Don’t feel bad if motherhood hasn’t exactly been the picture of happiness and serenity you imagined it would be. Postnatal depression, discovers Kerryn Massyn, is more common than you may think. Fortunately, there is light at the end of the tunnel.
With celebrities like the ever-enviable Chrissy Teigen and perennial favourite Drew Barrymore breaking the silence, postnatal depression is starting to become something we talk about, and in so doing, shake off the guilt and shame PND brings.
“I realised I had PND only years after having my daughter, but looking back now I had it from the beginning. I had my daughter in the UK and I felt very isolated. This only increased when we came back to South Africa when she was three months old. I thought it would be great being back here but all my friends and family were working. I didn’t have a network of new mom friends to talk to and I didn’t know if what I was feeling was normal. I remember telling my husband we should rather give her up for adoption, as I wasn’t a good enough mom – of course he was absolutely shocked. I felt totally disconnected from my baby. I loved her so much, but I was expecting something more, which didn’t happen for a while. It felt like all I was good for was feeding her. I had also had a very traumatic birth and felt that my body had let me down. I also felt overwhelmed at the thought that she would need me forever,” mother and doula at Beautiful Births and Beginnings, Chrissie Smith-Schuler, says of her experience.
Battling the blues
She’s not alone in these feelings. Around 34.5% of South African women struggle with symptoms of postnatal depression (PND), according to recent studies – that’s a little over one in three moms. But, says clinical psychologist Batetshi Matenge, this is probably not the whole picture. “This a greatly under-researched area in our country so I imagine PND is often underdiagnosed or misdiagnosed because of a lack of awareness and stigma,” she says.
Many moms are familiar with the baby blues – the feelings of weepiness and anxiety that set in around day three after the birth of your baby. Batetshi says that the baby blues can be attributed to the hormonal changes taking place in your body, as well the lack of sleep and sudden responsibility of being a parent (particularly, she adds, the pressure to be a “supermom”). This also coincides with your breastmilk coming in, which can also leave you feeling strange physically.
However, PND is something else altogether. The symptoms include feelings of sadness and uncontrollable tearfulness, feeling anxious, having sleep difficulties beyond that related to caring for a newborn, inability to concentrate, changes in appetite, a loss of interest in things you previously enjoyed, loss of libido, and even thoughts of suicide. “Postnatal Depression often presents in the first six weeks following delivery, but the onset can also be more gradual. Most cases require treatment from healthcare professionals. This type of depression differs from others in that women who struggle with it feel a deep disappointment in themselves because of the societal belief that motherhood should be positive, natural, fulfilling, and wonderful. Social media has greatly contributed to this – depicting motherhood and children as perfect and that the mother has time to go to the gym, wear makeup, and succeed in her career while raising her children. As a result, mothers often feel guilty, helpless and inadequate when faced with the day-to-day demands of a new baby. They, at times, lose interest in caring for the baby, expressing that ‘they do not want it’. Although research tells us that Post Natal Depression is the most common complication of childbirth, it is stigmatised and therefore — some mothers find it difficult to come to terms with it,” explains Batetshi.
There is yet another condition on this scale, called postnatal psychosis. “This is the most severe postnatal affective disorder. The onset is often rapid, with symptoms presenting as early as the first 48–72 hours postpartum. Over and above the symptoms of PND, mothers may have a depressed or elated mood (which fluctuates rapidly), disorganised behaviour, delusions and hallucinations.” This is a serious condition that requires immediate medical attention.
It’s not a simple matter
Sometimes, it’s the very expectations we have of ourselves, the birth experience and being a mother that lead to PND. “I had a hectic and long birth experience with my daughter, Milla. I had the birth I wanted: natural, with no meds. But it turned out a bit differently than I had imagined. After 24 hours in labour with slow progress, they had to rupture my membranes to speed things up. Her birth was an amazing experience but just overwhelming. I got all I wanted from my birth plan – took her out myself, with no intervention, candles were lit, music was playing, etc, but I got a shock was when midwife said, ‘Okay, now let’s stitch you up!’” mom of two, Olga Jardine, explains of her labour. “My lady parts were torn and in shreds disgusting – which had always been my only birth-related fear. This messed up my bonding experience for about three weeks. I still can’t remember anything about the first few weeks, except what I see from the photos.”
The pressure to be perfect doesn’t help either, says Chrissie. “I have seen an increase in PND amongst my clients. I think a lot of it has to do with having little or no support after the birth, but social media plays a big role too. We tend to compare ourselves to the picture-perfect lives we see on social media, but it’s important to remember that people generally only ever share the good stuff on these platforms and never the bad stuff. So, what you’re seeing doesn’t fully portray the realities of life as a mom and all the struggles that come with it. I feel that society makes it seem that we are ‘made’ to be moms and will know everything automatically after having a baby, which is not true,” she adds.
And if you’ve struggled with depression anxiety, or other mental health issues, you may be more likely to develop PND. “These factors can also include stressful life events like fertility complications, lack of social support, a strained marital relationship, socioeconomic status, unresolved emotional issues from the past, and prior sexual abuse. It is highly probable that many women may have experienced symptoms but never sought treatment. It is important to open up to health professionals about your past psychiatric illnesses or an increased awareness of your mood during pregnancy,” advises Batetshi.
Find a helping hand
“PND can have far-reaching consequences, such as an impairment in the mother-child relationship, child neglect, a breakdown of the family unit, cognitive or developmental delays, behavioural problems in the child, and even suicide or infanticide,” says Batetshi. “This is why it is so important to get treatment for your PND. Effective treatments include psychotherapy for the mother, parent-Infant psychotherapy that focuses on working with the parent-infant relationship, and medication. Mothers or family members can contact a clinical psychologist or psychiatrist to seek help.”
A good support network is also key. “What helped me get through it was help from others. My mom and husband Shaun helped a lot by taking her and letting me sleep after feeds,” says Olga. “I also got a lactation specialist help me with feeding, which was painful, and made an effort to get out of the house. Breaking the never-ending cycle. Try to remember that this is just a stage – you’ll have a life again one day!”
“Speaking about it and sharing my experiences is how I healed. Ultimately, Training to be a doula started the proper healing process for me,” says Chrissie. And time – she grew bigger and I began to really enjoy her. Mostly, when it comes to PND and any other struggles, I tell my clients that they should never be too worried or embarrassed to ask for help. Talk to someone.”