Normalising the conversations around postpartum/postnatal* depression is the goal, according to Susan Hogan, midwife, mother-of-two and co-founder of the educational support platform, The Baby Academy

“There is still a stigma around new mothers who are experiencing depression or anxiety despite more conversations around mental health taking place,” she says.

“This can lead to it being dismissed as ‘baby blues’, or not discussed by a new mother out of fear. This in turn can impact the number of women seeking help and support.”

Susan believes that it is important to remember that postpartum depression is a real illness that can have serious consequences if left untreated.

“By breaking down the stigma and educating others on the realities of postpartum depression, we can help to ensure that women receive the support they need,” she says.

When to seek help

So, what are the most common symptoms of postpartum depression and at what stage should help be sought?

“The most common symptoms of postpartum depression include feeling depressed, anxious, hopeless, irritable, tired, and unable to sleep, although these are not the only symptoms of postpartum depression*.

To identify if a new mother may be suffering from postpartum depression, it’s important to pay attention to how she is feeling and if these feelings are impacting her daily life. If a woman reports feeling ‘not like herself’ for 14 consecutive days or more, it’s important to encourage her to seek support.”

Ensuring there is adequate, accessible healthcare and support for women experiencing postpartum depression is essential, she adds.

“A lack of supports available may have a serious impact on a woman’s mental and physical health, as well as her relationship with her baby. By providing accessible healthcare and support we can help to improve the mental health of new mothers and their families, ensuring that they have the best possible start to life with their new baby.”

Where to seek help

Support for women and their partners in Ireland can be sought via one’s GP, maternity hospital, public health nurse or an organisation like AWARE, but the HSE also provides what’s called the ‘Specialist Perinatal Mental Health Service’.

“This service is accessible to pregnant women and women with a baby up to one year old who may have an existing or new mental health problem,” Susan says.

“This service is also open to women with severe mental health problems who are planning a pregnancy. It offers assessments, treatments, and referrals and an overall support for women attending the service.”

Sign of strength

Seeking help for postpartum depression can be difficult for new mothers, however, especially when caring for their baby leaves them very little time and very little energy.

“It’s important to remember, though, that seeking support is a sign of strength, and is the first step in feeling better.”

Andrea’s story

Andrea’s baby is almost two and she talks about her experience of postpartum depression:

“When I had my first baby the transition from being pregnant to an exhausted and completely overwhelmed first time mum shocked me and I felt completely unprepared. I had done so much research and baby classes but I still felt so overwhelmed by everything, from changing nappies to feeding and like I couldn’t be the mum my baby needed. The first three months of my baby’s life is a blur. I only have the photos and videos as memories. I was constantly crying and felt like I couldn’t look after him now that he was out from the safety of my uterus.

“I was terrified to sleep because I was terrified that he would spit up and choke or stop breathing while I was asleep. I had constant intrusive thoughts and vivid images of the worst case scenario, like dropping him while going down the stairs, waking up and him not breathing, just horrible constant images of this happening.

“This all had a debilitating impact on me. I was terrified to sleep, terrified to be alone with my baby. I lost so much precious time with my baby over it. I found myself hiding the fact that I was crying and having anxiety attacks from my husband. I just sort of snapped out of it long enough to realise that if I couldn’t speak to him about how I was feeling, when previously I shared everything with him, that I needed help. I spoke to my GP who suggested the maternity hospital mental health team and starting SSRIs [anti-depressants called Selective Serotonin Reuptake Inhibitors]. The mental health team also set up counselling sessions for me.

“I’m still recovering 18 months later. I have down days and anxiety but I feel much more capable of recognising when I’m not okay and how to cope.

“My advice to mothers would be to take each day as it comes. Check in with your partner, friends and family because I promise you no one will judge you if you are struggling or need help. Raising children truly takes a village so utilise your village. If you notice signs of PPD or anxiety don’t be afraid to speak to professionals. I promise you no one will take away your baby if you’re dealing with these issues. Unfollow [social media] accounts that show unrealistic portrayals of motherhood and follow wellness pages that will empower you. You’ve got this. You are a good mum.”

Ashley’s story

“For me, my PPD [postpartum depression] didn’t develop until my little girl was around five months old, which surprised me as I had always thought that it was something that happened earlier.

“We all know that adapting to motherhood is a huge adjustment and we all crave that little bit of our ‘old selves and lives’ but for me this just wasn’t going away. I know I was being the best mother for our little girl and she is the light of my life. However, for me, Ashley the person, I resented how I looked and not being able to wear my clothes, which for me is a big part of my identity. I had to ensure everything was easy access for feeding whereas all I wanted to wear was the beautiful summer dress that was hanging up in my wardrobe.

“Other things such as the house not being perfect, crying at the smallest things was a shock for me. I was even becoming slightly jealous that my husband was able to go to a gig with his friend yet I was stuck at home with my baby permanently attached to my boob. This led to arguments and we never argue.

“In addition, I was anxious about our baby - was she putting on enough weight etc. My anxiety was through the roof.

“Eventually I reached out to my public health nurse and the tears just flowed. I was referred to my GP who prescribed a small dose of anti-depressants and also advised me it was important to get some ‘me time’, whether that be getting my nails done or arranging a lunch/dinner with a friend. With my baby now starting to take a bottle I would be able to do this so I booked a dinner with a friend for the following week. Wow! It was just the medicine I needed. I planned regular breaks after that to give me something to look forward to.

“My public health nurse also advised me of this great programme that the HSE provides to new mums who are experiencing PPD, called The Ups and Downs course which was really helpful.

“A big part of it [recovery] was understanding to let go of the huge expectations we put upon ourselves. One of my traits is perfectionism, which can be a good and a bad thing, but it was time to let go of this and know that what I was doing was more than good enough, though it was easier said than done.

“I am now four months into my PPD journey and feel like I have made huge strides. I feel like ‘me’ again. I know my road is going to take time, there is no quick fix for getting your hormones in check … but I feel I am now equipped to identify if I am, perhaps, taking some steps backwards and that I may need to reach out for help again.”

Immediate action needed If you have these symtoms

1. Postpartum psychosis is a rare and severe form of postnatal depression. It is also called postnatal or puerperal psychosis.

2. Postpartum psychosis happens within the first few weeks after giving birth. It can begin as early as two to three days after childbirth.

3. You are most at risk of postpartum psychosis if you already have a mental health condition. For example, bipolar disorder, schizoaffective disorder or schizophrenia.

Symptoms of postpartum depression include:

  • feeling paranoid
  • having delusions or hallucinations
  • mood swings
  • confused thinking and associated changes in behaviour
  • you may also have other symptoms of psychosis and thoughts of harming yourself or your baby
  • Immediate action required

    Contact your GP or obstetrician urgently if you are experiencing any of these symptoms or if you notice a new mother experiencing them. They will arrange rapid assessment by the HSE Mental Health Services.

    Treatment usually includes antidepressants and anti-psychotic medication and care from mental health experts.

    * The terms postpartum and postnatal are used interchangeably but technically, partum refers to the mother and natal to the baby.

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