The article below was recently shared with NCT editors for use in
their newsletters. As someone that has suffered from postnatal depression, I
thought it would be useful to share it on our blog.
My daughter, Maria, is now 17 months old. I found the first
year of motherhood very difficult. She didn’t sleep at all well and she
wouldn’t be put down during the day. I didn’t adjust well from having routine, independence
and lots of company every day to being completely depended on, tired and lonely!
I felt like I’d completely lost my
freedom and I couldn’t get anything done!
The worst effects were on my sleep. After a few months, I
developed insomnia – I could never sleep during the day when Maria slept and my
sleep patterns were so disturbed that I would lay awake at night for hours. I
dreaded going to bed. It was exhausting and I was tearful a lot of the time. I felt
much better when I was out and about but I didn’t like to plan anything in advance
in case I didn’t sleep well.
I also received quite
a lot of criticism from family, friends and health professionals about my
parenting choices. Because Maria was quite an unsettled baby, some family
members thought that my breast milk wasn’t enough for her so were convinced
that I should bottle feed her! She wouldn’t take a bottle – she’d scream if I
tried to put one in her mouth – and trying to get her to take it was an added
stress!
She would only sleep in a sling during the day and in our
bed at night. I was told that this was the “biggest accidental parenting
mistake” I could make! Even a health visitor, a doctor and Maria’s eczema nurse
said I should try controlled crying. So I tried to get Maria to sleep in the
cot. Again, she would cry and scream until she made herself sick and bang her head
against the side of the cot! Another added stress!
I kept my feelings well hidden (I think!), pasting the smiles
on when I was out! I remember being at one of our baby groups and other mums
seemed so happy when I just wanted to cry!
For many months I didn’t attribute my feelings to PND. I
thought I’d just developed insomnia and the way I felt was a knock-on effect of
that. It was only when my mum said she thought I had it and I looked up the
symptoms online that I accepted it could be PND.
I didn’t feel that the doctors were particularly supportive
at first. When I originally went about not being able to sleep, I was just
given some fairly rubbish advice about developing good sleeping habits and was
told I couldn’t take any sleeping tablets because I was breastfeeding. PND
wasn’t mentioned.
Eventually, the need for me to take some sleep medication
was behind my decision to stop breastfeeding after just over a year. It was
then that the doctor also prescribed me some antidepressants.
Since then, things have definitely improved. I’ve slept better
and started enjoying motherhood! One of the factors behind feeling much better has
been accepting that I’ve made the right parenting choices for my child. She’s now
a very bright and happy toddler and it no longer bothers me if I get any negative
comments about things such as bedsharing! I can just brush them off! And after almost
five months, I’ve halved the dose of my antidepressants (with the consent of my
doctor) and hope that I can come off them altogether soon.
If you have been experiencing similar
problems or feelings, the following advice may be useful. It was written by Dr
Charlotte Granger. She is a clinical psychologist working on a research trial for
the University of Oxford, which aims to develop effective psychological
therapies for postnatal depression.
Understanding postnatal depression
Having a baby involves
considerable adjustment for a woman, whatever her age, lifestyle or how many
children she already has. From conception,
pregnancy and birth, to the practical demands and responsibilities that take
over daily life, it is a transformation on many levels, biological, physical,
social and emotional. Every baby will be different in the challenges they
present from pregnancy onwards, and each mother different in how she is able to
cope with these and what other pressures she will also have to cope with during
this time. In 10-15 per cent of new mothers, the changes and challenges involved
in this adjustment will overwhelm their usual coping strategies, and they
develop postnatal depression.
Symptoms of postnatal depression are
similar to that of typical depression, and happen within the first year after
having a baby. Natural adjustment to motherhood often includes feelings of
being tired and overwhelmed, changes in sleep and appetite, and less time to
relax and enjoy things. In the first 10
days after giving birth, 80% of new mothers will experience ‘baby blues’,
feeling tearful, exhausted and tense, and these feelings typically go away by
themselves. Post-natal depression differs from these natural feelings when
feelings of sadness, being overwhelmed or feeling anxious last longer than two
weeks and are around most of the time. This persistent low mood is accompanied
by difficulty in sleeping even when the baby is asleep, lack of energy,
feelings of worthlessness or guilt, struggling to concentrate or make
decisions, or thoughts about harming oneself. It can develop at any time in the
first year of having a baby, although between three to six months after the
birth is the most common time for it to occur.
