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Post Natal Depression: An in-depth look

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Post Natal Depression: An in-depth look will give you the insights you need to recognise and deal with Post Natal Depression (PND), also known as Postpartum Depression

There is a wonderful book on post natal depression (PND) called When your blessings don’t count by Linda Lewis. The first time I heard the title I was blown away by the power of this phrase. It is such a true description of how one feels when you have PND.

When you have a baby,  everyone tells you how blessed you are and what a blessing this new life will be. Every depiction in the media of a new mom and her baby paints a rosy picture of love and contentment. But what happens when your blessings don’t count? When you can’t see the rosy picture? And when you feel so anxious about this new life that you can hardly enjoy the simple moments of caring for your baby?

Post Natal Depression: An in-depth look

If this sounds familiar, you may well be suffering from baby blues or postnatal depression. Another less commonly used, but I believe better term for PND is “postnatal distress.” The word distress is a better descriptor for PND because not everyone who has PND experiences depression. Many moms experience symptoms of anxiety, fear and overwhelm rather than sadness and despair.

What’s important to remember that no matter what you are feeling – you are not alone. As many as 30% of moms experience some form of postnatal distress, which encompasses a wide range of conditions, from baby blues to postnatal psychosis.

  • Baby blues are very mild and short lived. They are usually limited to the first few days after delivery and are strongly influenced by hormonal shifts. You may feel overwhelmed, sad, dependent and vulnerable. You may have difficulty sleeping and experience high levels of anxiety. However these feelings do not linger and within a week or two, you love being a mom and look back on the feelings as opposed to having them linger.
  • On the opposite end of the continuum is Postnatal Psychosis. This is the most severe form of post natal depression. It is rare but exceptionally dangerous as the mom poses a risk to herself and/or her baby. Often the mom is out of touch with the severity of her symptoms. She may hallucinate or have episodes of mania. Psychosis is reason for admission to hospital. If you suspect a loved one is suffering with Postnatal psychosis, you should seek medical attention immediately. 
  • Post natal depression, which is somewhere in the middle of the range, is experienced differently by each person. Some moms feel very sad and have no energy or will to engage with their babies. Others are so anxious that they don’t interact with their little ones out of fear of harming them. Many moms feel angry, particularly towards their partners and may resent the world for going on while they are trapped in a tunnel with no light at the end of it.

No matter what your experience of postnatal  distress is, you should chat it through with someone you trust and preferably, a trained healthcare professional.

My experience with post natal distress 

After the birth of my first baby, I experienced baby blues for a short period. It would raise its ugly head each evening at about the same time. I would feel myself being sucked into a dark tunnel, feeling utter dread for the night ahead. I was unable to even think about the next day and how I would cope.

My saving grace was my mom, who would talk me through it. She would reassure me that all I had to do was take it one step at a time. I would tell her as it was starting and she would help me fall asleep by massaging my feet. Having someone sit with me while I felt so desolate was a great help.

The effects of PND

PND affects not only your ability to carry out daily tasks such as planning meals, getting yourself dressed and caring for your baby. It also affects the way you interact with your partner and engage with your baby. Many women feel angry towards their partners – it feels unfair that he can escape the responsibility of this new life. Of course this is not a logical feeling or thought but then not much is logical when you feel this distressed. In addition, PND can impact on your interaction with your baby. It may prevent you from spontaneously engaging, making eye contact and responding to your baby’s little coo’s. On an emotional level, this can have a negative impact on your baby if it continues for any length of time.

It is these two effects of PND that pose a great risk to your future. Risking your relationship with your partner and not connecting with your new baby can have devastating long-term consequences. It is for this reason that you should seek help as soon as possible.

What to do

If you think you may have PND the first step is to find out if you do. There are organisations all over the world that can help new moms determine if they are suffering with PND. In South Africa, there is PNDSA (Post Natal Depression Support Association) – they have an amazing website where you can take an online test to see if you have PND. In the US & UK, you can find a number of online quizzes, including this one from Patient.info.  Or this one from the NHS.  This would be the first step in the right direction. From there, you can find the right intervention to help you manage your PND.

If you do have PND, there are a variety of options for treatment:

  • Your GP or gynae would be a good place to start. They may prescribe medication or refer you to someone to prescribe medication or counsel you. You will be prescribed an anti-depressant that can be used whilst breastfeeding.
  • Support groups are a wonderful way to manage PND. Not only do you have the opportunity to talk through your feelings and fears but in addition, you will find comfort in simply knowing that you are not alone.
  • Private counseling is also a great option. It allows you to explore reasons for your feelings and heal by talking it through with a professional.
  • There are also over the counter natural medications that can make a difference, especially if you have baby blues. But if your symptoms are more severe it is preferable to use stronger, more effective medication.

PND & your family

When one part of a family is hurting or damaged, it may be hard to see the effects on the others. New research highlights the effect of PND on men and we are starting to acknowledge that dads may suffer from PND too. After all, becoming a parent is a life changing event and men too grapple with the weight of responsibility that comes with caring for a baby. 

So to all the mom and dads reading this, if you suspect baby blues or more severe forms of PND – seek help. PND is not something to be ashamed of – it’s far more prevalent than you might think and it is 100% curable with the right treatment. 

Ref: Faure M & Richardson A, Baby Sense 2010 Metz Press & Lewis L, When your blessings don’t count 2011 Metz Press

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