Friday, April 23, 2010

When the baby blues won't go away


If you don’t feel the way you expected to after having a baby, you could be showing signs of postnatal depression

Imagine being told at your 20 week ultrasound that you are expecting a baby boy.
Then imagine that after giving birth you are told instead that you have a girl.
Baby is healthy, you’re healthy, so who cares if they got it wrong.
But for one mother, this “change of plan” sent her into a very different mindspace.
She believes that it was the trigger for her postnatal depression.
She said that she knew something was seriously wrong when she was sitting by an open fireplace with her baby.
Something in her said: “What if I put the baby in the fire?”
A frightening scenario that thankfully never became reality because her husband then took her to a doctor for help. Postnatal depression (PND) affects almost 16 per cent of women and 10 per cent of men in Australia and it is caused by a combination of biological, psychological and social factors.

Contributing factors which can lead to PND include physical changes, drop in pregnancy hormones, broken sleep, exhaustion, emotional changes while adapting to parenthood, loss of independence, financial hardship, and social changes as new mums may feel less connected to their friends or work colleagues.
Other contributing factors include a predisposition to developing depression, nutritional deficiences, traumatic pregnancy and/or birth, infertility or use of assisted conception, history of premenstrual tension, unresolved relationship issues between the mother and her own mother, traumatic childhood, unresolved grief and loss (such as a previous marriage or death in the family), lack of family support and social isolation.
A different combination of these factors determines each woman’s unique experience of PND, and recovery will only happen if these factors are addressed.
It’s no secret that adjusting to life as a parent can be very difficult. After all, it is one of the most significant life-changing events you will ever experience.
Up to 80 per cent of women experience the “baby blues” about three to 10 days after the birth, but this feeling often passes within a day or two and is different to PND.
Symptoms of the baby blues include tearfulness, mood swings, irritability and anxiety.
PND comes on within 12 months of the birth, usually during the first few weeks or months.
It can range in severity from very mild and transient, to severe and lingering.
For some, it passes quickly, while for others it is a lengthy road to recovery requiring professional help.
The worst cases of PND are called postnatal psychosis or puerperal. This affects about 1 in 500 mothers and symptoms include severe mood disturbances, bizarre thoughts, insomnia, hallucinations and inappropriate responses to the baby.
This is a very serious condition as the mother may be unaware that she is ill because her grasp on reality is affected.
There is a great risk to the life of both the mother and the baby if the problem is not recognised and treated.
PND can occur unexpectedly after delivery and many women blame themselves, their partners or their baby for the way they feel.
Some try to “snap out of it” without understanding that they have little control over the way they are feeling.
That’s why it’s important that women and their partners learn to recognise the signs and symptoms of PND so they can get help early.
Some of the symptoms of PND include:
  • Low self esteem and lack of confidence
  • Feelings of inadequacy and guilt
  • Negative thoughts
  • Feeling life has no meaning
  • Tearfulness and irritability
  • Low sex drive
  • Loss of appetite
  • Anxiety, panic attacks or heart palpitations
  • Difficulty concentrating
  • Forgetfulness
  • Feeling unable to cope
  • Sleep disturbance not related to baby’s sleep needs
  • Fear of being alone
These symptoms can also apply to a man’s experience of PND.
Unfortunately, sometimes symptoms are harder to separate from normal changes after having a baby, but if you do have these signs, it’s better to speak to a health professional for an assessment.
Many women will put on a brave face and try to hide how they feel but PND does not usually resolve itself fully without treatment.
If you don’t seek help, it will take an even greater toll on you, the baby and your partner, as well as other relationships.
You may also experience future episodes of depression or mental illness.
With early identification and intervention, most women fully recover from PND and have no long-term effects.
Treatment for PND is tailor made for each woman by a health professional.
Alongside emotional support from family and friends, some women find psychological treatments helpful, or antidepressant medication more effective.
Medication aims to correct chemical imbalances in the brain, rather than change your personality.
Some antidepressants are safe to take while breastfeeding or pregnant, and they are not addictive.
Talking about your feelings, particularly with other women in support groups or to a professional counsellor, can also be helpful.
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.
The none-profit organisation PANDA states: “PND is not something to be ashamed of. It should be seen as one of the many complications of pregnancy and delivery. With appropriate help, women with PND do recover.”
PANDA was formed to provide confidential information, support and referral to anyone affected by depression during pregnancy and after childbirth (including partners, family members and friends). Check out the website at http://www.panda.org.au/ or if you need assistance, phone the helpline on 1300 726 306, Monday to Friday, 9.30am-4.30pm.
The beyondblue website contains some excellent resources on PND including a checklist for pregnant women and new mothers, fact sheets, information booklets and stories of hope and recovery. Visit http://www.beyondblue.org.au/
beyondblue is also interested in working with people (women, partners, families and health professionals) who have experience with depression and anxiety during pregnancy and after the birth of the baby.

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