Introduction to Postnatal depression
Becoming a parent can be a shock, and it is perfectly normal to feel emotionally vulnerable and sensitive after your baby is born, especially as these new experiences will be bringing up emotions that you might not have had before. Some mothers may be confused about their feelings, thinking that they should be overjoyed and instantly fall in love with their baby - but this is not always the case, especially if you’ve had a difficult labour or traumatic delivery. All these separate experiences can build up to overwhelm and shut down.
There are lots of different statistics about postnatal depression; ranging from 1 in 3 to 1 in 7 mothers suffering from it, so it’s not entirely certain how prevalent postnatal depression actually is. There are also different degrees of postnatal depression; postnatal depression for one mum may be comparable to a sniffle, whilst another mum’s postnatal depression may be more comparable to having the flu.
‘Baby blues’ typically occur between 3-5 days after the birth. One theory is that they coincide with the hormonal changes that occur as breastmilk starts to come in, another theory is that they’re due to the comedown after the endorphins or a physical shock reaction to the upheaval of birth. Some symptoms are as follows: you may feel weepy, irritable, have a low mood and feel you lack confidence in being able to look after your baby.
These feelings usually subside after a week or so, however, postnatal depression is more serious and must be treated immediately.
Symptoms of postnatal depression can include:
- Sleeping problems.
- Crying a lot.
- Not eating/overeating.
- Physical pains, such as headaches, stomach pains or blurred vision.
- Lack of motivation to get up and do anything.
- A constant sense of anxiety, sometimes escalating to panic attacks.
- A feeling of being lonely or isolated.
- Having difficulty concentrating.
- Overwhelm and unable to cope.
- No interest in sex.
- Feeling guilty about everything and wondering if you’re a bad mother.
- Being overly protective of your baby.
- Feeling emotionally disconnected from your baby.
If you’re ever at the point where you’re having thoughts about harming yourself or your baby then that is a code red. Do seek support; seek professional help, your GP may suggest antidepressants, or professional counselling, and your health visitor will know about local postnatal depression support groups.
Hopefully, this guide will help you see that you can manage it, you can be depressed but still carry on and pull yourself out of the hole as well. Don’t panic; you’ve got it. It’s just a case of breaking it into chunks, seeing what you can do practically and emotionally to help, and if it still doesn’t get better it may be the case of seeing a GP, or getting counselling.
Time to be sad
We’re kind of trained from a young age that some feelings are not acceptable, often in the case of women we’re not allowed to be angry - we have to be sweet instead. This can lead to feeling getting squished down, so the feelings aren’t dealt with and can create problems. This section will help you learn to recognise and deal with your emotions.
- Learn how your emotions feel in your body:
For example; sadness. How does it feel in your body? Where do you feel it? Is it in your heart? Do you get headaches?
Different people hold emotions in different places, so if you can learn what your different emotions feel like in your body, you can more easily identify your mood instead of just thinking you feel funny or off. This can then allow you to dissect the emotion more.
- Figure out what the emotion is trying to tell you:
Give some attention to that emotion, and really try to work out why you’re feeling it. What caused it? What do you need to do to make yourself feel better?
- Put an end time on mulling over the feeling:
Allocate a time to the feeling, let the feeling come through, and try to find out what it’s telling you. When this time is up you almost need to pack it all away - if the feeling’s still there then you need to tell it to wait whilst you carry on with the other things in your life. You might find that you need to allocate time to the emotion a few times a day, but it is important to have the time to release the emotion so that it doesn’t interfere with the rest of your day. If you don’t give the emotion time, it can become a scary monster that’s out of proportion. By facing it a little bit at a time you’re not getting overwhelmed, and you’re dealing with the emotion.
It’s not going to be easy – after reviewing your emotions you might find that you need to make big changes to your life.
- Get to know your triggers:
Spending time on your emotions can help you identify what your triggers are for that emotion, as you’ll be able to better identify when you start to feel the emotion. Once you get to know the cycles and rhythms of the depression you can see the signs as well. For example, when your depressive episodes begin you might start getting forgetful or overwhelmed. All of these signs might be telling you that you need to slow down, or take time to do some fun things that might help balance you out a bit.
Taking the time to acknowledge and analyse your emotions can help you figure out how to best manage your postnatal depression.
- Have awareness of where you’re at emotionally:
If you don’t know where you are emotionally then it’s hard to figure out where you’re going. It’s helpful to figure out how far into the pit of depression you are. Is it a case that you just need a little pick me up to get you out of the pit, or do you need some time alone to properly heal? Understanding where you are in the depression can help you understand what you need to do to get where you need to be.
- Where do you want to be?:
What is the situation like now and what do you want to change about it so you can feel happier and better in yourself?
To be able to figure out what you need to do to feel better, it’s important to figure out what better is to you. Having a clear picture of what better is will help you start taking steps to get there.
- Be observers not judges:
One way to help stop beating yourself up when things don’t go well is to become observers of your life instead of a judge. This means; don’t judge the things that happen in your life leading up to a depressive episode, instead just objectively identify them so that you can see if there are any common factors across the occasions. For example, does a depressive episode tend to come after you’ve not slept well, or after you’ve been overly social? Don’t beat yourself up that you didn’t sleep well, just acknowledge that it is a factor that you need to consider when managing your postnatal depression. Remember; self-compassion is key.
Be your own best friend
What does it even mean to be your own best friend?
