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Monday, 14 May 2018

Everything you need to know about postnatal depression

Postnatal depression crying baby stressed mum
The safe arrival of a new baby is always something to celebrate but, for many women, the birth of a child can be bittersweet.

In UK, around 10-15% of new mums will suffer from postnatal depression (PND), which is often accompanied by anxiety. Characterised by persistent low mood, along with the other classic symptoms of depression, PND can be anywhere on the spectrum from mild to severe and emerges within the first twelve months of giving birth.

This week-by-week pregnancy guide shows you how your baby develops
Certain mums are at higher risk than others – particularly those who've suffered a mental health condition in the past, have been through a traumatic pregnancy or birth, or lack an adequate support network. However, the condition can affect anyone regardless of background.

Dr Raja Gangopadhyay, a consultant obstetrician with a special interest in perinatal mental health, points out that while some anxiety and stress after childbirth is quite expected, it's important to watch out this doesn't spiral.

"If the symptoms are persistent and not getting better, it is always best to seek professional help to rule out PND. And there are certain cases in which the seeking help shouldn't be delayed at all – for example if the mother has any suicidal thoughts or thoughts of harming the baby."

The journey to recovery
Laura Clark, who runs the Butterfly Mother blog for PND sufferers, began to feel low shortly after her son was born. Having undergone a traumatic caesarian section, she experienced anxiety from the outset, which gradually grew in severity.

Following a bout of severe insomnia around eight weeks postpartum, she sought help from her health visitor, who referred her to her local Perinatal Emotional Wellbeing Service (PEWS). This was just the beginning of a long – but ultimately successful – journey towards recovery. As she explains:

"I started seeing one of the mental health nurses from the PEWS service, and they provided interim support while I waited to be referred to therapy. Eventually I managed to access a service on the NHS and qualified for eight sessions with them. I also started on some medication – initially they gave me some sleeping tablets and some anti-anxiety medication, and then some antidepressants, which I took in the longer term. Very slowly I started to recover."
Mother holding baby looking out the window sad
Don't give up on seeking treatmentLaura's own experiences in seeking help were quite mixed. Early in her illness, she encountered one particularly dismissive GP, and many of her blog readers have stories of postcode lotteries and long waiting lists. However, she feels strongly that persistence is key, and that no mum who's struggling should have to suffer alone.

"I would definitely say, seek help as soon as you realise there's a problem, even if your symptoms don't seem like traditional depression symptoms. And in the same vein, don't give up – keep trying until you get the support and treatment you need."


According to Dr Gangopadhyay, some new mums are deterred from seeking help because they are concerned social services might get involved.

"One of the reasons why mothers do not disclose their symptoms is that they fear the baby might be removed. But the whole focus of treatment is that the baby should stay with the mother, so this should not be a worry."

Donna Collins, managing director of PND charity PANDAS, adds that honesty and openness is always the best strategy. She believes that anyone who's struggling should see their GP, health visitor or midwife as soon as possible.

"There is no shame, and it is very unlikely that you could say something that the healthcare professional has not heard before – the more they understand, the better and more tailored their support will be. There are also helplines, and support groups that you can drop into in person. Or you can join an online support group supported by a reputable provider such as PANDAS, Mind and APP."
New born baby
Peer support is crucialLaura Clark now helps run Lotus Petal Family Support, an organisation providing peer support groups in South East Essex. She feels that, while peer support is unlikely to be a sufficient treatment in its own right, it can provide a useful resource for those who are waiting to see a professional.

In particular, it can mitigate some of the loneliness that often accompanies PND. According to a new study by the Co-op and British Red Cross, becoming a mum can be as lonely as going through a divorce or bereavement. And this feeling, perhaps, is compounded by our culture's emphasis on the happy side of motherhood.

As Laura puts it: "You go to baby groups and there's other mums with their children and they look so happy and relaxed. You feel like you're incredibly alone and you're not – it's incredibly common."

Donna Collins adds that the woman's family and friends can play an important role during the recovery process.

"Her family may have noticed that she is not herself, but couldn't put their finger on what was different. So their understanding and help is invaluable to her, giving her the confidence to reach out to the professionals."

A complete recovery is possible
The most important thing to bear in mind is that PND is fully treatable. Laura Clark says this is the one thing she wished she had realised during her lowest ebbs – that the anxiety, hopelessness and depression would not last forever.

"Your absolute worst fear is that you'll never recover. So if someone had been able to rub a crystal ball and show me how happy I would be now, that would have made me feel a lot better."

Dr Gangopadhyay adds that there is no need for stigma or blame; PND is simply a health condition rather than a sign of failure.

"Many times, mothers feel it is their fault or a sign they cannot cope as a parent. This is not true – it is an illness like any other that needs treatment and support. With treatment full recovery is possible."

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