep going. So find hope every day, whether it’s getting out of bed or going to the shops for milk. By grabbing hold of that hope, you can and will get better.” Thinking small may be all you can do. A good friend used to tell me, ‘Keep it in the day, don’t think further than today’, and that really helped. The days turned into weeks and months and, eventually, wellness.

© 2014 Martha Roberts

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Freelance journalist and mental health blogger, based in London UK

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