Imogen says, “I have a close friend with postnatal depression. Her new baby is only 7 weeks old and she has a toddler too. I want to help but she doesn’t seem to want any contact, she keeps pushing me away. I know she doesn’t have any family support, how can I help her?
Postnatal depression is a debilitating illness that devastates families and disrupts friendships right when you most need a network of support. Symptoms include: mood swings, anxiety or panic; sleep disturbances unrelated to the baby’s needs (this seems like a cruel joke – baby is sleeping soundly and you are wide awake), changes in appetite, chronic exhaustion or hyperactivity (ironing at 3 a.m?); crying – feeling sad and crying for no apparent reason or feeling like you want to cry but can’t; irritability (your partner can’t get anything right, no matter how hard he or she tries); negative, obsessive thoughts; fear of being alone or withdrawing from family and friends; loss of memory or concentration, unrealistic feelings of inadequacy or guilt, loss of confidence and self-esteem.
Often the mood swings, anxiety and irrational thoughts that can accompany this ‘invisible’ illness make it very difficult to accept help. Leila, a mum who suffered with depression after her first baby says, “I didn’t want anyone around because I felt embarrassed about how I looked and how the house looked. As selfish as it sounds now, having meals dropped off and people trying to do everything for me just made me feel worse. It was as if I couldn’t even take care of my family, so I became consumed with guilt and anger that other people were pitying me.”
Danielle says, “ I was suffering from severe anxiety. Offers of help seemed to fuel my anxiety – (in my mind) there were lots of ‘what ifs’ and catastrophic thoughts. On one hand, the thought of anyone popping in unannounced made me feel worse but if they planned ahead, I would often become so anxious that I would cancel a visit or an outing.”
The experience of PND and what would be helpful is as unique as the individual woman herself. Although there can be a sense of embarrassment or shame about ‘not coping’ for some women, others are much more willing to accept practical help. Tara says, “what helped me the most was knowing that when I really needed help, somebody was there. Daily tasks were a battle – one of my biggest challenges was wandering around the house not knowing where to start so it was great having someone to share them with. I had some great friends who would drop everything and come over when I wasn’t coping at all and just needed somebody to be with me. They would watch my baby while I had a shower and make me a cuppa or they would mind her while I slept. Sometimes I didn’t feel like talking at all but having them there was comfort enough.”
While it is awful watching a friend suffer with depression, especially if she seems to be pushing you away, there are ways to show your support. Here are some suggestions from mums who have been there. Consider which steps you can take, start small and please don’t take it personally if your efforts don’t seem appreciated right now. Remember, Postnatal Depression is an illness that your friend has no control over, she will get better (as long as she has appropriate treatment) and she will remember that you were there for her, even if you can only do seemingly small things to help.
Listen: Don’t offer advice and don’t compare your own experience to your friend’s. She may feel worse if you start saying, “when I had my baby……” Tread gently, and be comfortable with silence if she doesn’t want to talk –she will find it difficult enough to make sense of her thoughts, without feeling judged.
Text: She may not feel like a visit, but a text will show her you are thinking of her. Don’t take it personally if she doesn’t text you back. She will when she is ready. Remember, Depression is so debilitating, that just getting out of bed can be a huge effort some days.
Drop off food: Drop off a meal, a favourite cake or some muffins and perhaps a lunchbox and an activity (stickers) for her toddler, if this isn’t her first baby. You can leave food in an eski on her doorstep and text when you drop it or ask her partner to pick up on his way home. If you drop a meal inside, don’t stay unless she is ok with that and don’t race around her home doing things – hang out a load of washing, offer to take her children outside and play with them or watch them while she has a sleep.
Take her child(ren): Offer to take her older child to an activity class/playgroup/ your place/a playground so she can have a break and the little one has some fun.
Take her out: Sunshine and a change of scenery can be great for lifting moods but make it simple, perhaps a short walk together, a visit to a nearby park or coffee at a local café. Offer a short outing that isn’t overwhelming or exhausting. Again, don’t take it personally if your friend opts out at the last minute. Her anxiety may have surfaced so let her know it’s ok if she can’t manage this time.
Be there: Don’t disappear, don’t give up on your friend and don’t feel offended if she gets angry with you. Depression is a cruel illness and recovery will take months and longer, but with treatment and support your friend will recover. And when she gets better, your friendship will be even stronger, because you have been there all along.
For support and information about perinatal depression in Australia, see PANDA (Perinatal Anxiety and Depression, Australia), helpline 1300 726 306 (Monday to Friday 9am to 7,30 pm AEST)
Pinky McKay is an Internationally Certified Lactation Consultant, mum of five and author of ‘Parenting by Heart’, 100 Ways to Calm the Crying, ‘Sleeping Like a Baby’ and Toddler Tactics (Penguin Random House). See Pinky’s books and recorded interviews with experts here.