Self-help for post-natal depression symptoms

Between 10 and 15 women out of every 100 are unlucky enough to get postnatal depression after childbirth. The risk is higher if they were already susceptible to bouts of depression before pregnancy.

For many women having postnatal depression is a shameful thing. It bears the stigma of a mental illness. They feel guilty that they cannot enjoy their child as much as they expected, they are not the wonderful mother they thought they would be, they are not the mother that society would seem to expect them to be. So they try to hide it from their family and friends and the one who loses out most is the innocent baby caught up in the middle of it.

Having postnatal depression (PND) is most certainly nothing to be ashamed of and it is vital that prompt action is taken to tackle it as it can have long term affects on your child's development and behaviour which you may never be able to expunge no matter how much love you give them.

... does not exist. Truly. Despite the best efforts of magazines and television to persuade us that you will bloom during pregnancy, come out of labour looking flushed and provocatively tousled with your eyeliner still in place and then go on to be the glamorous, capable 'mom' that every kid wants, real life is just not like that.

Realising this fact may well just help you cope with PND.

Being honest about motherhood.

It is a fact that whilst most of us do realise that you can be fiendishly sick during pregnancy, that you feel bloated and uncomfortable and that giving birth is definitely going to be the proverbial pain in the ass, few of us will actually admit to being what they see as an inadequate mother.

This is one hurdle they need to get over as few of us ever live up to the expectations we have of motherhood. Being a mother means having the word 'guilt' tattooed across your forehead forever and the best we can do is ... the best we can do.

Most new mothers have been warned that they may get the 'baby blues' a few days after giving birth. This is easily identifiable by its mood swings and emotions can range from tearfulness to irritability, anxiety or depression. It is a natural phenomena and only if it lasts more than 10 days should help be sought.

PND is more full-on and can even start as early as depression in pregnancy. However most PND starts one or two months after giving birth and can sometimes start quite a few months afterwards. The warning signs are:

• Irritability

• Low mood/depression - often weepy - sometimes at specific times of the day

• Tiredness - difficult to identify from normal new baby sleep deprivation

• Sleeplessness - despite often being dog-tired

• Anxiety - about your baby's health etc. and your own inabilities as a mother

• Inability to feel anything for your child - this is so socially unacceptable that it naturally ramps up the anxiety levels

• Changes to eating habits - forgetting to eat/not feeling hungry or, conversely, comfort eating

• Lack of interest in sex - this however may simply be a natural reaction to tiredness

• Disinterest in life in general/lack of hope - this can be as deep as despair

• Avoidance of other people - specifically apparently 'successful' mothers

• Negative thoughts about yourself and the baby

• Panic attacks

• Thoughts of suicide - often as an alternative to the thought that you might harm your baby.

• Psychotic symptoms (Pueperal or Postpartum Psychosis) - which can include hallucinating/hearing voices and irrational beliefs.

  Pueperal psychosis is a very severe form of PND and requires non-negotiable and immediate medical intervention. It can come on very quickly after childbirth and can be life-threatening. Fortunately, only 1 in 1000 women will go on to develop this form of PND and it is possible to make a full recovery.

This will vary from sufferer to sufferer. From personal experience I would offer the following advice:

• Talk honestly to your midwife/health visitor/GP

Do this immediately you think things are not right. Tell them how you feel and describe your symptoms accurately, remember this will be confidential. This is not the time to hide your emotions. The more you tell them the more easily they can find a way of helping you through PND in as short a time as possible. Accept their advice. Take the antidepressants, go to counselling/group therapy etc. Do whatever it takes ...

• Ask for help from your husband, friends and family.

This may be the single hardest thing to do as it often seems like an admission of inadequacy and many of us are too proud to admit this, especially to mothers-in-law.

• Give up any idea of being 'Supermum' for the time being.

