I was incredibly stressed and I knew something was very wrong but I thought, I am a mum, I should be able to cope,” says Sandy, a Melbourne mother of two who was diagnosed with postnatal depression when her first baby (now three) was three months old.
Sandy’s bubble of pretence burst when, after a few days in a mother baby unit, she was told it was time to go home. “I couldn’t hide my feelings any longer. I bawled and bawled. I knew I couldn’t manage at home. It wasn’t about my baby not sleeping (the ‘reason’ I was in the Mother Baby Unit), I couldn’t sleep, I was anxious and I had no support.”
Evidence suggests that as many as one in 7 new mums and 1 in 20 new fathers are diagnosed with postnatal depression each year in Australia – based on 2012 birth rates, this means that around 14,000 new dads and 45,500 new mums are experiencing the devastating effects of postnatal depression.
Mood disorders such as depression and anxiety can present during pregnancy or after birth and may develop quite suddenly or more gradually over several months: The passing ‘baby blues’, where you are weepy for no apparent reason in the days following the birth (typically between the third and fifth day after delivery), affect up to 80 per cent of women. About 15 per cent of women and 5 percent of men develop moderate to severe postnatal depression, requiring medical treatment.
At the other end of the spectrum from the ‘baby blues’ is post partum psychosis, a severe psychiatric disorder that affects only two or three in 1000 women; symptoms include delusions and manic behaviour, and help should be sought urgently. Although this is not common, women who do experience post partum psychosis usually become ill within days of their baby’s birth so are likely to be either in hospital or at home with somebody present who can get appropriate care very quickly (Call your GP or the hospital where your baby was born for referrals). And, although it is frightening for family members to see a new mum ‘unravelling’, sufferers will recover with prompt and effective treatment.
Symptoms of postnatal depression may 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.
For men, symptoms can also include anger, loss of libido, engaging in risk taking behaviour, increased hours at work as part of withdrawal from family and increased use of drugs or alcohol instead of seeing treatment for depression.
Postnatal depression – just like any form of depression – is a serious condition that can have a devastating effect on the whole family –partners, children and worried grandparents – as well as the person who is unwell. Yet the condition is not widely acknowledged or understood in the community: the pressure on women to be ‘good mothers’ discourages them from seeking help and women in the clutches of depression have been told to ‘snap out of it’ or ‘pull yourself together.’ Partners are often given well-meant but inappropriate advice such as, ‘Take her out to dinner.’
Post and antenatal depression are not biological (hormonal) conditions only. In fact, they are more likely to be the product of a range of interrelated biochemical, psychological and social factors including a lack of social and emotional support; stress and changing relationships (particularly the couple relationship); social isolation, lack of sleep; a difficult pregnancy or birth experience; worries about extra responsibilities, financial stress and managing the stress of work. A previous history of depression or a family history of mental or emotional illness can also be a risk factor for developing postnatal depression.
For fathers, norms and attitudes around masculinity and being a dad can also play a part in the adjustment to fatherhood: according to PANDA, men are less likely to talk about how they feel and maintaining that they are coping is very important. Men can feel excluded from the parenting role or their relationship with their partner: Richard, father of a one year old says, “people would say, you must be so happy.” Part of me was saying, “I should be happy, I am a father,” but our lives changed so dramatically, that we were tired and stressed for weeks and months. There was a lot of getting used to the changes in the relationship with my partner. One day I was the centre of attention and the next day I wasn’t. There were times when I was very tired and stressed and wondered what was going on. I would wonder, does this mean there is anything wrong with me, or with me as a father?”
Dr Kathleen Kendall-Tackett, author of ‘The Hidden Feelings of Motherhood’ describes depression as ‘an illness that affects your mind and body and that both your mind and body contribute to depression.’ For instance, a chemical imbalance in our brains can influence our emotions and on the other hand, our thoughts, experiences and behaviour can affect the biochemistry of our brains.
The ‘upside’ of this is that we can make conscious choices to create and support a healthy biochemistry, such as making dietary changes and exercising daily – carbohydrates and exercise can increase levels of serotonin, a calming chemical and a US study at the University of Arizona Medical School (Freeman 2006), showed that increasing the intake of DHA (an essential fatty acid found abundantly in dark fleshed fish such as salmon and tuna) reduced symptoms of postnatal depression in women who had already been diagnosed with the condition. Also, because looking at events negatively can elicit the release of cortisol (a stress hormone), that can increase your susceptibility to depression, it can help to implement some stress management techniques such as meditation, as well as trying to maintain a positive outlook.
The good news about PND is that it is treatable. And, the sooner you get help, the more quickly you will recover. There is a range of treatments, from psychological therapies to medication – and yes, there are safe medications for women who are breastfeeding (to check medication safety while breastfeeding call Rodney Whyte at Monash Medical Centre Pharmacy helpline (03) 9594 2361).
As Sandy says, “if things don’t feel right, don’t try and be a superwoman, get help. It’s a huge relief to know you have an illness – and it is easy to fix. Treating Postnatal Depression is a quality of life issue for your whole family.”
PANDA (the Post and Antenatal Depression Association) is a not for profit, specialist national organisation that raises community awareness of depression and anxiety during pregnancy and after birth (perinatal period); and provides counselling, handouts and support services to families to assist in their recovery.
PANDA also have a ‘brother’ site – How Is dad Going? for Dads whose lives have been affected by postnatal depression.