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Depression / Post Natal Depression
Post Natal Depression
The Facts:
Postnatal depression ( PND) is a form of depression that occurs after you have a baby. Most women will feel weepy and a bit down a few days after giving birth. These are known as the “Baby Blues” and will normally disappear after a week or so. PND can manifest weeks after your baby is born or even up to 6 months later.
This can be a very distressing condition as it can make you feel very guilty as you may often find or feel that you are not looking after your baby in the right way. After months of anticipation, shopping for baby clothes, decorating the nursery, all the exciting things, reality will set in and the sleepless nights, the constant feeding and the demand on your attention will often take its toll.
PND is very common. About 1 in 10 women will suffer and without treatment it can last for months or years.
What will I be going through? :
Depression – You feel unhappy, low and maybe worthless for the majority of your time. You may find it difficult to get up in the morning, have a shower, run a brush through your hair, get dressed.
You will feel irritable with those around you as you may feel that they cannot possibly understand, as they haven’t given birth and therefore don’t know what you are feeling. This may cause arguments and you feeling irritable with your baby and any other children that you have.
All new mothers get tired; that goes with the territory but you will feel exhausted even after baby starts sleeping through.
Your appetite may wane and lose interest in food and therefore will not be getting the nutrition, vitamins and minerals your body needs to recover. Other people will comfort eat and put on weight which can add to your feelings of depression.
You will find it hard to enjoy anything. This should be a time of new beginnings and adventures but you may find it difficult to take part or show any interest in anything.
Sex: What’s that? You may well ask. Losing interest in sex just after having a baby is perfectly normal. It could be painful if you have had stitches or just the idea of it makes you unwilling to try again. Your partner may want the intimacy back in your relationship though and if you don’t feel like it this can cause friction between you as you will feel they don’t understand and they may feel rejected by you.
The feeling of being unable to cope. Having a baby is hard, especially if it is your first one. Finding a routine can be difficult at the best of times but when you’re suffering from post natal depression this can be doubled and can seem like an impossible task and you think your baby will never sleep though or get the hang of feeding or stop crying.
Anxiety: Anxiety can affect you at any time of your life but having a baby can increase these significantly. You may worry about the slightest cough, snuffle, scratch, tumble. You may worry that you are picking your baby up wrongly and you will hurt him. You may worry about your own health more and worry that something will happen to you and your baby will be left without you. You may have slight panic attacks where your pulse will race and your heart thumps. This can cause great fear and you may seek reassurance from your partner, GP or health visitor.
PND can start with no reason even if you have never suffered before with depression in your life. Mothers of premature babies may suffer more as you have the added worry of their health to contend with. If you do not have a supportive partner or network around you this can also lead to an increased risk. If you have added money worries because you are no longer working even just for a few months will also not help.
Hormones: we do tend to blame everything on our hormones but levels of oestrogen, progesterone (and other hormones to do with conception and birth) drops suddenly after the baby is born. It's not clear exactly how they affect your mood and emotions. No real differences have been found between women who do and do not get PND, and research does not suggest that this is a major reason for depression. Hormone changes may be more important in the baby blues and postnatal depression.
What Can I Do? : Don’t dismiss it as just the baby blues and think it will go away. You may not realise what it is and women can feel guilty that they are not “mother earth” or feeling all the joy that the books tell you should be. Not everyone squeezes back into their size 10s on the delivery bed and is up and about breast-feeding in fancy restaurants.
Talk to your GP or your health visitor, it is more common that you think and they are there to help.
What we can to do to help ourselves:
Don’t try to be superwoman. If someone offers to help accept it. When you come home from hospital with your new arrival the last thing you want to think about is washing and making cups of tea for the endless stream of visitors. Get them to make their own. Most people are only too willing to help so let them.
Take every opportunity you can to have a sleep. When the baby goes down for a nap you have one too even if it is only for 20 minutes. Let’s face it that washing up can wait.
Try to make friends with other mothers who are in the same situation as you. You will be amazed at how much better you will fell when you realise you are not the only one feeling this way. Also that network of friends can lead to long term friendships which can include shared care and babysitting.
If you are feeling depressed talk to someone. That is what your GP and health visitor is there for.
Eat well. Especially of you are breast-feeding. Make sure you get plenty of fruit and vegetables, as this will make you feel healthy on the inside.
Find time to have a break. Get a babysitter you trust and go out with your partner for a few hours or have your hair done. This will lift your spirits.
Don’t blame yourself. This is not your fault and doesn’t mean you are a bad mother. Give yourself a break.
Don’t be frightened by a diagnosis of postnatal depression. Once you are aware that what you are feeling can be dealt with you are half way there. Explain this to your partner if they are also alarmed.
What if I don't want treatment?
Most women will get better without any treatment after a period of weeks, months or sometimes longer. However, this can mean a lot of suffering and means that you won’t enjoy being a new mother as much as you should. Speak to someone as soon as you can and then you will feel the benefits of treatment earlier rather later.
What are my Choices? :
Medication:
If you have a more severe depression, or it has not improved with support and reassurance, one of the antidepressant drugs will probably help. Antidepressants take two weeks or so to start working and should be taken for around six months after you start to feel better. Consider all the option before you go on these. You might want to take an herbally based supplement.
How do they work?
It is not entirely clear, but antidepressants affect the activity of two chemicals in the brain, serotonin (also called 5HT) and noradrenaline.
Do antidepressants have side effects?
Some may cause nausea or an increase in anxiety at first, but these usually wear off. Others can make you sleepy or give you a dry mouth. Make sure that your doctor knows that you are breast-feeding. For many antidepressants, there is no evidence that they cause problems for breastfed babies, so breastfeeding is usually possible.
Some people get withdrawal symptoms when they stop these medicines, so it's best to come off them slowly. Your GP will talk you through all this when you are prescribed.
Are there alternatives?
Taking up some form of exercise can make you feel better. Try something like yoga, which heals from within. Or swimming which can the best form of exercise. Do it with a friend and it has the added benefits of getting you out of the house.
Whatever happens remember you not alone, that many women suffer but don’t suffer in silence.