Postnatal depression: The importance of early intervention

Postnatal depression and the difficulties it can cause, is now being recognised as a significant but treatable condition. It affects between 10 and 15% of mothers, yet early intervention can bring about profound and lasting change.

Tim Lott, author of the poignant memoir The Scent of Dried Roses, charting a lifelong depressive illness, writes, "...I haven't suffered postnatal depression - but I have suffered from it."

His article in The Guardian (October, 2014) draws attention, not only to the limited care of women who suffer postnatal depression, but also to what he calls "the scandal" of the impact of this illness, left untreated, on babies.

When he accessed his mother's medical records after her death, he discovered she had suffered some form of postnatal psychosis for the first three years of his life. However, the profound effect it had on her baby was overlooked. The legacy of this for Tim was 50 years of "being pinned to a bed by your own mind unable to think anything but the blackest thoughts."

Infants are acutely sensitive to their mother's faces and a mother suffering from postnatal depression is unlikely to be able to mirror and tune into her baby's needs or have the capacity to reach for an understanding of the baby's experiences. Her face will show no delight in her infant. A baby needs physical and emotional "holding". To have infant experiences digested and interpreted, there is a need for sensitive attunement.

There is now growing recognition of the earliest experiences having far-reaching effects on mental health in later life. Sue Gerhardt in her ground-breaking book Why Love Matters, powerfully illustrates the impact on the development of neural pathways in the infant's brain as a result of the earliest handling and affectionate responses by adult care-givers. Indeed it actually forms the pathways that develop. 

The seemingly helpless and unaware infant, from the beginning, has a burgeoning psychic life, a "circuit-board" of firing neurons and pathways being constantly built. This construction job is directly influenced by the environment... and at the very beginning the whole environment is mother.

A cross-party manifesto published in January, 2014 The 1001 Critical Days highlights early intervention. It acknowledges the importance of the 1001 days from when a baby is conceived until the age of two, and sets out a vision for radical change to promote sensitive and responsive care from main caregivers at this crucial time.