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Parenting - Post-Natal Depression

Tuesday, 20 March 2007

PARENTING - POST-NATAL DEPRESSION
Today Pat Rees is here to talk about the signs and symptoms of a common, but often undiagnosed disorder that affects new mothers. Post-Natal depression affects around 10% of women in the weeks after giving birth and in the studio with Pat is Madge Fogarty, chairperson of Post Natal Depression Ireland, to tell us about her own personal experience and how it motivated her to help others.

What is PND?
Postnatal depression is a term used to cover feelings of depression after having a babyAt first many women feel tired, feel unsure and are not able to cope when they come home from hospital. This normally passes within a couple of weeks. However, for mothers with postnatal depression, things do not improve.

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. These intense and prolonged mood changes should not be confused with the joyous experience of the birth, or the mild, short, limited "baby blues". However, "baby blues" lasting longer than a few days may be an indication of a more serious health problem.

What is the cause?
Despite much research, the exact cause is not entirely clear or straightforward. The following possible causes have been suggested: biological factors, birth experience, change in lifestyle, images of motherhood.

What are the signs/ symptoms to look out for?
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 feels that life is not worth living, at a time when it should be at its most joyous. Of course, depression is not to be confused with the baby blues which might come 3 days after the baby is born and is completely normal.
 
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 the matter.

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 difficult to establish.

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 out 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 postnatal 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, putting further strain on the relationship
 
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, creature in the world, they feel detached from the infant. The task of a new mother who hasn't yet 'fallen in love' with her baby is extremely 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? Will she ever have any energy again? Her feelings are so odd and unusual - Is She going mad?
 
How should it be treated?

Mild symptoms may clear up within days but medical treatments will be required for more severe symptoms, which may involve counselling and medication. The medication usually takes the form of non-addictive anti-depressant tablets which are taken for a few weeks or months. A very small number of women will need a brief hospital stay for more intensive treatment.
 
If you feel you cannot cope, do not feel afraid to tell family or friends, your doctor or Community Health Nurse, that you need some help. Arranging a baby-sitter for a few hours, which would enable you to have a rest, may be invaluable. Try not to let housework take over your days and nights. Ask your husband / partner, family or a friend to help out. Your health and well-being is very important. You should eat a well-balanced diet, little and often, and drink plenty of fluids, especially if you are breast feeding.

If I had Post Natal Depression after my last baby, could it happen again?
There will be a 1:5 chance of recurrence after the birth of your next baby. Being informed and knowing what help and treatments are available, helps with early identification and speedy resolution.

If you fear your partner is suffering how can you help?
. Encourage her to talk to her GP
. Encourage activity, even though she might resist, e.g. you might suggest going for a walk together.
. Try to ensure that your partner gets enough food and rest.
. Give her a massage - this will help her relax and restore her well-being.
. Reassure her of your support and that you will not abandon her.
. Reassure her that her illness is temporary and that she will get well.

If you fear your friend or family member is suffering how can you help?
. Encourage the depressed mother to seek help from a GP; public health nurse and counsellor.
. Encourage her to join a support group. Social Isolation can contribute to postnatal depression.
. Try to be patient
. Assist in arranging practical child care.
. Try to let her express her true feelings, and treat them with sympathy.
. Try to find out more about postnatal depression.

Madge Fogarty
Madge Fogarty from Co. Cork had PND after the birth of her second son. At the time she felt as though she was the only one on the planet going through this. She was totally unprepared for it. Madge had had a fantastic pregnancy and figured she knew it all second time around!  Unfortunately she suffered with a terrible delivery this time round. This was her starting point of the post natal depression.

Madge describes the illness as being very up and down. You can have one good day and then three bad days without any warning. She felt as though she was in a black hole and couldn't find the way out. Everything became an effort. She had no interest in anything, avoided going out meeting friends, felt there was a big sign over her head and that everyone knew. She felt embarrassed, ashamed, frustrated and very angry. She lost all self-esteem and confidence.  Her husband had to make all of her decisions for her.

She became like a child, hated being on her own and was desperately scared that something would happen to the baby. If her Husband rang to say he would be an hour late she would go to pieces. She says it was like she hung in there until 6pm but couldn't go past that. She couldn't sleep or eat because her mind was racing the whole time. She was a mess.

Madge went on medication, anti depressants, sleeping pills etc but they can take up to 6 or 8 weeks just to kick in. So what you supposed to do while you wait? Nobody seemed able to answer that and a day in the life of someone depressed is like a week to everyone else. Madge thought she was going mad and had no support at the time. It was a horrible period of her life. She vowed if she got better she would do something.

It took over a year for Madge to recover but when she did she started a support group for PND sufferers. It was 1992 and her dining room was her office for the first 4 years. Since then the group, Post Natal Depression Ireland has had a few offices but has been based in St. Finbarr's Hospital in Cork for 7 years now. They have a dedicated website www.pnd.ie. They are currently the only group dedicated solely to pnd sufferers and they have become the National Organisation. A group is about to start in Dublin and maybe another in Galway, which is very exciting and came as result of the website. They run support meetings where women meet others in the same boat and realise they are not going mad.

Unfortunately 3 maternity hospitals in Cork are amalgamating on 24 March, and PNDI are being left behind without their offices anymore. They are a voluntary group and feel they should be an asset to add to their service.

Additional Information
Practical Parenting - An Irish Survival Guide by Pat Rees is available in book stores nationwide priced at €13.00

Women with Post-Natal Depression Do Get Well

Contact for Help:
Professional, family and community support speed recovery
For Further information contact us at support@pnd.ie or call (021)4923162
www.pnd.ie

Parentline is also available to offer support and advice to those concerned with Post Natal Distress. 
They can be reached at : 01 - 873 3500   Monday - Friday
Website: www.parentline.ie

Aware - www.aware.ie - 353 (0)1 6617211

Mental Health Ireland - www.mentalhealthireland.ie - 01 2841166

Health Promotion Unit - www.healthpromotion.ie - 1 635 4000

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