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POST NATAL DISTRESS:
The myth vs. the reality
The Symptoms
Postnatal Depression
Post Traumatic Stress Disorder (PTSD)
Treatment
Things you can do to feel better
YOU ARE NOT ALONE!!!
You may think you are the only woman to feel like you do but you are not alone – one in five new Mums experiences postnatal distress. New fathers can also experience depression and anxiety after the birth of a new baby. It is a treatable condition and women (and men) do heal and recover!
Having a baby is a life-altering event that is generally anticipated and looked forward to with excitement, hope and joy as well as experiencing normal worry. Sometimes the reality of having a baby is in stark contrast to this idealized image, and to those images that appear in adverts on TV and in magazines. Becoming a parent does not require any training, qualifications or supervision; it can at times be daunting and stressful. The fundamental tasks of mothering are invisible and it can often be difficult to describe in language what it is that a mother does because practical tasks are only one aspect of mothering. The home may be in disarray, she may feel exhausted yet have been a brilliant mother that day.
All mothers find the first few months with a baby demanding and exhausting. With time and support most women settle in to their new roles and to the changes having a baby requires. But some women find this more difficult and become depressed, and some women are traumatized from the birth event.
"Postnatal distress" (PND) is the term that describes and incorporates antenatal and postnatal depression and anxiety, postnatal blues and pinks, postnatal psychosis and Post-traumatic stress disorder following childbirth (PTSD). A combination of physical, hormonal, social, psychological and emotional factors are all thought to play a part in triggering the illness. Postnatal distress happens in all cultures and for a variety of reasons. Risk factors can include:
- Having had previous episodes of clinical depression.
- Having had some symptoms of depression or anxiety when pregnant.
- A family history of depression, especially if the woman’s mother had a depression after childbirth.
- A traumatic birth experience.
- Many recent or ongoing stresses.
- Lack of an emotionally supportive partner.
- Lack of support.
Many new mothers experience the postnatal blues (lows) or postnatal pinks (highs) in the days and weeks following the birth of their child. For some women this will develop into postnatal depression, a common problem affecting up to 20% of New Zealand women and 10% of men. The onset of PND can manifest during pregnancy for 10% of women (referred to as "antenatal depression"); or occur immediately after the birth or any time during the first year, however it most commonly occurs within the first six months.
No one sign or symptom in the following list indicates PND but a new mother who experience's or exhibits many or only a few of the following symptoms may have PND -
- Sleep disturbance
- Anxiety – worrying a lot, having a sense of panic
- Low mood, tearful or feeling sad
- Loss of interest in previously enjoyed activities, including sex
- Appetite changes
- Negative and/or obsessive thoughts
- Irritability, grumpiness, rage and/or sensitivity to noise
- Memory problems and loss of concentration
- Exhaustion, extreme tiredness, no motivation and fatigue
- Inability to make decisions and feeling overwhelmed
- Body aches, pains and headaches – eg feels like you have the flu
- Excessive feelings of guilt and inadequacy and feelings of shame - wanting to isolate and withdraw
- Loss of confidence and self-esteem; fear of being alone
- Scary thoughts of harming the baby, children and/or suicide and death
The difficulty in knowing whether you or someone you know has PND is complicated by the fact that some of these symptoms are common experiences of being a new mother, especially with lack of sleep. However, when these symptoms of depression begin to have an impact on the mother, her baby, her other children and her partner it is time to get help! If you would like to know more about how talking to Susan could help you please contact Susan
Post Traumatic Stress Disorder (PTSD):
These symptoms should alert you to possible PTSD:
- Experienced an event perceived by the person experiencing it as traumatic
- Flashbacks of the event, vivid & sudden memories
- Nightmares of the event
- Inability to recall an important aspect of the event - psychogenic amnesia
- Exaggerated startle response, constantly living on edge
- Hyper-arousal, always on guard
- Hyper-vigilant, constantly looking around for trouble or stressors
- Avoidance of all reminders of the traumatic event
- Intense psychological stress at exposure to events that resemble the traumatic event
- Physiological reactivity on exposure to events resembling the traumatic event- panic attacks, sweating, palpitations
- Fantasies of retaliation
- Cynicism and distrust of authority figures and public institutions
- Hypersensitivity to injustice
(See www.tabs.org.nz for more information on PTSD)
There are several very effective treatment options available, ensuring that most mothers suffering with PND make a full recovery. These include support groups, individual counselling and psychotherapy, Cognitive Behavioural Therapy groups, and medication. Often a combination of any of these treatment options is used.
Psychotherapy will help to develop strategies for coping, to reduce and manage anxiety, build a woman's self confidence and self-esteem, identify negative thoughts and address relationship issues. Most importantly, a therapist who specialises in postnatal depression will be able to offer you support and understanding. You will be able to talk about your intimate fears and express your feelings in a safe, confidential environment without fear of judgement.
Many women are afraid to come forward. Sometimes it can be hard to bring yourself to make the appointment, and it can be extremely hard to ask for help. However, rather than thinking of yourself as a failure, know that you have taken the first courageous step forward to being able to enjoy your mothering experience. If it is your partner or friend that is suffering, maybe you need to take the initiative and make the appointment yourself and go with her, however always involve the mother.
It is important to remember that health professionals can effectively treat depression and most women fully recover! The sooner treatment begins the
sooner she gets better and therefore the fewer consequences there will be for herself and her family.
If you would like to know more about how talking to Susan could help you please contact Susan
Things you can do to feel better:
Recovery begins with asking for help, and making changes to create balance! Being in a place and space to simply enjoy mothering and to help with recovery from PND starts with you! There are things you can and must do to begin:
- Be kind to yourself!
- Get as much sleep as possible – put a sign at the front door when sleeping and limit your visitors. Birth is NOT a public event. New mothers need to rest and nest!
- Eat well - being thoughtful about nutrition is a positive form of self-care.
- Get exercise - moderate exercise can improve overall energy levels, relieve stress and muscle tension and help to improve muscle strength needed to carry and feed the baby.
- Develop a support network so that you feel less trapped and lonely. It is important to get out of the house.
- Accept help when it is offered! You are not superwoman and never will be.
- Recognise your own unrealistic expectations about what motherhood might be like.
- Go to the Plunket Family Centre for the day and have the nurses there take care of you.
- ASK for help without feeling guilty or embarrassed. Looking after a new baby is HARD work! You might need help with meals, housework and caring for the baby. An idea is to make a list of names and numbers of people who have offered help or whom you feel able to ask before the baby is born.
- Learn and become aware of your limits, triggers and warning signs of when you’re becoming overwhelmed e.g. clenched jaw, raising voice, door slamming, irritability, indecisiveness.
- Have a bath with oils and candles and music.
- Have a massage - either from a professional, partner or friend.
- Attend postnatal yoga classes to help with toning, breathing and relaxation.
- Consider alternative medicines and care such as those from a Naturopath or Homeopath.
- Allow yourself to take time out to read a magazine or book, garden or simply relax.
- Watch a funny DVD or go to the baby friendly movie sessions – laughing changes your mood.
- Get a babysitter to take time out as a couple. The importance of this strategy should not be underestimated.
- Have a girl’s night out or in.
- AND …care less about the housework!
Remember, if you feel that the person you have told hasn't heard you, don't give up - try again until you are heard. Keep on 'shouting' until someone hears and understands you! You will get better!!!
If you would like to know more about how talking to Susan could help you please contact Susan. You can also learn more by visiting Susan's blog here.