This week marks World Maternal Mental Health Week, and although attitudes are changing, post-partum depression still remains a serious issue for many women. Amanda Cassidy speaks to one mother who said giving herself permission to get help was the first step towards getting better...
Louise* is 37. After the birth of her first child, a son, the Dubliner says she was completely unprepared for the overwhelming feeling of being responsible for a tiny life. She is sharing her story in the hope that others can recognise some of the signs of post-partum anxiety.
"In the run-up to Dylan’s birth, I hadn’t slept properly for days. I had pretty severe preeclampsia and was eventually rushed into hospital for an emergency c-section. As soon as he was born, the world came crashing down. Fear and dread took over. Dylan was about 5 lbs when he was born, and he dropped down to about 4 lbs quite quickly. The nurses told me that because he didn’t have much body fat, he needed to put on weight, fast.
I remember thinking that this must be what a war-zone must be like — being trapped in a constant feeling of doom every way I turned...
"He wouldn’t latch on when I tried to feed him myself and the entire experience made me feel useless and panicked. I felt that by not being able to feed him fast enough, I was going to kill him. I felt like I was doing exactly the opposite of what mothers are supposed to do. I started convincing myself that my son was better off with my mum and my partner rather than with me.
"It was an exhausting cycle of good thought, bad thought, good thought, bad thought. I remember thinking that this must be what a war-zone must be like - being trapped in a constant feeling of doom every way I turned.
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"It got so bad that my partner had to get into my hospital bed and hold onto me because I was so distraught. The worst part was that I felt like my entire personality had changed and that this was the new me — that panicked me even more. I remember falling asleep and then waking up and being so elated that I felt a bit better and then slowly, that frightened feeling would hit me again.
"I kept telling everyone around me, ‘I’m so scared. Why am I feeling like this? Will this feeling ever go away?’ I’d heard all about post-natal depression before, but I wasn’t sad or down, I was simply terrified. My palms were sweaty, my heart was racing and my ears were buzzing.
The cycle of fear
"I kept imagining the countless things that could happen to my son — all the things I had control over, and too many that I didn't. I was given medication. In fact, I had round-the-clock care and a health-care worker at the end of my hospital bed. I had Dylan in the UK where the maternal mental health services are amazing. The government there has finally recognised how acute the issue is and pumped millions into support services.
"I immediately saw a psychiatrist, then a psychologist, and was put under a team of post-natal healthcare experts who I saw every day, then every second day and when I was let home, they came to my house every day. I saw them every week in the months afterwards and still go back for regular checks.
"I have a friend in Galway who went through the same thing — she's still not fully recovered. She got a few counselling sessions but I don’t think there is the same level of support that I got in the UK.
"Once home, I continued to be crippled with overwhelming fear. Because I’d had a c-section, my stomach muscles were torn. I began imagining that if I stood up while holding Dylan, I’d drop him and his head would smash on the floor. I lived out this scenario over and over and over again. I couldn’t escape this cycle of fear. It was terrifying. My mum and partner were brilliant but obviously hugely concerned."
The right support, fast.
Post-partum anxiety, like any form of anxiety, comes from the impact of the life-experience in question or can be a gradual build-up of stress. This stress then morphs into a form of anxiety due to the overwhelming nature of the scenario. Add in sleep deprivation and all this combined can reduce the person’s ability to cope.
Psychotherapist David Kavanagh says that the fear and anxiety that women can experience is often caused by the realisation that she is now fully responsible for another human being. He says the problem is not being fully addressed by our systems here in Ireland.
"I really wonder if birth was a male responsibility and not female, would post-natal depression even exist, or would it be fully normalised at that point and treated with the respect it deserves."
"We sometimes situationalise post-partum depression or anxiety as a ‘thing’ in the woman that she needs to 'fix', rather than examining the environmental experience of pregnancy and birth. We need to recognise that couples have to transition through the birthing process which is not always straightforward.
"No one in this state receives post-birth practical, emotional or education support. I saw the mother of my own child being treated like a cog in the mechanical wheel during the birth process. I was struck by the way we then describe women who have post-natal mental health issues. I really wonder if birth was a male responsibility and not female, would post-natal depression even exist, or would it be fully normalised at that point and treated with the respect it deserves."
There is something evolutionary about being overly concerned with a newborn or anxious when it cries — it’s our biological signal to react. But when such worries spiral, it becomes a mental health problem that needs to be addressed.
David says that the ‘fix’ for such anxiety lies in emotional and psychological support by the people closest to the mother, the staff and consultants in question. Louise says that she also attributes her recovery to having the right support very quickly, mindfulness, exercise, compassion and rest.
"Slowly, slowly I learned to trust myself. I went to regular CBT (Cognitive Behavioural Therapy) and learnt how to manage the fears that I was having. My medication was adjusted and I continued to take it for six months.
"I learnt to simplify my life. I had to stay within my comfort zone; I went for short walks. I stayed local, I kept busy and tried to stick to a routine. I started to feel better and began enjoying my amazing little boy. After a year, I felt 80% back to myself. Now I’m 100% me again. I had a bit of a blip when I went back to work a few months ago.
"Your confidence goes through the floor. I felt incapable and I didn’t trust myself like I used to do. I had to build it back up again and that is tough. On the plus side, it’s made me a lot more able to face up to things, and I try to deal with all challenges head-on.
"My son is two now, and every day I’m aware of all the things I can’t control in his life. My anxiety will always be lurking just below the surface, but I’ve learned the tools to manage it. I watch Dylan as he bravely ventures out to discover the world around him and I remind myself that if he can do this, then so can I."
*This mother prefered to remain anonymous