A midst all this happiness you may be hearing a different voice from inside of worries, self criticism, nagging doubts, concerns about bonding. If this is how you are feeling it is not only very normal for many but you are not alone in terms of help and support. A drop in mood or baby blues is so normal about day 3-10 to postpartum (after baby is born) that it happens to almost everyone. Although the exact cause is unknown the physical and emotional adjustment after birth combined with fatigue and disruption of routine is likely to contribute.
For new Mums this can be particularly disconcerting when everyone around is telling you how happy you should be. For those having their second baby or more there is the added pressure of having other siblings to care for and their emotional response to the new arrival to deal with.
But when does this normal, transient low mood or tearfulness become a more significant problem.
Post natal depression (PND) usually commences by 4 weeks postpartum but may persist for many months if not recognised. This makes sense as the honeymoon new-born period, and visitors with offers of help and well wishes have often petered out. Dad is likely back at work and the nights of disturbed sleep seem never ending, baby may be going through a difficult colicky phase or a return to work for Mum may be looming. Sometimes as with all forms of depression there is just no triggering reason.
As with other forms of depression guilt and self-criticism often predominate why am I not happy when I have this lovely baby? What is wrong with me? Why can I not bond and be a good mother? These thoughts or feelings and the guilt associated with them can be even more stark is it has been a long awaited pregnancy or if there are twins (an event that often coincides with the increase in assisted fertility treatments). Mums with poor social or financial support, unplanned pregnancies and personal of family history of mental health difficulties are also more at risk of developing PND.
The Symptoms Of PND May Include The Following:
- Low mood. Tends to be worse first thing in the morning, but not always.
- Not really enjoying anything. Lack of interest in yourself and your baby.
- Lack of motivation to do anything.
- Often feeling tearful.
- Feeling irritable a lot of the time.
- Feelings of guilt, rejection, or inadequacy.
- Poor concentration (like forgetting or losing things) or being unable to make a decision about things.
- Feeling unable to cope with anything.
- You may also have thoughts about harming your baby. Around half the women with postnatal depression have these thoughts. This can obviously be very frightening. If these thoughts or thoughts of harming yourself occur it is vital to seek help urgently.
- Many women feel frightened, ashamed and unable to tell anyone, they feel unable to cope this results in a barrier to asking for and receiving help. Loved ones may be able to offer an objective view.
If you feel this way you are not alone and this problem is not your fault and can be helped. A useful questionnaire, simple to complete the Edinburgh PND scale is a good starting point to clarify the severity of symptoms. Talk to your GP, practice or public health nurse. They are well positioned to help with this common problem and can offer help, advice and treatment. For most this is a transient difficulty, especially with the right support and often small changes in terms of greater rest, childcare support, exercise and talking openly about these feelings go a long way towards solving the problem. In more severe cases and especially in those with previous episodes of depression or mental health difficulties psychological supports and treatments and / or medication may be of benefit. Getting help will help make things better for you, your baby and your partner / family.