What
is Postnatal depression?
In my
opinion there are two different experiences of women that are both
commonly referred to as postnatal depression. I refer to these as
‘true postnatal depression’ and ‘adjustment/role
transition difficulties’. I know these are not fabulous names
but they do get to the point of what I mean! Read on for further
information about both of these experiences. Please note that postnatal
psychosis is a different condition that is not discussed here.
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True
Postnatal Depression
In the first of these experiences (the one that I call ‘true
postnatal depression') is where the main concern of the mother (and
those around her) is her relationship with her baby. These mums
feel as though they are not ‘bonding properly’ with
their baby and are usually also experiencing symptoms of depression
and anxiety such as nervousness, irritability, sleeplessness, appetite
disturbance, and/ or feelings of sadness
These women may also
feel:
• ‘numb’;
• as though they cannot care for their baby properly;
• ‘not good-enough’;
• ‘not maternal’;
• as though they should never have had children
The onset of these symptoms
tends to be in the first four months post-partum and tends to be
severe enough to disrupt normal family life.
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Who
experiences this and why?
Estimates vary on how many women experience postnatal depression
and this is in part due to different definitions of what it really
is. As a general idea, estimates range from 5%- 20% of women having
some form of emotional difficulties following childbirth.
Health professionals still really do not understand fully why some
women experience postnatal depression and some do not. Some risk
factors that have been identified through research include:
• A personal or family history of depression or anxiety;
• Having experienced physical, emotional, or sexual abuse
in childhood;
• Previous episode/s of postnatal depression;
• Relationship difficulties with partner or family;
• The recent experience of a stressful life event (such as
moving house, losing a
job, a death in the family, divorce or separation etc.);
• Poor support from family and friends;
• A traumatic birth experience (such as an
unexpected c-section, an extremely
short or long labour);
• Having a ‘difficult’ baby;
• Having a baby with some sort of medical or physical problems.
These
are some risk factors that have been identified, however some women
may have all of these risk factors and not experience PND and some
women may not have any and still experience PND.
Treatment
with This Life Psychology Services for ‘True’ Postnatal
Depression
involves counselling (assuming hospitalisation is not required).
The primary aim of counselling, as well as reducing the symptoms
listed above, is to facilitate the mother-infant relationship by
supporting the family in a practical and emotional way. I strongly
encourage the woman’s partner or other main support person
to be involved in counselling, and it is important that the woman
bring her infant along to the counselling sessions.
Some
women in these circumstances benefit from antidepressant medication
along with counselling and I will always encourage and support a
woman to make this decision if required. Some women may wish to
try complementary and alternative approaches to medication, and
again, I will support this decision and provide information if it
seems appropriate to the situation.
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Adjustment
or role transition difficulties
In the
second type of presentation that is also commonly labelled ‘postnatal
depression’ the primary concern of the client is not the developing
relationship with her infant, but rather her new role, status and
lifestyle.
These
women are usually happy with their infant, and report feeling connected
or bonded to the baby, but may also report low mood and feelings
of irritability, boredom, loneliness and a general dissatisfaction
with life.
The onset
of these symptoms begins sometime in the first two years post-partum
and may or may not be noticed by others around the client.
This type of ‘post-natal depression’ may also be experienced
by new fathers.
Who
experiences this and why?
There has been less research on so-called adjustment difficulties
in the transition to parenthood. However, we can make an educated
guess that men and women who have had quite a life before children
(travel, career, parties etc etc) may find the adjustment to being
a parent a difficult one as the roles of ‘mother’ and
‘father’ in our current society are certainly not a
highly celebrated or prestigious ones.
In addition to this, and particularly so for women at the moment,
there are many many pressures on women who have become mothers to
perform well at a range of tasks that have next to nothing to do
with being a mother, but have somehow been lumped in with it- a
gorgeous body, house, husband etc etc.
Treatment
with Angie Willcocks for adjustment/role transition difficulties.
The primary aim of counselling in these circumstances is to encourage
and support the client in creating a personal sense of meaning in
their ‘new’ life, as well as of course reducing any
unpleasant symptoms of depression and/or anxiety.
The client’s partner or other main support person is always
invited to be involved in counselling, and the client may or may
not chose to bring her child to counselling sessions (I would encourage
her to do so for the assessment session).
One of the benefits of living in our current society is that there
are many available ways of creating meaning and making sense of
our lives, and my aim is to support parents to not only become the
parents they want to be, but also to become the people they want
to be.
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