Difficulties in seeking help
For many women, getting help for
postnatal depression can be difficult due to the emotional impact that asking
for help involves. There a number of reasons why women can find it particularly
hard to admit to anyone else that they are struggling. Often women feel that
they shouldn’t be depressed after having a baby, and this leads to a sense of
guilt and unwillingness to talk about how they feel. They may also feel that
they have no ‘obvious’ reason why they should feel sad, particularly if the baby
was planned and they have a comfortable, settled lifestyle. Fears that family
and friends will think they are a bad mother who should be coping better are
common, particularly if experiencing low mood which increases negative thinking
and makes it difficult to make decisions such as who to talk to. Often not
talking about how difficult it all is leads to the depression increasing, as
the mother may feel a sense of loss about not enjoying their baby’s first year,
and worry that their baby is being affected.
Treating postnatal depression
Treating postnatal depression is
in some ways very similar to treating typical depression; the most effective
treatments are anti-depressant medication and talking therapies e.g. cognitive
behaviour therapy or counselling. GPs and health visitors are widely familiar
with the symptoms and will know what help can be offered in the local
area. Anti-depressant medication can be
rapidly effective, and GPs can discuss what type of medication may be suitable
for those mothers who are breast-feeding.
Talking to your GP or health
visitor is the best way to get help if you feel you are experiencing postnatal
depression. It can often be the hardest step, and if it is difficult, choose a
trusted friend or family member to try talking about it with first. It is
important to remember that health professionals see talking about feelings and
asking for help as effective coping, rather than not coping.
Self-help strategies
There are also a number of
self-help strategies that you can try to lift your mood.
Talk
Having the support of people who
know you well is very important. It can also be a little too easy in modern
life to not get enough daily human contact. Online shopping, emailing and
texting can all give us fewer reasons to get out of the house or pick up the
phone. Talking to people about the daily delights and stresses of having a baby
is an anti-depressant for a number of reasons. It puts life in perspective and
makes worries seem more manageable, and may lead to useful advice. It can also
distract you from how you are feeling, and help you feel relaxed and supported.
Be honest about how you feel with people who you trust and feel safe with. You
may help more people than just yourself. The more the reality of motherhood is
discussed, the more women will feel normal and understood about how they feel
after having a baby.
Organise your week
Getting organised is no mean feat
with any amount of small children, and therefore both the difficulty and the
benefits should not be underestimated. Getting a regular routine for the week
is a great anti-depressant. When feeling low, it can be too easy not to do
things that are good for us. Most people will have days when they don’t want to
go to work, however because they have to, they do, and generally after a short
while they will feel better for having done it. Having a baby and being at home
can make it much harder to get things done or go out. Make a routine for the
week and schedule in baby groups, walks, time to do chores and time for
yourself. Sticking to the routine even when you don’t feel like it can help you
feel more in control and keep you doing things that will help with feeling
better, such as getting physical exercise or seeing other people. Try to get a good
balance of activities across the week, including time for what your baby needs,
time for what your house and family need, and time for your own needs.
Be kinder to yourself
Often our harshest critic is
ourselves, particularly when we have a lot to cope with. Again, modern life is
a major contributor to us developing a way of talking to ourselves which is harsh
and judgemental. Television and the internet help us believe there is not only
a right way of doing things but that everyone else is doing it right already. However, learning to talk to yourself in
a warmer and encouraging way is not only likely to help you achieve more than
self-criticism, but chances are if you model this to your child, they’ll grow
up knowing how to talk to themselves the same way. Specifically, it is through
seeing you as their parent make mistakes and recover from them that children
learn mistakes are okay and how to work them out. Practice noticing your own
self-critical thoughts and gently challenging them with warmer and more
accepting thoughts. It can be surprising how hard this is and will take regular
practice. Keep at it: even small changes to your daily life will add up over
time and help life feel more manageable and enjoyable.
Advice on postnatal depression can also be found on the NCT's website http://www.nct.org.uk/parenting/postnatal-depression
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