Archive for May, 2012
These questions are ‘borrowed’ from a fantastic blog I discovered called “Beyond Postpartum” and I would recommend it to anyone interested in reading further.
In many ways this story is a long time coming. I work in such professional circles in my job and my charity – and even in the Maternal Mental Health world I’m often quiet about my personal experiences because I am unsure whether another ‘Health Professional’ working in the field will judge me for having had a mental health illness.
Depression has so much of a stigma attached to it, but in my opinion, post-natal depression does especially because it doesn’t just address you as a person, but you as a mother. Depression might say to some that you are “unhinged” and “not-to-be-trusted”. The post-partum bit attached to it suggests to someone who doesn’t know better that perhaps you’re not safe with your own child let alone anyone else’s. I believe there is so much shame that a mother experiences when she does not live up to her ideal view of “what a mother should be” – but even more so when she suffers from post-natal depression.
Post-natal Depression is invariably suffered in silence. A mother is often afraid to share what’s really going on for her to other mothers lest she be judged, criticised, gossiped-about. In her own mind she is not meeting up to the ideal standards she has set for herself. Her shame forces her to wear a mask. By the times the cracks show it’s likely that things are getting pretty bad. I am so passionate about breaking down the stigma that surrounds post-natal depression so that mothers can break the silence and remove their masks without feeling condemned or judged but understood.
This story is not only to encourage mothers to break their silence as I am doing now, but to say that all first-time mothers experience an Adjustment that can be quite traumatic and with the right stressors and risk-factors in place, could well lead to post-natal depression. If you are struggling in your new identity as a mother, or you have struggled when you became a mother, then you are in good company. This is a safe place where the masks can come off. Please feel comfortable to add your comments or email your story to me.
Tell us about you- what was your adult life like prior to having a baby?
I started late having my baby – about 35 years of age. By that time I was well-educated, had worked as a health professional and in the business world for a number of years. I had spent my early 20’s travelling around the world and experiencing what kiwis like to term “The Big O.E.” I was very independent, knew who I was and what I wanted in life. I’d had a lot of adventures, but prior to getting married and having my baby I had settled down and picked up quite a bit of childcare work and nannying and so on, so I would have thought it would not have been so much of a shock to me when I had my baby.
I’d always wanted to be a mother. Always wanted to be married and have a family with at least two children. I adored children and by the time I was 35 I began to wonder if I’d have the opportunity to have a child and thought it would probably take me a long time to conceive so we “started trying ” for a baby the moment we were married thinking it would take ages. In fact, I was pregnant as soon as it was possible for me to fall pregnant after our honeymoon.
Tell us about your pregnancy…was it planned? Was it eventful or pretty standard?
On the day we arrived back from honeymoon, I was told that I was going to be made redundant and had one month to find another job. However, in that time I discovered I was pregnant and by the time my morning sickness had subsided by 13wks pregnant, at best all I could secure at the time was a bit of casual nanny work. This put a considerable strain on our finances. We had used up all our savings on the wedding, and my husband was a student at the time. Towards the end of my pregnancy he had got himself a fulltime job and given up his studies, but even then living on one-income and planning for a baby was difficult.
We were absolutely thrilled when we found out though. I still remember my hands shaking in shock and wonder and excitement and then going out for dinner to celebrate (after doing 4 pregnancy tests because I couldn’t quite believe it!) And when I discovered he was a boy, we decided on the name “Nathan” (gift from God) as he certainly was a gift and a blessing.
Our marriage, however, was fraught with tension and conflict. We argued about everything. By the time I was 6mths pregnant we had separated. By my 3rd trimester, my blood pressure was becoming high and I had a lot of fluid onboard which meant I felt very uncomfortable, and in hindsight despite the fact that I was not working a lot of the time and despite my personal education and experience and all the reading and ante-natal classes I had done, I was actually really quite anxious about what to expect. I think part of my anxiety was due to the uncertainty of my marriage relationship and how things would be either on my own or with my husband with ongoing conflict – and knowing that I had very little support elsewhere. Most of my family lived overseas and we were not close anyway. The only family living in my city was my mother and father and my husband’s mother and sister and I didn’t know if I could go to them for support, but thought it was unlikely that I would get much help – practical or otherwise.
