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Postnatal depression came to the fore this month when Adele revealed her struggle with the condition after the birth of her son, Angelo. Dr Karen Morton talks about the effect of celebrity health confessions and how people put on a brave face to the media when they are suffering the worst agony inside.
I always admire celebrities who talk about their health problems. It’s incredibly brave to share something so personal with the world, and I have no doubt that fellow sufferers and their families gain extra strength. Sometimes the story is not revealed by choice – Kanye West’s sudden hospitalisation due to a mental health issue was all over the news last week. But when a celebrity voluntarily chooses to share their story, I feel they do a great deal for awareness, understanding and compassion.
A few examples of stories that have inspired me include that of Victoria Derbyshire, who shared her breast cancer story, writing a blog from her hospital bed and bravely sharing her surgical recovery and radiotherapy with her viewers. Steve Hewlett chats openly with Eddie Mair on the PM programme on Radio 4, as he shares his gruelling journey with advanced cancer of his gullet and stomach – a journey which he knows is unlikely to have a happy end. I also thought Stephen Fry’s 2006 programme, ‘The secret life of the manic depressive’ was a masterpiece, as it opened peoples’ eyes to the world of bipolar disorder and other psychotic mental illnesses.
But being an Obstetrician, Adele’s story of postnatal depression struck a particularly strong chord with me. In my experience, it is a hugely misunderstood condition, but I hope Adele’s bravery gives thousands of women a chance to be understood.
Postnatal depression (PND), that most incomprehensible consuming gloom, can affect anyone. Up to 20% of women have some form of perinatal mental illness, with PND being the commonest problem. The other conditions range from anxiety, through post-traumatic stress disorder, to puerperal psychosis.
The thing which is most difficult is that, to everyone around you, the idea of being depressed at this point in your life seems totally at odds with your situation. Here you are with this beautiful new baby, very often with no other apparent worries. It is not because you are a single mother or homeless. It is definitely not that you don’t love your baby, or your partner. It is not because you are tired or because your breasts hurt. It is a consuming illness. And to make matters worse you feel guilty! What about all those friends and family who are longing for a baby or have just had a miscarriage. ‘How dare I be so ungrateful? I don’t deserve this beautiful baby.’
You might think that midwives would be the least likely to get PND, but I recently came across a Facebook post from a friend and colleague of mine, a fantastic senior midwife called Claire. The picture above is of her and her baby.
“You may all see a happy mother of a tiny baby with a top covered in baby vomit and a grin on her face. What I see is completely different. I see a mother who is holding and cuddling her baby as her crippling anxiety meant that she couldn’t think of what else to do. She would wander from room to room only vaguely aware of where she was and what she was doing, as her mind was elsewhere, obsessing about her own health, convinced that at any minute that she was about to drop dead and leave her beautiful children motherless. That mother is me and I have struggled with anxiety since the day my last baby was born (longer if I am completely honest). When people saw me with my baby, continuing with life, getting the kids to school etc they saw what you saw in the picture. But if you look deeper you can see a deadness in my eyes, a disconnection from my baby, from my children, from the world.”
When I read Claire’s Facebook post I felt ashamed. I had never known how ill she had been.
Claire has let me share this because she said she would like as many people as possible to know about and understand what a terrible thing PND is.
“There is no weakness in getting help, taking anti-depressants, seeing a counsellor etc. There are so many people who want to help you, there is light at the end of the tunnel but sometimes you just need someone to hold your hand and guide you towards it.”
To finish, I asked my colleague Dr Rebecca Moore, a consultant perinatal psychiatrist, to give her advice on what to do if you think you are experiencing PND. ‘Postnatal depression and/or anxiety is common, affecting up to one in seven of all new mums. It can present with low mood, tearfulness, anxiety, intrusive thoughts, a change in appetite or sleep, feeling guilty or thoughts of self-harm.
There are a range of treatments, and different women need different things. Treatment can be with therapy such as Cognitive Behavioural Therapy, dietary changes, using exercise, meditation, mindfulness or medication. Ask for friends and families support if you can. There are wonderful supports on line such as PANDAS, Netmums or Mothers for Mothers.
An excellent book to dip into to hear other women’s stories is ‘Fine (Not Fine)’ by Bridget Hargreave. The prognosis is good and the majority of women make a full recovery and may never have a further episode. If you go on to have subsequent pregnancies, don’t be afraid to ask for specialist care to ensure further episodes of depression do not occur.’
See also Dr Morton’s – Pregnancy Advice
This blog was published on 06/12/2016