This is when you must remember that you will get through this in time and can then you will be able to regain your credibility as a mother. Your immediate concern is to get through it. Always remember: 'This too shall pass'. Write this on a piece of paper, stick it to the fridge and really 'see' it everyday and take it to heart.

• Distract yourself.

If you find it too hard to mix with the other, apparently more successful, mothers do something that pleases you for a short time everyday, usually whilst baby is napping. Be creative. Creativity accesses a different area of your brain and you can find yourself 'in the flow' as it were. This is where you can lose track of time and forget your problems for a while. Writing and painting can be extremely helpful right-brain pastimes for this sort of self-healing.

• Do not beat yourself up.

Please, this is so important. You did not fail. For most of us there is no way we could have done anything different to avoid it. It is simply a lottery. Give yourself love and understanding. You will get through it intact and return to being your loveable, sunny self.

Nearly 40 years ago I gave birth to my first child, my beloved daughter Anna. My husband and I had planned to have a child and I had had a wonderful pregnancy and was looking forward to her arrival. I was relaxed and supremely happy.

She arrived a month early, a breech birth after 24 hours in labour. I saw her fleetingly hanging by her feet from the hands of a male midwife before she was whisked away to a warm nursery. No-one thought to check if I wanted to hold her, or even see her ... for a couple of days. I was left to my own devices and being a fairly retiring type then I did not dare bother the busy nurses to ask if I might go and see her. It is amazing to me now that I was so unassertive. It is also amazing that no-one thought to chivy me into going to see her. My husband on his visits saw more of her than I did.

So, I believe I lost the chance to bond with her and also the chance to breast feed as she was fed through a tube for those first days. It was a poor start and gradually I began to feel inadequate especially as she did not thrive when we got home. I became worried, then exasperated with her inability to feed as I expected her to. Despite help from my husband and his mother, neither of whom really understood what was happening to me, I sank into PND after about 5 months.

My GP was my lifeline. He called everyday despite censure from his senior practice partner and told me, over and over again, that I would get through it. This too shall pass, became my mantra, even as I begged him to commit me to an insane asylum fearing I would harm my daughter. I contemplated suicide because I felt that only that would keep her safe.

I had so little self-esteem that I would wash down my anti-depressants with neat whisky ... even though I hated whisky. When I was on my own I sat huddled on the floor leaning against the childproof fireguard to keep warm and I ate only toast and jam until my husband came home to cook. I didn't want to go out and I certainly didn't want to see my best friend competently coping with her new baby son.

Looking back, even from this distance, all my memories are seen 'through a glass darkly'. There is a cloudy black frame around each remembered scene. Gradually I began to write. Each day, after I had put my daughter down for her nap, I wrote feverishly. The result was an extremely poor screen play about PND and its effects on a family; I was writing about what I knew and, despite the subject matter, it helped.

Eventually having to admit that I could not tackle this problem by myself I was persuaded by my doctor to go to the nearest mental hospital (we had them in those days) and join a group therapy class. I went ... but I didn't feel that it helped me at the time. I was resistant but I still went once a fortnight in the hope that I would have some sort of catharsis, obtain some sort of healing.

I cannot remember how long I had been going to these sessions when I one day, one well-remembered day, I came away thinking how pointless it all was and I suddenly found myself determined to sort it out for myself. In that instant I felt a strange wash of strength flood through me. It was so startling that I knew then that I was mending. I had survived, my daughter had survived and we would go on together. But I had lost a lot of valuable time with her. In all it had taken me well over a year to get through it.

The constant memory of that year meant that it took me five years to pluck up the courage to have another baby. This time I planned. I vowed this time I would not get PND, it would not happen again if I could possibly help it, this time at least I would bond with my child. I made many stipulations and even though there were complications towards the end, even though it did not go entirely as I planned I managed to hold my son from the moment of his birth. I was on cloud nine. I was haemorrhaging dangerously but in that moment I didn't care if I lived or died. I had my child, my baby boy in my arms.

The bliss of that moment lasts to this day ...