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Do I have postnatal depression?

If you’ve landed on this article, it’s likely that you or someone close to you is struggling with their feelings during parenthood. You might be a relatively new parent, or you might be wondering if postnatal depression is still a thing if it happens years after birth.

What is postnatal depression?
What is postnatal depression? Depression is a low mood that can ask a long time or keep returning. Postnatal means it happens in the period after you give birth.

Depression is defined as a low mood that can last a long time or keep returning, affecting your everyday life. Postnatal depression is simply when this happens after you give birth. It can also happen in pregnancy, when it is labelled 'Antenatal Depression'.

Postnatal depression is very common - it is estimated that it affects 1 in 5 mothers and 1 in 10 fathers, with around 3% of parents severely affected. Postnatal depression can still carry a stigma and it is estimated that 50-60% of those suffering are doing so in silence. Even for those who are courageous enough to seek help, only 50% go on to receive adequate treatment.

What causes depression in the postnatal period?
What causes postnatal depression? Image of several jigsaw pieces coming together each with various factors: finances, pressure of perfection, culture, lack of support, hormones, lack of sleep, trauma, change, lack of control...

Our society's common understanding of postnatal depression is that it is caused by hormonal changes after birth. People worry about "getting" postnatal depression, like it's a disease we catch that we can't do much about. Indeed, the massive hormonal shifts during pregnancy, birth and breastfeeding can be one factor that contributes to emotional difficulties, just like some women can have challenges during certain parts of their cycle or during menopause.

However, biological changes are only a small part of the puzzle. Postnatal depression is rarely a 'disease' you are stuck with. There are a myriad factors that can contribute to low mood in the postnatal period, and many of them are changeable. Exploring these additional factors is key to begin to feel better.

What is it about parenthood that is so challenging for our mental health?

Parenthood is a unique time of change. Neuroscientists have found that the changes that occur in our brains during pregnancy and early parenthood are of an equivalent magnitude as toddlerhood and adolescence! Our relationships change with our partners and our own parents. Our lifestyles change - we have a lot less time to ourselves and a lot less control over our environment. We are often sleep deprived. Finances can become more stretched. Gender equality within our relationships can become more challenging, and status and earning power can shift for different partners. We are often prompted to reflect anew on our own childhood experiences as we parent our own children. I'm sure you can think of more! Many of these changes are challenging for our mental wellbeing.

Our western culture doesn't help and is remarkably unsupportive of early parenthood. We're expected to 'bounce back' and 'get back to normal' almost immediately. Extended families are often far away and high quality childcare is extremely expensive. There's more information than ever on 'good' parenting and huge pressure and expectations to know everything and do everything 'right'. There's often a perfect storm at work too - just when we're starting to hit our stride in our careers we suddenly have all these new competing priorities at home, and with shifting gender role expectations we are all expected to do it all.

Are you surprised that so many parents struggle to feel ok?

Why do I feel worse than everyone else?

For some of us, we may have enough resources or support around us to keep our heads mostly above water. For others of us though, this combination of change and pressure can tip us over from feeling upset, frustrated, busy or worried, to feeling completely overwhelmed. It may be that our circumstances in the present are particularly lacking in support, or it could also be that challenging experiences from our distant or more recent past are being triggered - even when they seem completely unconnected. Reasons are completely individual.

I often describe depression as being like a chronic 'freeze' state. In times of stress, our nervous systems start in fight or flight, but if things just become too much sometimes the only thing left to do is give up, and hope it passes - freeze. It's a very difficult place to be.

What helps postnatal depression?
What can help postnatal depression? Talking therapy, building your web of support, changing your environment, dismantling parenthood myths, trauma therapy, anti-depressant medication

Many parents I work with find relief in anti-depressant medication. For some, they need some relief from overwhelming symptoms before they feel able to engage in therapy. For others, medication helps enough that they feel able to cope again. There are anti-depressants that are compatible with pregnancy and with breastfeeding if necessary and your GP is the best source of support here.

Instead of, or in combination with medication, counselling or talking therapy can be incredibly impactful. A solution focused approach can be used at first, to explore what unique puzzle pieces in your external environment can be modified to provide some immediate support. We'lll often also reflect on ways of thinking (your internal environment) that are eroding your mental wellbeing and changing these can have a huge impact too - thoughts like "I've no idea what I'm doing", "I'm not a good mum/ dad" etc.

A therapist can also help you talk about the feelings that are 'frozen' in depression, and begin to dip into feeling them. It can feel difficult to consider opening the door on some of these feelings - they have often been locked away for so long and feel so big that they might overwhelm you. There may be a need for specific trauma techniques to help to settle down challenging past experiences. We always begin slowly, opening the door just a crack, taking a peek, closing the door again. Once you have a better outline of what's behind the door you will build confidence in opening the door wider, for longer, adding detail and colour. It will likely take some time.

Depression is often a sign that something has been locked away, that there are thoughts and feelings inside that need some light shone upon them. Sharing them, being witnessed with compassion, being understood often allows those feelings to move through. With a therapist to support you, you will become more confident at feeling the sadness, the anger, the frustration, the overwhelm, whatever feeling it is that is stuck. In time you will learn how to become unstuck, and unfrozen. You will begin to move out of this fearful frozen state and start to re-enter the world.

What would it take to begin?
Get support for postnatal depression checklist: talk to a trusted friend, talk to your GP, self refer for NHS therapy, search hearts and minds map for perinatal charity support, google local perinatal counsellors

What is the smallest step you could take today to feel better? Maybe you've already done it, by reading this today. Maybe you have some thoughts on what you'd like to do now?

Here are some more ideas:

  • You could send a text to a trusted friend and ask for support

  • You could make an appointment with your GP to talk through your options

  • You could self refer for free NHS talking therapy (in Kent, take a look at Live Well Kent & Medway)

  • You could search the Hearts and Minds UK map for charity sector perinatal support near you. If you live in West Kent or nearby, you could book a free Perinatal Listening Service appointment with Baby Umbrella.

  • You could google a perinatal counsellor for private therapy, or contact me to book a taster counselling session in Sevenoaks

You deserve support
Large heart outline - You deserve support for postnatal depression: It's not your fault you're feeling this way. There are people who can help you. Take the first step.

Please know that there are people out there who can support you to feel better.

We care about you.

If you haven't found the right person yet, please try again.

Don't wait and hope for it to pass, but take the first step today.

Laura x

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