You could virtually tick off everything on the list of risk-factors of post-natal depression. I had a traumatic birth (even now I find it very difficult to retell my experience), I had difficulty breastfeeding (it took me 6 weeks of training my son to suck and weaning him off a bottle while expressing), I had a history of a depressive episode due to previous relationship trouble, I had current relationship problems, I had little family support and while my little boy was still a baby (under the age of 1yo), my mother was diagnosed with cancer. She was treated with two types of very aggressive chemotherapy and the doctor’s were not sure she would survive it. With no other family around except for myself and my father, it was a very difficult time. I’m pleased to report that my mother fought cancer and survived her chemotherapy treatment and is now either in remission or cured – time will tell us.
I was induced for labour and had an epidural, an allergic reaction to the epidural (severe itching) followed by large doses of Phenergan so that I slept through the remaining hours of my labour and while I dilated to 10cm the cord was wrapped around my baby’s neck and he could not come down the birth canal and was getting very distressed, exposed to meconium etc. so I had an emergency c-section. The worst part was that I did not get to hold my son for at least an hour after his birth – that was really devastating to me, and the fact that I was heavily drugged and sedated for at least 4 days meant that I didn’t really have a good bond with him straight away. Due to a tongue-tie he could not breastfeed and his glucose levels dropped and there were concerns about that following birth not to mention how much of a failure I felt for not being able to breastfeed (the tongue tie was not picked up until day 5 in hospital). I had a suture line infection, cellulitis (infection in the tissues following the operation) and was heavily medicated for pain. Not long after being discharged home I developed mastitis and was admitted back to hospital. I was crying every single day particularly about not being able to breastfeed and Nathan screaming at the breast. On the one hand I had family urging me to breastfeed. On the other I had family wondering why I bothered and urged me to bottlefeed. There were so many problems and so much stress, I honestly felt I had not been able to simply enjoy my son and celebrate his birth and feel the joy of a long-awaited arrival. It took time for me to have that full sense of bonding and connection with Nathan.
You’ve dealt with postpartum depression. When did you first feel that something was not “right” with you?
After admitting to my midwife that I was crying every day for quite some time (particularly when breastfeeding), she told me that if I was still crying by day 7, she would suggest I see my GP. By day 7 I still felt like crying but I forced myself to stop. That’s when I had this irrational belief that if I made myself swallow the feelings that I would be okay – that I could prevent myself from having post-natal depression. It was an irrational thought and looking back it was partly denial, but partly the hormones that were raging at the time.
I did see the GP but I managed to convince her that I was okay and that I would try seeing a psychologist to see if that would help. So I saw the Psychologist a few times but I was so sleep-deprived and in survival mode and had to bring Nathan with me to appointments that I couldn’t clearly reflect on what was really happening for me.
Finally I saw a counsellor who convinced me to go back to the GP and tell her my symptoms. I knew that if I went she would put me on medication, but in the end the symptoms became so unbearable that I had to go. It was then that I admitted that I had post-natal depression. By that time my son was 9 months old and I had separated from my husband for the second time.
What symptoms did you experience and how did you deal with them?
I was extremely low – some days I felt so bleak like there was nothing good about the day or about life or about myself. I had very low energy to the point of exhaustion (and by 9mths my baby was sleeping through the night so it wasn’t sleep-deprivation causing it). I had anxiety so that there were days where I felt so overwhelmed that I literally believed I could not cope with caring for my son and I would phone up my husband in a panic and beg him to come home from work and he would get very upset at me and refuse – so I literally had to manage, I had no choice – there was no one to turn to for help. I was very irritable and angry. There were times where I would completely lose it and scream at my husband or overreact to a situation completely. I was very sensitive and felt easily hurt by things people said and did and usually had a very angry response. I felt like my emotions were all over the place and I couldn’t control them. With the conflict and negativity that was happening in my marriage, I had extremely low self-esteem and felt very self-loathing. Sometimes I wanted to die but thanks to Nathan, I knew that I never would consider doing anything about those thoughts and feelings. The little energy that I had I would pull together and use it being a good mother to Nathan. That was really hard, but it gave me a reason to live, a reason to get help, a reason to get better and looking back, I feel so proud of my devotion to him even when I was at my very lowest.
