Perinatal and Postnatal Depression

Depression is isolating and miserable, and depression during pregnancy or after giving birth often has an added ripple effect as the whole family can be impacted. Recent research highlights that between 10% and 15% of all mothers will experience postnatal depression[i]. However, the most recent and alarming statistics are that a significant number of mums may continue to suffer from severe depression years after giving birth[ii]. New research into epigenetics (the study of how a foetus can be genetically changed due to events suffered by the mother in pregnancy) is highlighting the significance this may play in the baby’s future life, with the possibility that this may dramatically increase the baby’s chance of suffering mental health disorders at some stage during their lifetime. 

Another area of new research highlights the levels of anxiety and stress during and after pregnancy with many women struggling with negative thoughts and heightened feelings of distress, yet this would not be classed as depression per se and can go unnoticed by GP’s, midwives and health visitors. Given that a survey commissioned by the NCT in June 2014[iii] highlighted the lack of care in the NHS for postnatal depression - with many areas having little or no commissioned care for this condition - those mothers who are suffering from stress, anxiety and depression have little option but to suffer alone.

Yet pregnancy and birth are often portrayed in the media as this wonderful, life enhancing event and perhaps this is the problem for many women. As in many areas of life (the perfect home, the perfect job, the perfect relationship), is the need to be a perfect mother so intense that when the reality bears no resemblance to this the mother feels desperately inadequate, useless, and a rubbish mum? Many women admit to being too scared to tell their doctor or midwife how they really feel in case their baby will be taken away. So whom can they tell? How does a mum verbalise her worst fears, or admit to being overcome with anxiety sometimes to the point of listlessness, unable to care for herself, let alone her baby? 

There is hope for sufferers of these pervasive conditions. Firstly, there are organisations that offer support groups, such as PANDAS. Reading and participating in the forums on NetMums are also options which may reduce the sense of isolation for women and help engender a sense of “I am not alone” and “I am not a bad mum”. There is useful information on accessing care on both of these sites, which may be helpful to mums.

Also, “talking therapies” can offer a relief of symptoms, giving a space for women to openly admit to their worst fantasies with no fear of judgment or recrimination. This is hugely important as the inability to voice a fear can sometimes make that fear escalate out of all proportion. This may be playing a large part in the stress and anxiety women talk about feeling during pregnancy. Thoughts continually revolving round and round with no outlet are called ruminations and these thoughts can influence the way we behave whether or not we are pregnant or have a new baby.  They also may affect the way a mum might respond to her baby’s distress, and may reduce her ability to meet her baby’s needs. Once those thoughts are verbalised and explored and all the worst fears and fantasies are expressed, those thoughts often begin to dissipate, hence the saying “a problem shared is a problem halved”. Look for a suitably skilled and trained therapist who will listen, hear, and offer empathy and solace. Such therapists can be found on the UKCP or BACP website. Please ensure the therapist is accredited to the organisation you choose before contacting them.

[i] Scottish Intercollegiate Guidelines Network (SIGN) 2002

[ii] Vliegen et al (2013) “Hospitalization-based treatment for postpartum depressed mothers and their babies: rationale, principles and preliminary follow up data. Psychiatry 76 (2) Summer 2013 pp 150-168

[iii] BBC News 6 July 2014 “Huge gaps in mental health care for new mothers”