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Coping with postnatal depression

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Most women experience the baby blues shortly after giving birth, becoming weepy and emotional for a few days.

But Post-natal Depression (PND) is a different and far more serious condition that sometimes coincides with the baby blues, but which can occur any time during the first year after birth.

Mothers with PND may have difficulty bonding with their babies, but although they often believe they are bad mothers they are usually able to care for their babies at least as well as other mothers. Only in rare and extreme cases of post-natal psychosis is a mother at risk of harming herself or her baby.

Depression can also strike during pregnancy. The symptoms of ante-natal depression (AND) are much the same as those for PND, with the added complication that depression which starts in pregnancy is likely to continue after the birth if it is not treated. Ante-natal depression also means having to weigh the risk of taking anti-depressant medication during pregnancy.

Many women struggle with PND alone because they feel guilty and ashamed to admit what they are really feeling. The birth of a new baby is supposed to be a happy time and the expectations of family and friends weigh heavily on the new mother.

But PND is a very real, physiological condition that can affect anyone. The depression may be mild or severe, but either way it should be taken seriously and treated timeously.

Symptoms of AND and PND

  • Feeling angry, irritable and aggressive
  • Feeling anxious, guilty and fearful
  • Feeling helpless, inadequate and unable to cope
  • Crying a lot
  • Loss of appetite or change in appetite
  • Unexplained weight loss or gain
  • Feeling tired all the time
  • Difficulty sleeping
  • Lack of pleasure and enjoyment
  • Feeling dislike towards your baby or that you don’t love your baby the way you should
  • Feeling like a bad mother
  • Feeling that your baby would be better off without you
  • Fantasising about harming yourself or your baby
  • Suicidal thoughts or a pre-occupation with death

PND may be triggered by a combination of factors, including the hormonal “crisis” that occurs with pregnancy and birth. Other risk factors include:

  • A previous history of depression
  • Unplanned or unwanted pregnancy
  • Lack of family and other support systems
  • Difficult or painful personal circumstances such as unemployment, stress, miscarriage, bereavement, divorce, etc.

It is extremely important to tell your doctor or midwife if you suspect you may be depressed. Help is available, although it may take several months before you feel better. There are also several strategies for self-help and the support and understanding of family and friends is vital.

How husbands, family and friends can help:

Offer practical help

Offer practical help such as babysitting, getting up for the baby at night or cooking the dinner so mom can catch up on her sleep, read a book, have a bath or whatever.

Offer emotional support

Be there, listen to her, encourage her to express her feelings and ask her what she needs. Don’t impose solutions, judgements or unwanted advice.

Acknowledge the depression

Acknowledge that depression is a real, medical condition and that it is not her fault or "just in her mind".

Advice for moms

  • Get professional help and treatment – PND is not just in your mind.
  • Know that you will get better – although it may take some time.
  • Ask for help from family and friends – whatever kind you need.
  • Be realistic about your expectations – you don’t have to Supermom.
  • Know that you are not alone – all women struggle in different ways to come to terms with motherhood; it is a crisis of identity that involves the loss of the former self.
  • Remember that the best thing you can do for your baby is to help yourself – so don’t feel guilty about taking time for self-care.
  • Try to eat properly and to get enough sleep – low blood sugar and fatigue will make depression worse.
  • Keep things in perspective – the difficult, sleep-deprived and house-bound early weeks of your baby’s life are temporary and short-lived.
  • Talk about your feelings honestly to someone who understands and limit contact with anyone who makes you feel drained or anxious.
  • Don’t compare yourself to other mothers – you are the best mother for your baby.
  • Postpone major life changes such as moving house or changing jobs.
  • Forgive yourself for the way you are feeling – it is not your fault.
  • Work on regaining your sense of humour – there are plenty of books and movies, etc. out there that will make you laugh as you realise that many women can relate to your experience.

The South African Depression and Anxiety Group can help. Contact them on 082 882 0072.

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