What is postnatal depression?
Understanding postnatal depression
A continuum of feelings associated with becoming a mother, the task of keeping a tiny baby alive can feel daunting and stressful. A baby’s needs are relentless and can be difficult to understand at first. Even when things are going well, many new mothers will experience intense feelings of anxiety and depression that can come and go from hour to hour, or day to day, depending on how things are going. Postnatal depression describes an experience where these feelings persist for a long period of time and are difficult to shake.
Feelings of depression are often linked to low self-esteem. Mothers can feel that they have nothing to offer their baby and that their baby would be better off with someone else. They can feel that they are not doing it right and everyone else around them seems to be coping and managing.
This can be all the more difficult if a mother is feeling isolated and has no one to turn to. She can feel more easily overwhelmed and exhausted. There is a high incidence of postnatal depression amongst women who have had difficult or traumatic births. This can leave a mother feeling completely out of control, her sense of capability shattered. At a time when she might be in need of care and support herself to recover, she is faced with the enormous demands of a newborn baby.
Low self-esteem can affect how a mother interprets what is going on with her baby. If the baby is unwell or is experiencing difficulties, she may feel as though it is her fault, and that she is doing a bad job as a mother. It may also affect how she hears the cries of her baby.
When a baby is first born it can’t make any sense of feelings and life is just a mass of sensations and chaotic impressions. Babies are unable to differentiate different sensations, they don’t know if they’re hungry or tired, they just feel pain and this can feel terrifying, to them and their mother. Babies attempt to manage their feelings by getting rid of them and they do this by crying. It is hard not to feel your heartstrings tug at the desperation of a newborn’s cry. A baby needs their mother to make sense of their feelings and physical states and to help them manage them by comforting them and being able to think about what their cries might be communicating.
A mother who doubts herself might feel intense anxiety when her baby cries. The cry might sound like an angry accusation, “I’m feeling bad, you’re not helping me, you’re getting it all wrong.” This might prevent her from thinking calmly about what is needed and rather than feeling comforted, the baby might sense her anxiety. This escalates its own terror, and so a negative cycle is created.
Many women overcome doubts about themselves and their own self worth, by throwing themselves into a career and being successful at work. Having a baby is a very different change of pace. There is often very little noticeable achievement at the end of a very long day. The washing basket is still full, tasks remain undone. The task with a newborn is more one of ‘being’ with the baby, than of ‘doing’ and some women find this difficult. It can leave them feeling as though they are doing little of value. It is important that those around them can value the time spent being with and holding their baby. Research has shown that babies who are held more often, tend to cry less and are more securely attached.
From the moment of conception a woman will have ideas about what kind of mother she wants to be. Often she might want to pass on the good things she received as a child, or she may want to offer her baby the things she never had - an ideal image is created in her mind. The reality of having a baby can be different to the ideal though. A mother might feel resentful of her baby’s relentless demands through the day and night and she might mourn her previous freedom. All these feelings can leave her feeling terribly guilty and reinforce the fact that she is a bad mother, who doesn’t love her baby properly.
It is natural to have good and bad feelings in any relationship and surviving them together, is part of the bonding process. Mothers need help from those around them to accept their ambivalent feelings towards their baby. Accepting that these feelings are part and parcel of having a baby can help a mother feel less overwhelmed, or less of a failure. If a mother does feel overwhelmed by negative feelings it is wise to seek professional help.
Postnatal depression is often treated with antidepressants and increased health visitor support. In addition, counselling can help mothers to make sense of their feelings and identify their underlying causes. This can alleviate anxiety and depression. It can also support mothers to respond to their baby’s needs constructively and creatively. We now know that a secure bond between a baby and mother is an important part of developing trust, confidence and self esteem and early intervention can alleviate difficulties before they become deep rooted and enhance the relationship between mother and baby.
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