- Don’t beat yourself up:
When you make a mistake it’s easy to say “oh you should’ve known better, that was a stupid mistake”, and other negative self-talk that is unnecessary. If you wouldn’t say that kind of stuff to other people then don’t say it to yourself.
It’s hard enough when it feels as if everyone’s against you, and judging you so why do it to yourself too? The best person to have on your team is yourself. This doesn’t mean to make excuses for yourself, and to let yourself get away with everything. You still need to be responsible and accountable for your actions, but you don’t need the negativity around it. Just look at things objectively – give yourself a break when you need it, and don’t judge your emotions.
- Be nice to yourself:
Start by just doing little things. For example, say “well done” to yourself for having a shower, say “well done” for doing the washing. If all you’ve done throughout the day is feed your baby, acknowledge that that is also an achievement – you’ve kept another human alive.
There’s always a dialogue going in your head, if it’s always negative it’s going to be harder to be there for yourself, and often when depression is the worst you cannot reach out to other people so there is only you to help yourself.
- Set boundaries with other people:
Once you’ve built the boundaries with yourself in regards to negative talk, start to build boundaries with other people.
For example “I don’t want to be talked to like that, I don’t deserve to be treated like that”. You need to set your own standards.
- Give yourself permission to have time off:
If you have a cold you’d let yourself take time off to recover, this isn’t any different. Sometimes a break is exactly what you need to be able to climb out of the pit.
- Ask for help:
You shouldn’t feel guilty asking for help. If your car breaks down you wouldn’t think twice about calling a car recovery service. Why, as a new mum, is there the idea that you can’t ask for help? Mums aren’t superwomen, they’re not martyrs, they’re just human. Sometimes humans need help, and sometimes we help other people. Maybe at this point, it’s you that needs the help, and maybe in the future you’ll be able to help someone else – that’s the point of family (blood or found); there’s no shame in asking.
- Look for evidence of things that you’re good at:
People are so good at looking for things that support our beliefs. For example, if your postnatal depression is telling you you’re not a good mum, your brain will be automatically finding ‘evidence’ for this.
But this needs to change, look for evidence for the things that you’re good at/ that dispute the beliefs you might have that you’re bad at being a mum.
Make a note of all the little things you’ve achieved, all the little wins of your day. For example, you left the house today, you made a meal – any achievement, any success.
Look for evidence to show that you’re doing a good job, and come back to this list as often as you need to remind yourself.
- Write down these achievements:
Make a list of these achievements. This can help as it will show you that you are having a lot of successes and achievements each day. By writing it down you will also have a record of what a great job you’re doing, and you can refer back to it as much as you need to remind yourself of this.
You could also make this a fun activity for all the family – write down the achievements of your children too, e.g. they held their own cup today. By identifying the achievements and successes of everyone in your family it can help you get into the mindset of looking out for and paying more attention to the achievements in life rather than on the things that went wrong.
- Celebrate these successes:
Maybe at the end of the day celebrate that you’ve survived the day. Treat yourself to something that you like, maybe a hot chocolate, or some biscuits.
By celebrating your successes, it shows you that you are doing a good job. You celebrate your child’s achievements, so you should celebrate yours too.
- End the day on a positive:
As you’re falling asleep, ask yourself “what went well?”.
For example, you had amazing hugs with your little one that made your heart feel really full.
Ending the day on a positive can also help set you up for the next day, and help you start believing that you’re doing a good job.
The way forward
- Score your mood:
It’s important to notice how you’re feeling, and how this changes throughout the day. For example, did you wake up feeling low, start to feel higher, and crash later in the day? You can take an average at the end of the day, or you could do multiple scores for the day.
These scores could be on a scale from 1 to 10, or it could be a smiley/sad face; whatever works for you to best keep track of how you’re feeling.
Keeping a track of your mood can help you manage your depression better, as you will be more aware of where you’re at, and will have a better idea of what your needs are.
- Communicate your needs to others in your life:
Even if it’s just telling the people in your life that you’re not having a good day, they will have a better idea of how to help you – or at least not put as much pressure on you. For example, if you tell your partner you’ve not been having a good day then they’ll be less annoyed that you might not have done as much as normal that day.
It can be really hard to do this at the beginning to actually admit to people that you’re not in the best place, but it does help.
- Figure out what things help keep you ‘ticking along’:
These can be little things that help make your day a little brighter, or the reminders that you are important and wanted. For example, when your baby smiles at you, or when your cat comes and sits on your lap.
Find what relaxes you, what makes you happy and try to make time for that in your day, this will help get the balance back in your life.
- Have things to look forward to as often as you need them:
Having fun things to look forward to can be the thing that helps you make it through the tougher times.
This can also help break up the monotony that can come with being a new mum, keeping a baby alive, and change can sometimes be as helpful as some rest. When you’re doing the same thing all the time your brain sometimes falls asleep as you can do things without thinking, so doing something new or different can help increase your awareness and help you engage in life again.
You deserve to have things to look forward to, and to have a little bit of a break from your everyday life.
Postnatal depression isn’t fun, but it is manageable – it doesn’t have to define your life. This guide is designed to help you manage your postnatal depression, but if these steps aren’t helping, or you feel like you need some extra support please do seek it out. See your GP, ring Samaritans, talk to your health visitor or seek the help of a professional counsellor. Although it’s hard, do take advantage of these services if you need that extra support.
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About Jasvinder Jessy Paston
I’m Jessy, a qualified BACP person-centred counsellor and coach, supporting clients through talking and phototherapy. I specialise in postnatal mental health issues, depression, anxiety and bereavement, working in partnership with my clients.
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