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Post Natal Depression INTRODUCTION:
 Post-Natal Depression (now often referred to as 'PND') means becoming depressed after having a baby. Sometimes this is easy to explain - the baby is unwanted or abnormal.
Mostly, though, the depression makes no obvious sense: 'I was so looking forward to having this baby, and now I feel utterly miserable. What's the matter with me?' 'The labour went beautifully - much better than I expected, and everyone's been marvellous, especially Jim. So why aren't I over the moon?' 'I was so afraid there'd be something wrong with her, but she's perfect. So why aren't I enjoying her? Perhaps I'm not cut out to be a mother?'
These women are not ungrateful or unmotherly: they are experiencing one of the most common complications of childbirth, from which too many women still suffer unnecessarily in silence - Post-Natal Depression.
HOW COMMON IS IT?
Very! Again and again it has been found that no less than one in ten women suffer depression after childbirth. This blight on the experience of motherhood is therefore one of the most common illnesses following childbearing. It can go on for months, or even years, yet if treated soon enough it can be nipped in the bud.
SYMPTOMS
Depression
This is the most common symptom of PND. It means feeling low, unhappy and wretched for much or all of the time. Sometimes the depression is worse at particular times of the day, like mornings or evenings. Sometimes there are good days and bad - which are the more disappointing because the previous good day raised hopes of getting better.
Sometimes it can seem that life is not worth living, at a time when it should be at its most joyous.
Irritability
Often accompanies the depression. It can be shown towards any other children, and occasionally the baby, but most of all the partner, who may well wonder what on earth is wrong!
Fatigue
All new mothers get pretty weary, but the depressed mother is so utterly exhausted that she may think that there is something physically wrong with her.
Sleeplessness
However, when at last she gets to bed she may find that she cannot fall asleep - or if she does, that she wakes early, even if her partner is feeding the baby that night.
Loss of appetite
Depressed mothers usually haven't the time or the interest to eat, and this contributes to feeling irritable and run down. Some women, though, eat too much, for comfort, but then feel guilty and uncomfortable about getting fat
Loss of enjoyment
What used to be a pleasure is unappealing, what used to be of interest is a bore. This may be especially true of sex. Some women regain interest in sex (if they ever lost it) before the 6 weeks post-natal examination, but PND usually takes any enthusiasm away. The partner who seeks to share the comfort and excitement of intercourse meets reluctance or a rebuff. This puts further strain on the relationship.
Not coping
PND causes a feeling of having too little time, doing nothing well and not being able to do anything about it. A new routine, to cope with the baby as well as everything else, is hard to establish.
Anxiety
Is acute. Often it takes the form of being afraid to be alone with the baby, who might scream the place down or not feed or choke or be dropped or harmed in some other way. Some depressed mothers perceive the baby as 'it', instead of feeling that they have given birth to the loveliest, most adorable creature in the world they feel detached from their infant. They can't see that it's all that beautiful - indeed, they may find it a rather strange, mysterious little being, whose thoughts (if any) can't be fathomed and whose unpredictable needs and emotions have somehow to be satisfied. The task of a new mother who hasn't yet 'fallen in love' with her baby is extra difficult. The love comes in the end, but usually when the baby is older and more interesting.
However, PND may develop even when love is strong. The mother then worries desperately in case she should lose her precious baby through infection, mishandling, faulty development or a 'cot death'. Snuffles cause her terrible worry, she frets over how much weight has been (or not been) gained, she is alarmed if the baby is crying or if it is too silent - has its breathing stopped? So she wants constant reassurance from her partner, the Health Visitor, the doctor, her family, the woman next door - anyone, really.
Anxiety may also make the mother concerned about her own health. She may panic when her pulse races and her heart thumps and then she may feel she has heart disease or be on the brink of a stroke. She feels so drained - is there some dreadful illness, and will she ever have any energy again? Her feelings are so odd and unusual - is she going mad? (The answer is NO!).
The terror of being left alone with all this can cause even the most capable woman to cling desperately to her partner, not wanting him to go to work.
AREN'T ALL WOMEN LIKE THIS AFTER HAVING A BABY?
Thank goodness, no! Many women - at least one in two - feel a bit weepy, flat and unsure of themselves on the third or fourth day after having a baby. This is the 'Baby Blues', which soon passes. Of course, many women are weary and a bit disorganised when they get home from hospital, but they usually feel on top of the situation in a week or so. But for mothers with PND things get worse and worse.
WHEN DOES IT HAPPEN?
Most cases of PND arise within a month of the birth, but sometimes depression appears up to six months later.
WHY DOES IT HAPPEN?
We don't know enough about why women get PND to be sure who will or won't suffer it. Probably there isn't a single cause, but a number of different stresses may have the same consequence, or may act together. We know that among these 'risk factors' are:
· a previous history of depression (especially PND)
· lack of support from the partner
· a premature or otherwise ailing baby
· the mother's loss of her own mother when a child
· an accumulation of misfortunes, like a bereavement, the partner's losing his job, housing and money problems, etc.
However, a woman can suffer from PND when none of these apply and there is no obvious reason at all.
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