Time. Those early years of a young baby are the most difficult. Even without all the other stresses going on in my life, just being newly married, having a young baby, sleep-deprived, on one income, and adjusting to a new role and identity as a mother is enough to contend with. Adjustment happens with time. Adjustment to my new role as a mother, adjustment to living within the boundaries of one income, adjustment to having a baby dependent on me and sharing him with his dad. And with time, he has become less dependent on me and sleeps for longer periods of time so that I am able to meet more of my own needs including the need for sleep! In those early days, it feels like every day is the same and that day goes on forever and nothing is going to change. I loved my beautiful little newborn baby but it’s good to be on the other side of that!
Finding myself again. I have very little resources when it comes to family support and childcare options, but with the little resources I had, I found ways in which I might find time away from my son so that I could see to my own needs and rediscover my identity again. That included going back to work, using my strengths and abilities to help others and feeling good about what I achieve, attending some counselling and some personal-growth courses to work on some of the loss of self-esteem I had felt during that time. And a bit of medication. Once I found the right medication and the right dose of medication, within a few weeks I was starting to feel much better and more able to make the positive changes I needed to make.
Sometimes “Depression” can take away a bit of your mana. For me, going back to work in professional roles where others respected me and where I could see I was achieving and contributing a lot helped me to gain self-respect again.
Bonding with Nathan. It took a while to bond with him. I am so grateful for the midwives that popped him in my bed with me for a snuggle to help him to breastfeed. It was all that snuggling and sleeping near each other that brought the connection. Now, even though he drains my energy, he gives me so much joy and unconditional love that sometimes just cuddling up to him or resting my hand on his head while he’s sleeping is the cure to a difficult day. I try to enjoy the special moments we have when we laugh together and cuddle together and make them as frequent as possible.
Little things. Adequate sleep, doing something I enjoyed (coffee, a book, sitting in the sun, going for a swim or a walk, going to a movie). Getting out and about even though many days all I wanted to do was stay at home and hide.
Who did you talk to?
It’s worth noting that essentially I had post-natal depression for 9 months before I admitted it and got help so throughout that time, no one knew or understood or supported me besides the little bit of help I got from my GP or counsellor. After seeing the GP and being formally diagnosed, I didn’t tell many people I had post-natal depression. In the beginning, the only people who knew were my husband and my mother. As time went by, I told a few more family members. I told only two people from coffee-group – the two that I had felt most close to. At the same time, I also told them I had separated from my husband (I had been keeping that from people too as I just didn’t want to deal with being the only single mother in my coffee group and wanted to pretend I was just like everyone else). The two I told seemed very uncomfortable when I told them, and there was definitely an awkwardness. They murmured “that’s terrible” and that was the end of it. I did share the news with a couple of other friends, and it was a relief to be able to be honest with them since they’d had their own experience with depression. But overall, the response was pretty inadequate and didn’t result in much understanding or practical help or a huge amount of support from those who knew of my circumstance. I believe that most people don’t understand what you are going through and don’t know what to say or do that would be helpful.
What would you have liked to have had?
Health professionals being more active in getting me help and information. Getting help sooner (going to the GP sooner and telling her my symptoms and being diagnosed earlier so that I could look at treatment). Having a counsellor that was more effective – the best thing my counsellor did was to strongly suggest I see a GP to discuss my symptoms. Having people to talk to regularly who genuinely understood how I felt – that I could be honest and real with. Having regular practical help so that I didn’t feel so overwhelmed with my role as mother and housekeeper. And being informed of help and resources that were out there. During my pregnancy, being a health-professional with a previous depressive episode, I knew that I was at-risk of PND but despite my requesting help and resources from my midwife, she did nothing and because I didn’t know where else to go for help, inevitably I developed post-natal depression.
Perhaps I would have developed PND anyway, but I believe if I had adequate help and support from the very beginning – access to information, resources, practical support and so on – it’s possible it could have been prevented, or at the very least, treated earlier on and more effectively so that it did not rob me of some of the joy of those early months with Nathan – and it may not have had such a detrimental affect on my marriage.
It’s this experience that has motivated me to start Mothers Helpers. Because I have worked in the Health and Education fields and because I have experienced this personally, I recognize the gaps that are there and what might help. It is a personal passion that information, resources, practical and emotional support is made available to a mother who is struggling and at-risk.