Dealing with Depression

Alex Bollen (Postnatal Leader, Clapham NCT) writes about Post Natal Depression and how to get help and advice.

What is Postnatal Depression?

Having a baby is an emotional rollercoaster. There is little – if any – time to recover from the physical and emotional challenges of birth and pregnancy before being plunged into a twenty four hours a day, seven days a week whirl of feeding, crying and nappy changing.

It is completely normal to feel drained, overwhelmed, confused and vulnerable in the early days and weeks of motherhood. Indeed some researchers argue that most women who have babies have some sort of depression. However some women find that their experiences are particularly difficult and prolonged. In the words of depressed mothers:

“Even the smallest task just felt monumental” - “The fogginess would set in” - “Everything was black”

It is estimated that around one in ten mothers become clinically depressed. Postnatal depression usually develops in the first four to six weeks after childbirth, although in some cases it may not develop for several months. Symptoms can include some or all of the following:

- A persistent feeling of sadness and low mood

- A loss of interest in the things you used to enjoy

- Lack of energy and feeling tired all the time

- Feeling like you can’t cope or are a failure

- Strong feelings of anxiety or guilt

- Loss of appetite

- Difficulty sleeping

- Finding it hard to make decisions

Postnatal depression is different from puerperal psychosis, a serious mental illness often needing psychiatric treatment and possibly a hospital stay. This condition is rare, affecting only one or two mothers in every 1,000, and most commonly occurs in the first month after having a baby.

The main symptoms of puerperal psychosis are delusions, hallucinations, confused thoughts and a lack of self-awareness. In very severe cases, the mother may try to harm her baby or herself. If you are, or know someone who may be, suffering from puerperal psychosis, you should get medical help from your GP, midwife or health visitor as a matter of urgency.

What Causes Depression?

We don’t know for sure what causes postnatal depression, although it seems likely that a number of things may contribute. Hormones may possibly play a role, while social and emotional factors have been shown to be important. The following circumstances have been linked with a higher risk of depression:

- Stressful recent life events

- Lack of social support

- Previous experience of depression

- Negative pregnancy, birth or feeding experiences

Dads and Depression

Fathers can also suffer from depression – around one in ten dads develop depression in the year after their child is born. Symptoms are similar to postnatal depression. If you are depressed or know a dad who may have depression, it’s important to get some help and support.

Preventing Depression

Research has consistently found that social support can help guard against depression. One recent study found that the support of partners and mothers made a real difference to how confident new mothers felt.

Other new mothers can be a great source of support. Part of the NCT’s purpose is helping new parents meet each other, whether through our antenatal and postnatal Early Days courses, postnatal teas, playgroups and events. You can find out more about what we offer parents locally through the NCT website or by following us on our Facebook page - Clapham NCT.

Related to this, research shows that new mothers feel the need to talk through their experiences. Indeed the risk of depression increases in women who do not have someone to talk to openly. However new mothers can find it hard to admit to finding things difficult. One of the key benefits of an NCT Early Days course is that it provides a safe environment for mothers to share their experiences, providing reassurance that their feelings are normal.

There are other ways to increase your emotional wellbeing in the postnatal period, for instance getting as much rest as you can and eating properly. Gentle exercise, such as a walk in the park, can be beneficial. Trying not to do too much and being realistic about how much you can achieve at the same time as looking after your baby can also help. We can put enormous pressure upon ourselves to be perfect, but it is much better for you and your baby to aim to be a happy mum rather than a “supermum.”

In her book Postnatal Depression: Facing the Paradox of Loss, Happiness and Motherhood  - Paula Nicolson advises, “the best survival strategy is to ensure that the low moods, distress and intermittent depression do not last too long. If they join up, severe clinical depression might set in and that is more difficult to shift. A major factor in avoiding prolonged depression is to find a way, however small, of taking control of your life.”

How you take back some control of your life will be very personal to you. It may involve having a haircut, relaxing in the bath, reading a magazine or watching a film.

Dealing with Depression

If you are concerned you may have postnatal depression, it is important that you do not suffer alone. Postnatal depression can affect anyone and you are not to blame. Speak to your family and friends to get their support. Talk to your health visitor or GP to see what help is on offer. Treatments for postnatal depression generally include:

- “Talking” therapies such as cognitive behavioural therapy or interpersonal therapy either one-to-one with a counsellor or with a group

- “Self-help” therapies such as guided self-help or computerised cognitive behavioural therapy which can be provided by your GP

- Anti-depressants

Unfortunately one of the downsides of living in an area with such a high birth rate is that postnatal health services can be stretched and you may not get the help you need the first time you ask. Don’t give up and remember that there are other sources of support. See below for details.

Support for Depression

The Cedar House Support Group is a registered charity which supports mums suffering from postnatal depression. A support group is running in Balham every Friday in term time (more details here: www.postnataldepression.com/cedar-house-support-group). The weekly groups are run by Liz Wise, a professionally trained counsellor, who herself suffered from the illness after the birth of both her children. Liz is also the PND coordinator for the NCT at national level and has over 15 years’ experience working in this field.

Liz Wise, says, “postnatal depression is a terrifying illness and mums can sometimes suffer in silence. Our groups offer a supportive and confidential space for mums to gain the help they so desperately need. We also have a creche for babies and toddlers run by our fabulous volunteers who are all CRB checked. I’ve had the privilege to help some seriously ill women over the last 20 years and people do recover. Our groups really aid recovery at a time when mums can be feeling frightened, isolated and suffering from horrendous intrusive thoughts. Please do contact us if we can be any help.”

Where to Get Help

- Further information on Post Natal Depression, Cedar House Support Group: www.postnataldepression.com/cedar-house-support-group

- Liz Wise, Postnatal Depression Counsellor, Cedar House Support Group

lwise@talktalk.net, 07773 283556.  All calls are confidential

- The Association for Postnatal Illness - www.apni.org.

They run a free helpline (0207 386 0868 Monday-Friday 10am-2pm)

- NCT’s Shared Experiences Helpline - 0300 330 0700 on Monday - Friday from 9am – 7pm.

Things to Try

There are also a number of things to try which may help:

- Look after yourself – eat well, rest as much as you can, do things just for you

- Take one day at a time and do only what you feel able to do

- Take some gentle exercise, such as a walk

- Accept that there will still be bad days, even when you are on the way to recovering

- Talk things through with people you trust

As one depressed mum said about her road to recovery: “I began to realise that this is about taking care of me. But it was also about reaching out and asking for help.”