When it all becomes too much

Postnatal depression affects one in seven new mums. If you're one of them, don't suffer in silence

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It was a sunny Tuesday morning when Heather was awoken by the sound of her 4-month-old baby babbling in his crib. It was well past feeding time and Heather knew Thomas must be hungry, but instead of getting up and preparing his bottle, she rolled over and buried her head in the pillow, letting out a long, silent scream.

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‘I just didn’t want to get up,’ recalls Heather. ‘In fact, if I’m honest, I just didn’t want to exist. What was the point? I felt I was a useless mum to Tom and he’d be better off without me. Everything in my life seemed so bleak and meaningless. But I didn’t even have the energy to cry. I was at my lowest ebb.’

As Heather later discovered, she was in the grips of postnatal depression (PND), a condition that affects nearly one in seven new mums in the UK. It can touch anyone, regardless of their background, and doctors can’t predict exactly who will develop it – celebrity mums including Brooke Shields, Suzanne Shaw and Gail Porter have all admitted to struggling with the condition. The good news is, with the right support and treatment, nearly all sufferers will fully recover.

Heather, who works as a healthcare professional, is all too aware of PND. But she initially wrote off her symptoms as just baby blues – the emotional low that many women experience shortly after giving birth. It’s a perfectly normal and healthy part of the transition into motherhood, affecting about 80% of new mums, and usually vanishes within a week. However, 15% of new mums will go on to develop PND, which can appear up to a year after giving birth.

Symptoms of PND include overeating or loss of appetite, constant tiredness and a lack of interest in your appearance. A baby will change you, but new mums who change dramatically may have PND.

A lot of publicity is given to the extreme form of PND, called pueperal psychosis. Symptoms include hallucinations and irrational thoughts, and most sufferers need psychiatric treatment. But this affects only 1% of mums.

For sufferers to recognise they have PND is the hardest but most important step to recovery. Heather now admits, ‘Even when I knew there was something wrong, I couldn’t admit it – it made me feel like a complete and utter failure. Tom was such a wanted child and I love him so dearly, yet I was barely able to function as a human being, let alone as a mother.’

Jacqueline Dunkley-Bent, consultant midwife of public health at Guy’s and St Thomas’ NHS Foundation Trust, says, ‘Most just try to get on with it and don’t like to
admit they’re depressed.’ As a recent survey for BBC1’s Real Story discovered, nearly half of all mums with PND lie to their health visitor about how they’re feeling. This is because they worry people will think they’re a bad mother, or social services will be called and their child taken away. But health visitors are there to help and offer support to vulnerable new mums, and as Jacqueline stresses, ‘It isn’t the mum’s fault.’

Many GPs and health visitors ask new mums to fill out the Edinburgh Postnatal Depression scale. The respondent underlines one of four possible answers to 10 statements that best describes her feelings. It’s a useful tool in assessing PND, but it must be answered honestly. A partner or friend may actually be a better judge of whether a new mum needs support. They will know her better than anyone and will notice if she’s not acting normally.

In Heather’s case, it was her husband Rob who recognised her symptoms as PND. ‘Heather’s such an upbeat, positive person, a real bundle of energy,’ he says. ‘Yet, here was this panic-stricken, hollow-eyed creature who couldn’t even eat.’

Why some women suffer while others don’t is a subject of much medical debate. There’s no conclusive research, though several contributing factors have now been identified. Dr Michael Killoran Ross, manager for a child health project called Starting Well, says, ‘Suffering from depression in the past is the single biggest predictor for PND.’ Other causes include a traumatic delivery, or a stressful life experience such as splitting up with your partner or moving home. Hormone levels can fluctuate dramatically, but Dr Killoran Ross asserts, ‘There is no clear evidence of hormonal changes predicting PND.’

Whatever the cause, PND requires treatment, so if you suspect you have it, tell a healthcare professional. You’ll probably be referred to a counsellor. Their objective, professional support can be beneficial. Equally, confiding in friends and family can help. There are support organisations too, and some mums find it helps to share their experiences with other sufferers through chat rooms on the internet.

You may be prescribed antidepressants or tranquilisers, which balance the brain’s mood-altering chemicals. But antidepressants can take up to four weeks to work. Also, tell your GP if you’re breastfeeding as certain types of medication aren’t suitable.

Finally, cognitive behavioural therapy can be offered in conjunction with drugs and counselling. This looks at the effect of negative thoughts, and finds new ways to deal with them.

Heather’s PND was treated with antidepressants and weekly counselling
sessions. ‘Within a few months the black cloud had lifted,’ says Heather. ‘The drugs
helped me regain my balanced outlook, while talking to someone about my anxieties made me realise I wasn’t going mad.’

So what does the future hold for those who are suffering from PND? ‘You can
move on from it entirely,’ promises Dr Killoran Ross. New mums are never alone and there are lots of women who’ve had PND and are now enjoying life as a parent to the full.

NATURAL MOOD BOOSTERS

  • Go outside or sit in a well-lit room. Light stimulates the brain
    to produce serotonin, a hormone that makes you happy.
  • Exercise for 30 minutes a day. This helps produce serotonin.
  • Avoid stimulants like caffeine and alcohol as these affect mood, and eat little and often to keep your blood sugar levels stable.

Parenting consultant Debbie Lewis on how new mums can beat the blues

  • Having a new baby is a massive life change. If you’re feeling upset or worried, tell someone about it. Talk to your partner, good friend, or a professional. Don’t be afraid to ask for help if you need it.
  • Make sure you take it easy on yourself over the coming months. Be realistic about what you can achieve and take all the practical help you’re offered.
  • Remember, you don’t have to be supermum. Being perfect isn’t realistic – it is okay to make mistakes.
  • Make time to have fun and enjoy yourself, even if it is just a quick bath by yourself with a magazine.
  • Celebrate what is going well in your life, even if it’s a small issue like making it out of the house by 10am.

What real mums say…

‘I used to dread my husband going to work – it was the thought of being on my own with Isobel. It wasn’t because she was difficult. In fact, I couldn’t have had a better child. It was this feeling of not being in control. I became completely obsessed by her routine, and if anything was five minutes out, I couldn’t cope.’
Emma McAllistar, has a daughter, Isobel, 2

‘I’m a very open person, but suddenly I found myself clamming up. How could I explain my life was falling to pieces and I was a wreck, constantly crying and shaking? I felt so ungrateful. I’d been blessed with the most beautiful baby. Why wasn’t I happy?’
Laura Davies, has one child, Orion, 10 months

‘It was only when my partner Justin kissed me and said, “That’s the first time I’ve seen you laugh in months,” that I realised he was right. I’d been so depressed I’d barely smiled. It felt so good to feel positive again.’
Mandy Oliver, has two daughters, Jessica, 3, and Becky, 8 months

Support organisations

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  • APNI (Association For Post-Natal Illness). Go to www.apni.org or
    call 0207 386 0868.
  • MAMA (Meet A Mum Association). Visit www.mama.co.uk or call 0845 120 3746.
  • NCT (National Childbirth Trust). See www.nctpregnancyandbaby
    care.com or call 0870 444 8707.
  • Look out for web forums where you can log on and chat to other sufferers, such as www.pni.org.uk.

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