Placing the spotlight on Postnatal Mental Illness

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Placing the spotlight on Postnatal Mental Illness.

When a mother is ill, it affects not only her, but her immediate family, her partner, friends and acquaintances. It makes her incapable of functioning at work or at home. The sufferer finds it very difficult to be honest about what is happening. They often feel embarrassed and always feel helpless.

This illness can take on three forms. They include: • The “Baby Blues” (40-80% of all mothers) • Postnatal Depression (0-30% of all mothers) • Postnatal Psychosis (0.1 -0.2% of all mothers) The “Baby Blues” This affects the majority of women following the birth of a baby. The new mother becomes weepy, tense, anxious and very emotional on about the third or fourth day after delivery. Often, this is baffling for an unprepared new father, who cannot understand what is happening to his normally happy wife. The “Blues” are thought to be due to one, or a combination of the following factors: • A sudden change in hormone levels following birth. • Further hormonal changes as breast-milk is established. • The arrival of a long-awaited baby and the realization that life will never be the same again. Whatever the cause, the “Blues” are likely to be short-lived. The reassurance that this is “normal”, and that it is the result of hormonal changes, is usually enough to help the mother cope with it. Postnatal / Postpartum Depression Postpartum depression is a mood disorder that can affect women after childbirth. It affects 10-15 percent of new mothers. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others. Postpartum depression does not have a single cause, but likely results from a combination of physical and emotional factors. Postpartum depression does not occur because of something a mother does or does not do. After childbirth, the levels of hormones (estrogen and progesterone) in a woman’s body quickly drop. This leads to chemical changes in her brain that may trigger mood swings. In addition, many mothers are unable to get the rest they need to fully recover from giving birth. Constant sleep deprivation can lead to physical discomfort and exhaustion, which can contribute to the symptoms of postpartum depression. Postnatal Depression affects 10-30% of all mothers. It may appear as a continuation of the “Blues” but develops slowly over the months that follow the birth of the child. It is also extremely likely to be found in women
who have been depressed during pregnancy. It is thought to be caused by the interaction of: • Biological/physiological factors • Social factors • Stress • Personality factors Symptoms The mother often becomes increasingly angry, weepy, tired, anxious, panicky, and generally overwhelmed. She may be unwilling to leave the house and/or be afraid to be alone. Her moods are likely to be unpredictable; she loses enjoyment of life and of her usual interests, including sex. Her confidence disappears; she can’t sleep normally; her eating patterns change. She feels that her life is out of control; she may want to harm herself or her baby; she may contemplate, or even attempt suicide. Although she feels trapped, and utterly at the mercy of a demanding baby, she may also feel unable to accept help in caring for the infant, because of feeling guilty, or because she is unable to trust anyone else with the task. She may be overwhelmed with conflicting feelings or love for and resentment towards the baby, and other people around her. She may perceive her partner and her family and friends as uncaring and unsupportive. She may resent the fact that the baby’s father’s life is continuing as usual, apparently unaffected by the birth. His attempts to help her may be unacceptable and rejected. She feels abandoned when he goes to work, resentful when she has to prepare meals and take care of the home, and, at the same time, feels guilty because she knows that she is not being a good enough wife or mother. She may, in fact, be so overwhelmed that she is unable to continue to take care of herself, her home or her other responsibilities. If there are other children, the depressed mother may behave resentfully, angrily, and unfairly towards them. How can you tell if you are experiencing Postpartum depression? Because symptoms of this condition are broad and may vary between women, a doctor can help a woman figure out whether the symptoms she is feeling are due to postpartum depression or something else. A woman who experiences any of these symptoms should see a doctor right away.
• Symptoms of depression during or after a previous pregnancy • Previous experience with depression or
bipolar disorder at another time in her life • A family member who has been diagnosed with depression or other mental illness • A stressful life event during pregnancy or shortly after giving birth, such as job loss, death of a loved one, domestic violence, or personal illness • Medical complications during childbirth, including premature delivery or having a baby with medical problems • Mixed feelings about the pregnancy, whether it was planned or unplanned • A lack of strong emotional support from her spouse, partner, family, or friends • Alcohol or other drug abuse problems. The impact of a Mother’s Postpartum depression on her Child(ren) As the initial stress related to labor, delivery, and bringing the baby home give way to new experiences, the behavior pattern of the baby can either make the symptoms of postpartum depression worse or better. As the emotional toll of PPD mounts in the mother with increasing guilt, a sense of being overwhelmed by child care responsibilities, and fear of being unable to cope, she may give way to bursts of uncontrollable anger, show less affection to her baby, and be less responsive to his/her cries. These infants in turn tend to be fussier, more distant, and make fewer positive facial expressions and less noises. Adverse effects on the child continue throughout the first year after birth, but PPD places children of all ages at risk for impaired cognitive and emotional development as well as overall mental and behavioral disorders. There are multiple implications for infants of mothers with PPD, whose developing capacities for emotional regulation and healthy attachment relationships become compromised. These infants exhibit insecure attachments to their mothers (disorganizeddisoriented), more negative, sober, flat affect, protest behaviors, regulation difficulties, and gaze aversion. They also exhibit decreased eye contact, vocalizations, activity levels, and environmental exploration. They are at risk for impaired language development and perform less well on cognitive tests at 18 months when compared to their peers of non-depressed mothers. Indeed, the effects of PPD are still evident in children at ages 4-5 years old. How is Postpartum depression treated? Treatment and help are available for postpartum depression. A doctor can help choose the best treatment, which may include: Counseling/Talk Therapy: This treatment involves talking one-on-one with
Placing the spotlight on Postnatal Mental Illness When a mother is ill, it affects not only her, but her immediate family, her partner, friends and acquaintances. It makes her incapable of functioning at work or at home. The sufferer finds it very difficult to be honest about what is happening. They often feel embarrassed and always feel helpless.
Guyana Inc. – Issue 26 P.35
a mental health professional (a counselor, therapist, psychologist, psychiatrist, or social worker). Two types of counseling shown to be particularly effective in treating postpartum depression are: • Cognitive behavioral therapy (CBT), which helps people recognize and change their negative thoughts and behaviors; and • Interpersonal therapy (IPT), which helps people understand and work through problematic personal relationships. Medication: Antidepressant medications act on the brain chemicals that are involved in mood regulation. Many antidepressants take a few weeks to be most effective. While these medications are generally considered safe to use during breastfeeding, a woman should talk to her healthcare provider about the risks and benefits to both herself and her baby. Without treatment, postpartum depression can last for months or years. In addition to affecting the mother’s health, it can interfere with her ability to connect with and care for her baby and may cause the baby to have problems with sleeping, eating, and behavior as he or she grows. Family members and friends may be the first to recognize symptoms of postpartum depression in a new mother. They can encourage her to talk with a health care provider, offer emotional support, and assist with daily tasks such as caring for the baby or the home.

