Help for Postnatal Depression

If you are suffering, or think you may be suffering from PND, first be reassured that you are not alone and the vast majority of people with it survive with few long-term ill effects.

Here are some suggestions that may help.

  • Get help where you are. Tell your nearest and dearest how you really feel.“I found the hardest bit was to admit that I wasn’t coping, even when it looked like I was, I was fine on the outside but was a complete mess on the inside.” Many women testify how supportive their partners and families and close friends are once they understand – ask them to help with the basic jobs of daily life; cooking, cleaning etc. Help them to see how useful you will find it when they listen to you with acceptance and without judgement, and how their understanding when things go wrong is vital. Guilt is a large part of PND and many kind people may inadvertently add to this burden.

  • Get help from your local health care providers. This may be your GP, your midwife, your health visitor, your local SureStart centre. The quality of care from these resources can vary enormously. It can help to write down on paper how you feel in advance and what you think you need (validation, formal counselling, CBT or medication, for example) and take it with you to appointments. Continuity of care is great, if available; a HCP who listens and cares can make a greater difference than one who fires questions and is keen to tick boxes and prescribe medication at once. “Guilt and lack of confidence are so typical of PND and my HCP was essentially validating those feelings even though objectively I was doing a great job!” Be armed with information (e.g. if you wish to carry breastfeeding, sertraline is safe in these circumstances). The Breastfeeding Network is a valuable resource. If you are not satisfied with the care you are receiving, find different care.

  • Get help from your local non-NHS resources, such as HomeStart (a befriending service) and local PND groups. A postnatal doula may help, and there are many national helplines and resources (see below)

  • Get help from online social resources – there are many forums and parenting groups full of people who know how you feel, and will listen and share. Being among people with the same values and parenting beliefs may be a source of great encouragement. Equally, avoid too much time online.

  • Get out! It can be very hard to actually get out of the house when struggling with dark thoughts or hopelessness, but it is worth the effort involved. Even a walk down the road is a good start, and encourages release of endorphins (the natural feel-good hormone). Arrange to meet some friends, and ask them to encourage you to come. Try to make a plan for most days, and be kind to yourself if you decide on a pyjama day instead. Try to arrange some time to spend alone with your other half, to remember who you still are, as well as parents.

  • Get nourishment – good quality food, drink, exercise and sleep are vital to your own health and sanity, as are times to enjoy the things you used to. Dress well in bright mood-enhancing colours. You are still a person and your own needs should be met as much as your child’s. Some people make use of night-time carers to allow some much-needed uninterrupted sleep.

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  • Get a sling or carrier. Keeping your baby physically close is well known to improve bonding and attachment through the action of oxytocin, and reduce anxiety and depression. “The sling brought us back to an almost pregnant-like state, with him a part of me, listening to one another’s cues. He was calmer for being close to me, which made me feel more confident, which brightened my mood. Leaving the house felt less daunting so I got more exercise and again increased my confidence. I talked to him more, whether he was awake or not, and he became my son rather than a tiny scary stranger.” “My favourite thing in the whole world, that never fails to calm me or lift my mood has been cuddles with my baby, particularly skin-to-skin. For me, there is no antidepressant like it.” “When she was in her pram I felt completely removed from her and her world. I was just an accessory, she was a job to do and I was irrelevant. Using a sling finally helped me bond properly with her and made a massive difference to the PND.”

 

 

  •  Get past your birth story – For many women, recovering from birth takes a while, especially if it was not the hoped-for experience. The NHS Afterthoughts service and counselling can help if you feel a sense of grief.

 

  • Get a sense of perspective. What matters in these early months is you and your baby. It does not matter what other people think; the house does not need to be pristine, you do not need to impress people with how well you are taking to parenthood. I have heard many women describe how they “are falling apart on the inside” and “I thought because I wasn’t suicidal or not looking after things that it couldn’t be PND so held back for a long time from accepting it and getting help.” “I found the hardest bit was to admit that I wasn’t coping, even when it looked like I was, I looked fine on the outside but was a complete mess on the inside”

  • Get confident again – reflect on what you have achieved so far and use that to build self-belief. Learn to trust yourself, be an instinctive parent – and you will fin that as you encourage others, you will find yourself lifted too. Some people find going back to work can be very helpful; the chance to use skills again and have adult interactions once more can be a great boost to self-confidence.

 

by Dr. Rosie Knowles – our resident GP.

 

 

Useful Resources

Postnatal Depression Information Leaflet

Postnatal Depression Information Leaflet 2

Pre and Postnatal Depression Advice and Support (PANDAS)

Doula UK

Mothers for Mothers Postnatal Depression Support

Postnatal Illness Information (PNI)

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