I'd been sitting on the end of the bed, semi-dressed, staring at the
clothes hanging up in the wardrobe and sobbing for hours. Ever since the
midwife rang, in fact, and cancelled the appointment we had scheduled for
that morning. She was deeply apologetic and deeply overbooked owing to a
complication with another patient. Was I OK? Her tone anticipated that she
could see no reason why I wouldn't be, and circumstantial evidence was in
her favour: I was 31; I didn't live alone; this was my second baby; I'd
given birth naturally to a healthy boy; I seemed relatively intelligent and
competent.
At that precise moment I felt utterly abandoned and so heavy with despondency
that I could barely contemplate the walk down the hallway to the foot of the
stairs, but I was up against the patient with a complication who was
haemorrhaging over her kitchen floor, and it felt wrong to take up any more
of the midwife's time. Of course I was OK.
We rescheduled and she hung up. I don't know how long it took me, but I
eventually made my way back upstairs. The wardrobe doors were still open,
but as the midwife wasn't coming, getting dressed became an impossible feat;
one I knew I'd never accomplish that day. Then, with a realisation that
brought on more sobs, I suddenly understood that it was how her life had
sounded so busy and full that had really affected me and not the cancelled
appointment.
I'd given birth three weeks previously in the way I wanted, thanks to two
hugely supportive delivery-room staff, an aggressively determined partner
and a bottle of Neal's Yard Remedies massage oil. Our baby was delivered
safely and naturally; our older son was now an older brother and in the
outside world my third book had just been published. I was on a complete
high.
So what had gone wrong? Sitting in front of my wardrobe that day, I concluded
that my post-birth high came to an end around the same time as my partner's
paternity leave. The sound of the front door slamming shut in the morning -
when my older son left for school, and then again when my partner left for
work - gained a whole new resonance that I came to associate with profound
loneliness.
My first pregnancy was unplanned
Having a baby hadn't felt like this first time round, and circumstances
couldn't have been more different. Our older son was unplanned. I had him
when I was 19 and my partner and I were still at university. Our son's
routine was dictated by our lecture and seminar timetable, and if there was
a play or film we wanted to see, we took him with us. I was exhausted and
anxious, and yet I never got depressed.
We were still growing up ourselves and every upheaval we experienced, our son
went through it with us. I started to feel increasingly guilty about this
and by the time I became pregnant again, I was obsessed with doing it
“properly”, despite the fact that our 11-year-old son was happy, healthy and
thriving academically.
The “doing it properly” package consisted of a planned pregnancy, a home of
our own and a fixed routine. But while the package may have worked for
others, it just didn't for me.
I was terrified of revealing the helpless, hopeless person I felt that I'd
become to those who knew and loved me, especially my partner, in case they
started to see me in a different light - or even stopped loving me at all.
Every time my partner so much as mentioned the word “depression”, I felt as
if I was under attack.
I put what little energy I had into concealing my feelings from my son and my
husband. The consequence of this was a self-inflicted feeling of isolation.
There was a strong local parent/baby network, with countless drop-in groups,
that I could have gone to, but the few I tried had a competitive element
that was counterproductive: from who's got the best buggy to who can
publicly love their baby the most? We were all going through the same thing,
learning to become mothers, and all pretending that we were absolutely fine.
Society has a lot to answer for in being so slow to acknowledge that the myth
of motherhood is precisely that. Having a baby is the most emotional and
psychological experience of a woman's life, whatever her class. Some women
get happy after having a baby, some get sad, and most get both. Until
recently postnatal depression wasn't even supposed to exist, which was why
our mothers' generation was treated for it on general psychiatric wards.
Today, a readily available variety of support is available at primary care
level in the shape of cognitive behaviour therapy and/or a pharmacological
approach.
I should have spilt the beans
Just as the depression started when my partner's paternity leave finished, so
it ended - gradually abated would be more honest - when my son started
sleeping through at three months old. I started to plan my days; to leave
the house and seek company rather than avoid it. My energy was back. My
depression had been relatively mild, but I started to realise that I would
have had far fewer bad days if I'd even once spilt the beans at a
parent/baby group and brought the monster out of the closet. Likewise, if
I'd answered the phone when my partner rang and I was sobbing uncontrollably
rather than ringing back when I was done with the tears.
The more I think about it, the more I have come to realise that postnatal
depression isn't a condition so much as a process - unavoidable and even
necessary - that all women go through. In my case, there were no indicators
that it would descend unannounced; I'd never suffered from depression. But
just how realistic is it to assume that a combination of acute sleep
deprivation, disorientating hormone imbalance and overwhelming love for 7lb
worth of human being who shares the same genes as you will leave a person
emotionally unscathed?
Having a happy family takes hard work, and knowing how much work has gone on
behind the scenes in our family, not a day goes by when I take for granted
that I have two wonderful children and a loving partner.
Sarah May's new novel, The Rise and Fall of A Domestic Diva, is published on
Monday (HarperCollins, £6.99). It is available from Times Books First at
£6.64, free p&p. Phone 0870 1608080; or log on to timesonline.co.uk/booksfirstbuy
Understanding postnatal depression
What is it?
Postnatal depression (PND) affects one woman in ten. It usually starts within
a month of giving birth, but can begin up to six months later. It can occur
even when a baby is eagerly anticipated and it creates feelings of guilt and
worthlessness.
Isn't it just the baby blues?
No. Although about half of new mothers will feel weepy, drained and unsure of
themselves immediately after giving birth, this usually passes after a few
days.
What causes it?
Although hormones may cause the “baby blues”, they do not seem to play a role
in PND. A number of factors may prompt the condition, including a history of
depression, an unsupportive partner, a premature or sick baby, losing your
mother at a young age, bereavement, housing problems or financial worries.
Symptoms
Feeling low, especially in the morning and evening. Irritability and
exhaustion, yet finding it hard to sleep. Loss of appetite and sex drive.
Overwhelming anxiety about the welfare of your child and dread at being left
alone with them. Although depressed mothers are usually crippled with worry
that they may harm their child, this rarely happens.
What you can do
Leading up to the birth, make sure not to get overtired. Try to postpone
moving house until the baby is six months, and make friends with women who
are expecting or have recently had a baby. After the baby is born, it's
important to tell someone - partner, friend, family or health visitor - if
you are feeling depressed. Don't feel ashamed to admit that you're having a
hard time and don't blame yourself or your partner.
Treatment
PND usually gets better on its own with time, but it's a tough ride and
requires support from partner, friends and family. Counselling may help;
talk to your GP or health visitor about this. Antidepressants may help
severe cases of PND, although these do have side effects.
Puerperal psychosis (postnatal psychosis)
This affects one woman in 500 and is characterised by rapid mood swings,
strange or bizarre beliefs and, in some cases, hearing voices. It can begin
hours, days or weeks after giving birth and is more likely to affect women
with a history of bipolar disorder. It requires urgent medical attention.
More information
Royal College of Psychiatrists, www.
rcpsych.ac.uk ; Association for Post-Natal Illness, www.apni.org
. Feelings after birth: The NCT book of Postnatal Depression, by Heather
Welford, NCT Publishers Ltd (2001)
KATE WIGHTON
Source: Royal College of Psychiatrists