Dealing with Postnatal / Postpartum depression Postpartum Depression is a common occurrence, experiencing depressive symptoms after giving birth does not make you an “unfit” or “bad” mother. The stigma of mental illness must be reversed so that women can be more comfortable admitting to being diagnosed with and treated for postpartum depression. Celebrities, such as Brooke Shields, Courtney Cox, Celine Dion, Britney Spears and Gwyneth Paltrow have all experienced some form of postpartum depression. They have broken some of the initial barriers by coming forward with their personal stories and helping women know that they are not alone, nor are they anything less than loving mothers wanting desperately to provide the best care possible for their children, if they could only rise above the suffocating feelings of depression and anxiety. If postpartum depression is to be quickly treated or even prevented, women cannot be afraid to step forward themselves and admit to feeling anything less than enjoyment upon becoming new mothers.

Helping someone affected with Postpartum Depression Here are some other practical ways in which you can help: • Take care of the baby, and encourage the mother to have a long, hot bath; go for a walk; visit or call a friend; and even take a nap • Help her plan a schedule for handling a few simple tasks. • Assist and encourage her in arranging child-care. • Encourage joint activities, even though she may resist. Suggest going out for dinner, watching a TV programme together, going for a walk together. Recognise that what she may need is sleep. Encourage her to rest without allowing her to feel guilty. But even though she is probably exhausted, the depressed mother may be unable to sleep. She may be helped by: • A warm bath before going to bed. • A snack, or warm, milky drink. • Avoiding exercise or excitement before bedtime. • A loving massage. • Listening to gentle music. To help her with ANXIETY and TENSION: • Massage her neck and shoulders. • Encourage her : • -to walk, swim, go to gym, or yoga classes. • -to do deep breathing exercises. • -to listen to relaxation tapes, or to music. • -to apply moist heat to her neck and shoulders. To help her with IRRITABILITY and DISTORTED THINKING: • Try not to take her criticisms personally. She is really angry and frustrated with herself. • Encourage realistic thinking, but don’t be drawn into an argument at this time. She cannot help her negativity. • Direct your own feelings of anger and frustration at her illness, not at her. She is doing the best that she can. • Talk to an understanding counsellor or doctor yourself. You also need support

• TAKE ANY TALK OF SUICIDE VERY SERIOUSLY, AND CONSULT A PROFESSIONAL IMMEDIATELY. HELPING THE OLDER CHILDREN Not only the baby, but the older children too, will be affected by a parent’s Postnatal Depression. Their mother will not be as available to them as she was previously; she may be making unreasonable demands on them. They may also feel that their father, too, is cut off from them by his worries. They may be left for long periods with friends and relatives; their social and emotional behaviour may change as a result of the ongoing family stress, resulting in bed-wetting and misbehaviour. Coping with the older children may be an additional burden on the father. Try to find someone who can talk to the older children in an empathic way, and who can explain to them that their mother’s illness is not their fault, re-assuring them that she will recover. The children need someone skilled, who will listen to, and help them to express their feelings. Postnatal Psychosis This extremely serious condition is relatively rare, affecting 1 or 2 new mothers per thousand. In this instance, the mother loses a sense of reality, may hallucinate, hear voices and think in a bizarre manner. She may believe that people are trying to harm her, that she has given birth to a monster. She may become manic, out of control and very excitable, alternating suicidal with homicidal thinking and behavior. The mother needs urgent psychiatric help, usually involving hospitalization. She may be dangerous to herself and those around her, and will certainly need medication and professional supervision. The mother may have to be separated from the baby, which is difficult for everyone. Treatment is usually very successful.

HOW EVERYONE CAN HELP • Re-assure the mother that she will recover. • Re-assure the mother that she is not alone in feeling like this. • Listen to the mother; do not judge her. • Be patient. • Encourage the mother to seek professional help. • Encourage the mother to join a Support Group. • Re-assure the children that their mother will recover. • Re-assure the children that the illness is not their fault. • Don’t let your own feelings of helplessness get you down.

Article Categories:
Health · Issue 26

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