Postnatal depression – what is this beast and what can you do to help?

Becoming a mother is a time of intense, overwhelming joy, right? Where every new mum is perfectly groomed, perfectly poised, smiling, and happy, happy, happy?

I remember sitting with my eight-week-old baby in my rocking chair, rocking back and forth, wishing, hoping and praying he would just go to sleep. I was exhausted beyond anything I could ever have imagined. I was most definitely not joyful, well groomed, poised or smiling. I was sad, scared, exhausted, wearing tracksuit pants and crying. He was my first baby. I was a capable, intelligent woman – a psychologist, no less, who was usually in control and on top of her game. So why was I so sad and scared? This sense of shame added to my feelings of hopelessness.

This continued until he was about five months old. I didn’t feel this way every single day, but I felt it on more days than I didn’t. Then something clicked. Perhaps what I was experiencing was beyond the usual adjustment difficulties that come with a new baby. Perhaps I needed to admit I was struggling and seek help. So I did.

I was diagnosed with post-natal depression, often abbreviated to PND. I’m not going to say it was easy, but I recovered. Support, medication, awareness – they all helped. I began to actually see the sunshine through the clouds. And most importantly, I began enjoying my baby on more days than I didn’t. He is now an amazing, thoughtful, caring, intelligent seven-year-old boy who I love more than life itself. And he has a sister – a cheeky, energetic, intelligent, empathic four-year-old rainbow. I had a recurrence of PND after her birth. But I was prepared – I knew the signs and what I had to do. I recovered much quicker and had mechanisms in place to minimise my relapse.

I am still a psychologist, and I work in private practice, with a special interest in helping people adjust to life transitions, especially the transition to parenthood. Difficulties in transitioning to parenthood can include antenatal depression, anxiety, and of course, PND.

What is this beast we call PND? For 15-20% of women, it’s a beast that invades their minds, their emotions, their thoughts, their behaviour, their family and their community. PND can mean different things to different mums, but it usually includes feelings of depression, anxiety, sadness and difficulty coping, that last for more than two weeks. These feelings appear either suddenly or gradually, within the first twelve months after having a baby.

So how do you know you’re dealing with PND? Some of the features include:

• Sleep disturbance unrelated to your baby’s sleep – wanting to sleep all the time, or not being able to sleep
• Appetite disturbance – wanting to eat all the time, or not being able to
• Persistent crying, often for no reason
• Feeling unable to cope
• Irritability
• Anxiety
• Negative obsessive thoughts
• Fear of being alone
• Concentration difficulties.

These should persist, on more days than not, for two weeks.

So what should you do?

As a mum, I can tell you what worked for me, and I recommend all mums do, even if they’re not experiencing symptoms as severe as PND:

• support, support, support. Get a good support network of like-minded mums around you. Check with your local council for a mothers’ group, or find out where your local playgroup meets. Go there, even though it will feel like the last thing you want to actually do. Go. You will feel better.
• see your GP. GPs are trained to assess PND and will know where to refer you for treatment. Form a relationship with your GP as they can also be a strong source of social support. If your GP isn’t supportive enough, find one who is.
• visit your local Maternal and Child Health Nurse. Again, they can be a strong source of social support and will know of local groups and activities in your area that could be helpful for you.
• get out of the house and be around other people. You don’t even need to be interacting with them, just be around them. Local libraries were great for that.
• try and be kind to yourself. Book a massage, get your nails done. Do something just for you each week.
• tell people how they can help. Most people want to help you, but they don’t understand what’s wrong or don’t know how to help – telling them will help you and them. If someone asks how they can help, don’t pretend you can do it all on your own. Accept their offers of help and get them doing tasks that you can’t manage – cooking a meal, doing your washing, getting your groceries.

As a psychologist, I can tell you what works for recovery from PND:

• consider medication. Your GP will be able to discuss your options with you. If you take medication, it doesn’t mean you’ll be on it for the rest of your life. Anti-depressant medication is not “addictive” either, as is often thought, so when you’ve recovered and you can cease your medication, you can do so quite easily under medical supervision.
• get therapy. There are biological, psychological and social factors to PND. Psychological factors can include personality type, perceptions and expectations of motherhood, perfectionism, unresolved trauma and others. Working with a skilled psychologist can help address these factors while the medication is also doing its thing. It is also a great source of support during the tough days.

I can’t promise you it will be easy, but I can promise you motherhood will be totally worth it. Big hugs to you, mamas. You’re doing the best you can. If you need help to do even better, consider seeing your GP and a psychologist.

Melissa is a mum of two, a supervising psychologist and a survivor of PND. She has her own psychology practice in Armadale, Melbourne. This post is dedicated to those mums who were there with me, every Friday morning, from when our oldest babes were 6 weeks old – Bek, Kate, Jacqui, Kirsten, Loo, and whom I still consider my dearest, dearest friends.

PANDA National Helpline (Mon to Sat, 9am – 7.30pm AEST/AEDT) Call 1300 726 306