The mother and baby on the front of this typical Mother and Baby magazine typifies what we all expect and hope for when we have a baby: a happy, smiley relationship. The magazine itself was given out at the maternity hospital, reinforcing the message that having a baby is a joyous time. But sadly, for many mothers, having a baby can be a desperate time, a time of high anxiety, low mood and great distress. At its worst, mothers can lose the will to live; at best, families are robbed of happy family relationships. One in five families are affected by mental health problems around childbirth.
Although postnatal depression is the most widely known illness, there is as much depression during pregnancy as postnatally. Anxiety is also very common, not just worry about the new baby, which is quite normal, but crippling anxiety that saps confidence, interrupts sleep, affects appetite and prevents enjoyment in life. As with all illnesses, the symptoms of antenatal and postnatal depression can be anywhere on the spectrum from mild to severe. But unlike physical health, mental health is accompanied by a dreadful stigma associated with blame rather than sympathy.
Also, just as we are understanding that illnesses such as cancer are not all identical, we are understanding more about postnatal depression, its causes, and treatments.
There are three main types of postnatal depression.
The first is depression that people who have a history of depression may experience at any time in their life and for them, it is no different from their usual symptoms, except for its timing and the additional pressures of caring for a baby. People who have episodes of depression from time to time may have others in their family who suffer from depression and so have a genetic vulnerability to it, in the same way that other illnesses run in families, such as asthma or breast cancer. Also, in the same way, the illness may be made worse, if not triggered, by stress.
For some women, their experience of depression may be circumstantial, related to their lack of job status, fatigue, social isolation, boredom or relationship stress. So for these women, depression may only be experienced with their first baby, as life will be very different when they have their next child.
Finally, there is a type of depression that some women have only around the time that they have a baby, because it is triggered by the birth. This can come completely out of the blue to women who never experienced depression before and they may never experience depression again, perhaps until they have their next baby. It can be a mild illness, but it can also be severe and require a hospital admission.
Whilst dads too can have depression at any time in their lives, including after they have had a baby, they will obviously not experience depression triggered by the act of giving birth.
Treatment for depression falls into three main categories: medical treatments given by your GP or a hospital doctor, psychological or talking treatments that might be delivered by a psychologist or mental health worker, and support that a wide range of people can provide.
Medical treatments include medication provided by GPs and antidepressants are the most commonly prescribed medication. They are used to treat the clinical symptoms of depression, which are difficulties with sleep, particularly early morning waking, poor appetite and lack of enjoyment. Postnatal depression symptoms commonly include heightened anxiety with intrusive thoughts that won’t go away and antidepressants also treat these symptoms. Antidepressants are not addictive but they take four to five weeks to kick in and sometimes people need to try more than one antidepressant before they find one that works.
Where the symptoms are mild to moderate, psychological (talking) treatment will generally be a better option. Whilst most people know that they can see their GP to discuss their symptoms and if they need a prescription, less well known is that people can refer themselves to the mental health workers based at their GP practices for psychological treatments. There are a range of different treatments on offer and an initial assessment will advise which treatment will be most suitable.
Last but by no means least, is support. Any support is valuable; whether from a partner, relative, friend or neighbour. These days families are often miles apart from each other or working but there are a number of local and national charities that provide good support to families, including Light, Homestart, Forging Families, PND Hour, Post Natal Illness.
Postnatal depression can be a most dreadful illness. The stigma of mental illness is huge and the outcomes of untreated postnatal depression can be very serious. But there are effective treatments, there is good support out there and all mums will get better. The most important thing is to tell someone and accept all the help and support that is offered.
Light is a charity, set up by three Sheffield mums who wanted to support families struggling with their mental health around the time of having a baby. The mums chose the name because they wanted others who were suffering to know that they would get better, that there is Light at the end of the tunnel.
Light offers peer support from trained and vetted volunteers, most of whom are mums who have experienced mental health problems themselves. The volunteers provide support in groups run at Children’s Centres, by telephone, text and email and by meeting them one to one. For more information about Light and all the services we offer please visit www.lightsheffield.org.uk
Jan Cubison – Trustee, Light Sheffield
Postnatal Depression in mums and dads originally appeared in issue 171 of LINK magazine.
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