Coping with post natal depression

Life in Balance: “How to cope with post natal depression”

The arrival of a new baby is usually a happy event but it can also be a stressful time during which many adjustments have to be made. Unfortunately, many women do not expect the mood changes that are common after childbirth. These can vary from mild to severe. Statistically, in the year after childbirth a woman is more likely to need psychiatric help than at any other time in her life.

Types of postnatal mood disorder

There are three recognised mood disorders in the period after birth:

At one end of the spectrum is ‘baby blues’, affecting about 80% of new mothers and occurring between the third and tenth day after birth. Symptoms often include tearfulness, anxiety, mood fluctuations and irritability. The ‘baby blues’ are transient and will usually pass after a few days. All that is needed is understanding and support.

At the other end of the spectrum is puerperal or postnatal psychosis. This affects about 1 in 500 mothers, usually in the first 3-4 weeks after delivery. Postnatal psychosis is a serious condition. The mother herself may be unaware she is ill as her grasp on reality is affected. Symptoms include severe mood disturbance (either marked elation or depression or fluctuations from one to the other), disturbance in thought processes, bizarre thoughts, insomnia and inappropriate responses to the baby.

There may be risk to the life of both mother and baby if the problem is not recognised and treated. While postnatal psychosis often requires hospitalisation, with appropriate treatment women suffering from this disorder usually have a full recovery.

Between the ‘baby-blues’ and psychosis lies post natal depression (PND). Most women find adjusting to life with a new baby very difficult, but 10-15% of women develop PND. Many women do not know that PND can occur unexpectedly after delivery and typically blame themselves, their partners or their baby for the way they feel. Some try hard to ‘snap out of it’ without understanding that women with PND have little control over the way they are feeling. It is very important for women to learn to recognise the signs and symptoms of PND so that they can ask for help as early as possible.

Symptoms of post natal depression

Sleep disturbance unrelated to baby’s sleep needs: most women with a young baby fall asleep as soon as they are able to. Women with PND often lie awake for hours feeling anxious while the baby sleeps. Some women have trouble falling asleep or wake early in the morning. These disturbances in sleeping patterns are often accompanied by bad dreams.

Appetite disturbance: women may feel totally uninterested in food and say. ‘I force myself to eat because I am breastfeeding, but I don’t taste anything’. Sometimes women overeat in an attempt to control their anxiety, or they forget to eat.

Crying: women may feel sad and cry without apparent reason. Tears come easily. They may cry watching news coverage of a plane crash. Some women say, ‘I want to cry but can’t. I am crying on the inside’.

Inability to cope: daily chores seem insurmountable. Women may feel like running away from it all.

Chronic exhaustion or hyperactivity.

Irritability: women with PND may snap at their partners without cause. Partners often say, ‘I can’t do anything right. If I fold nappies she complains I do it the wrong way. If I don’t help, I’m being unsupportive’.

Anxiety: women may feel a ‘knot in the tummy’ much of the time and panic without cause. Some women experience heart palpitations so severe that a heart attack is feared. They may be anxious about their own health or their baby’s, even after reassurance that nothing is wrong. Many women describe anxiety as their most obvious symptom and reject the term postnatal depression. They deny being ‘depressed’. The term ‘postnatal disorder’ might more accurately describe the way some women feel.

Negative obsessive or morbid thoughts: women may be afraid to let their partners go to work in case ‘he has a car accident’. They may be afraid to leave the baby with a friend in case something happens. They may feel like life has no meaning.

Fear of being alone: many women go out a lot because they are afraid of being alone at home.

Fear of social contact: some women don’t want to go out and may find being with groups of people overwhelming.

Memory difficulties and loss of concentration: women may forget what they want to say mid-sentence or be unable to concentrate on simple tasks.

Feeling guilty and inadequate: women may feel they are ‘bad mothers’ even when those around them comment on what a good job they are doing.

Loss of interest in sex.

Loss of confidence and self-esteem: women who enjoyed their jobs may panic at the thought of going back to it. They are no longer sure they are able to do it. Women who enjoyed entertaining may panic at the thought of visitors. They may feel unable to prepare a meal when they enjoyed doing so before the baby was born.

Feelings of self harm, harm to the baby or suicide: this may be fleeting or very detailed. It is important to assess the risk to the mother and her baby’s wellbeing, and to intervene if necessary.

Some women sum it all up by saying, ‘There is no joy in anything any more’.

The severity of the illness depends on the number of symptoms, their intensity and the extent to which they impair normal functioning.

Why does post natal depression happen?

In the hypothalamus, neuro-transmitters which control mood, interact with neuro-hormones that stimulate all the other hormones maintaining our systems and usually our emotional equilibrium. The hypothalamus receives constant internal input from various parts of the body and from the higher brain centres that have been exposed to external stimuli. The hypothalamus’s job is to balance it all out.

However if the system is overloaded the hypothalamus gets into a state of disequilibrium. That is why in addition to mood changes we also find sleep disturbances, changes in appetite and decreased sexual interest. The regulatory system can’t cope. This explains why stresses that a woman can cope with at other times, when exacerbated by these internal changes become too much.

Partners

Living with a woman suffering PND is difficult. Partners too need a lot of support. They often feel confused, lost and helpless. It is important that partners be included by the health professionals treating women with PND. Partners are much more supportive if they understand what the problem is and what they can do to help.

About The Author

Sharn Waldron is a psychotherapist and counsellor in private practice in Sawston, Cambridge.

Contact and appointments (£45 per session) for individuals, couples and families can be made by telephoning 01223 839867, via email sharn@sharn.go-plus.net or visit Sharn’s website www.sharnwaldron.co.uk

Or you can visit Sharn’s GoToSee profile page here


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