Excerpt from chapter 4 - When your Blessings Don't Count - by Linda Lewis
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There are three types of mood disturbance that could follow childbirth and they are frequently confused or inadequately grouped together under the heading of postnatal depression.
These syndromes can be seen as existing on a spectrum where the mildest condition is the “blues” and the most severe condition is postnatal psychosis. Postnatal distress falls somewhere between these two and is distinctly different in terms of onset, severity, duration and treatment.
THE “BLUES”
The “blues” a very mild and common syndrome that occurs within the first few days after delivery, caused by a sudden drop in the hormone oxytocin – it is experienced about 85 per cent of women. So if you don’t get the blues, consider yourself lucky. It is caused by hormonal changes that occur during pregnancy, delivery and lactation. Typically, on about the third day, the mom will feel any or all of the following symptoms:
A feeling of sadness
Tearfulness
Clinging dependency
A fragile mood
Feeling overwhelmed with the huge responsibilities with which she is now faced
Exhaustion
Inability to sleep
Some anxiety
This experience, although distressing and unpleasant, shouldn’t last longer than a few days and is not PND. If it continues for more than two weeks, it is important to consider that it may be the onset of PND and you should have this assessed by a professional.
POSTNATAL PSYCHOSIS (PNP)
On the other end of the spectrum is a very severe disorder called postnatal psychosis. PNP usually occurs within the first three months after childbirth and is very rare – only one to two in a thousand women who gave birth will experience it. The most common symptoms of PNP include:
Seriously disturbed thinking
Delusions about the baby being dead or defective
Hallucinations about harming the baby
Agitation, irritability and restlessness
Manic behaviour
This is a very serious condition which requires immediate hospitalisation and medication, as the new mom may be a danger to herself, her baby or others around her.
POSTNATAL DISTRESS (PND)
Each mother’s experience of PND is unique – there are no two women who would describe it in an identical way.
The following list covers a lot of the thoughts and symptoms that women use to describe what they are going through in the postnatal period and you may experience them on a scale between mild and severe:
Anxiety
Feeling a sense of panic which may express itself in panic attacks with palpitating
heart, sweating palms, feeling as though you’re going to die
Agitation: inability to sit still, constantly uncomfortable in your body
Fear of anything and everything: from driving alone to security in your home
Irritability: especially with those close to you, including your partner
Anger: especially with your partner
Tearfulness: an inability to stop weeping
Acute sensitivity/vulnerability: from what your mother-in-law says to worrying about
the beggars on the streets
Repetitive thoughts which are sometimes frightening or irrational: be it about something happening to your baby or not being able to get a song out of your head
Feeling overwhelmed: wondering how you will ever manage and asking yourself how any other mother does
A lack of self-esteem/confidence: you keep questioning whether you are doing the
right thing with your baby
Indecisiveness: for example not being able to decide what to wear or what to make for dinner
Forgetfulness: you walk to the kitchen to get something and by the time you get there you have no idea what it was
Difficulty concentrating: you can’t even read a magazine or watch your favourite show on TV
A constant need for company/support: you can’t bear the thought of your husband going to work or coming home five minutes late from work; you dread your domestic helper or night nurse having a day off
You can’t face socialising or being around people with whom you need to hold up a mask
Feeling like you are a terrible mother and that someone else could do a far better job
with your child
Detachment from your baby, yet still protective over her
Insomnia: even when your baby is sleeping you can’t sleep
Inability to be in the moment: continual anticipation of your day/life ahead
Loss of appetite: you have no desire for food and simply eat whatever is available
and easy to prepare
Having no passion for things you’re usually passionate about, be it cooking or eating good food, shopping for clothes, watching movies, reading books etc.
Waking up in the morning dreading the day ahead
Wishing you could just turn back the clock because it feels like you’ve made a big mistake by having this baby
Thoughts of harming yourself or the baby
Wishing that someone could just mother you
Inability to understand how other people’s lives can continue as normal
Inability to believe that for some moms this is easy
Completely obsessed with what you are going through: you could talk about it every waking minute
Just being on autopilot: you have to talk yourself through the motions of getting out of bed, brushing your teeth, having a shower, feeding baby, bathing baby etc. The pervasive feeling is that you have lost the self that you know and can’t imagine ever being the same person again.
To summarise, from having been an independent, competent woman you have become a dependent, needy, insecure mother and this is all so very different from how you expected motherhood to be.
Where you can get help - Post Natal Depression Support Association (PNDSA)