How to Survive Postnatal Depression
An article by Melissa Hughes. Updated 27 March 2010
Perinatal Psychotherapist and Director of Baby and Beyond Parental Counselling
There are many articles that are targeted at assisting women to identify postnatal depression but this article serves as a resource for those who have identified it and want to know how they live through postnatal depression.
At the outset it is important to note that different strategies or a variety of different strategies will help different individual women. What is also important to note is that there is help available and that you will get through to the other side.
Living with postnatal depression can range from merely surviving each day with your head feeling like it is in a cloud, having difficulty making decisions to not functioning at all and believing that the world would be better off without you. Many women struggle with the first step in coming to terms with living with postnatal depression, which is to believe that you actually do need and most importantly deserve help. Often once a woman has made that decision it then becomes the issue of where to look for help and what exactly will work.
For some people, talk therapy alone may be very effective in treating anxiety and/or depression and there are several different types of talking therapy. Among these, CBT may be helpful for treating mild to moderate depression or anxiety and looks at changing unhelpful ways of thinking.
Individual psychodynamic psychotherapy may also be helpful for mild-moderate anxiety and/or depression and is generally a longer-term treatment process that aims to address deeply rooted triggers affecting the new parenting experience. The one on one work provides a foundation to work through the fundamental issues that are often at the core of the postnatal depression. Often times these emerge as a strained, distant or absent relationship with the new parents own Mother, difficulties in their current marriage or significant relationship, highly organised women who identify with the term ‘perfectionist’, older women who are having their first baby later in life and not adjusting to the situation as well as they had hoped, also long term IVF clients whose hopes dreams and aspirations of a new family addition are not meeting up to the ideals.
For some people, medication may also assist them in the management of depression and/or anxiety and this, in combination with talk therapy, is probably the most effective treatment for people with moderate to severe depression and/or anxiety.
Deciding what to do can be confusing and overwhelming and we support women to discuss their concerns with their local GP. A health professional who specialises in perinatal mental health can also provide invaluable assistance with these concerns.
Living with PND can be crippling, it is for this reason that it is important that you have a list of phone numbers of friends, help lines, doctors and loved ones handy so that you can reach out, even if it is by phone in the first instance. Getting in touch with someone who will listen to how things are for you is very important. It’s also really essential that you reveal your thought processes at that time. It is only when others know that you need help that they will step in. Often Mothers are afraid to ask because either they are afraid of seeming incompetent as “surely they should be able to do this?”, or that they are afraid that the person they reach out to will say no, which will leave them more devastated than they were originally. To this effect choose the people you will reach out to, this may mean that your Mum is not the first point of call. That’s okay. As long as you are getting your needs met it doesn’t matter that the fairytale of Mum-to-the-rescue does not exist at the moment.
Group support is very useful to women who are struggling with the day to day realities of being a parent. Mothers group however can be a bit of a hit and miss affair leaving many women feeling down and out rather than supported and normal. Even the most competent new Mother can sometimes feel the undercurrent of competition that often runs through the core of a standard Mothers group.
Group support is a useful way to normalise the parenting experience, however for women who are experiencing some sort of perinatal mood disorder it is important that you find a professionally facilitated support group. In NSW the Baby and Beyond Supported Playgroup provides men and women the opportunity to discuss the realities of parenting through the structure of group therapy. The Group therapy I have established is now run with Dr Sasha Campbell, Perinatal Psychiatrist as co therapist. Sasha and I work together to facilitate the group and explore the interpersonal relationships that form, as well as providing some education around depression, anxiety and the importance of self care. It also supplies the group with qualified child care workers who offer structured activities for the children and monitor how the children are coping in the parent-infant relationship.
The benefit of the group therapy experience is that members of the group are encouraged to provide a support network to each other outside group time. Members have indicated that it is often easier to reach out to someone who has experienced the pain and frustration of PND first hand than it is to try and explain how they are feeling to a loved one or friend.
I never knew that the way I was feeling had a name that went with it. I kept it to myself for a long time and didn’t tell anyone that I really wasn’t enjoying this experience of Motherhood. I just assumed that I was bad at being a Mum and that if I let people know they would judge me and think badly of me.
I would wake some days and feel as though I had a large black cloud over my head. My thoughts were fuzzy and vague. Even the simplest task felt like a herculean effort. Some days I didn’t get out of bed, I mean I would pretend I did, see my husband off and then return to bed for the day leaving the room only to change a nappy or get some food, until I needed to get ready for my husband’s arrival home.
I hated answering the phone and talking about how things were, I could just never muster up enough enthusiasm to mask the way I was feeling. I left the phone off the hook a lot. Fortunately for me I had a friend who had suffered with post natal depression and she came around one day “for coffee” and to ask me how I really was. She shared with me that she had not coped well at all, that her experience involved similar symptoms to me as well as feeling very very angry. I admitted the cracks that were forming within every facet of my life including my relationship with my husband. It was so great to hear that someone else had felt the same way.
We went along to the Baby and Beyond Supported playgroup and it was here that I had the opportunity to talk to other parents who were feeling similar ways to me. There is a true relief to feel that you are not alone. I even brought my husband along to some of the playgroups and he was encouraged to speak about his experience of both having a new baby and the challenges that brings as well as what it was really like to live with me while I was feeling down.
The one thing that started to occur to me when I attended the group was that PND wasn’t a life sentence. It was manageable. I saw some women deal with it by combining therapy with medication and some women who opted for therapy alone. All of us were encouraged to find some time for ourselves, which sounds cliché now, but I really needed to be reminded that I had needs, and that it was okay to attend to them.
The one thing I would say is that there are good days and bad days and the most important thing that I experienced was that however I was feeling on any given day that I went along to the Baby and Beyond Supported playgroup was okay. I tried Mothers group but I was so fragile that any indication that my child might be behind the others, or that I was doing things differently to the other Mothers upset me so dramatically that I quickly stopped going along.
The good thing about a group where people aren’t all pretending that everything is wonderful is that I was able to be real. The real me was okay and I was accepted. I would recommend facing up to the reality of the mothering experience to any new Mum. The good the bad and the ugly are all part of Motherhood, and as I realised I am only human.
* Names have been changed.
If you would like to speak with Melissa, phone (02) 9957 5858 to make a face to face appointment or email firstname.lastname@example.org for online counselling options.