Best Way to Deal with Postnatal Depression

All new mothers experience mixed emotions immediately after the birth of their baby Almost 80 percent of women have mild feelings of depression and anxiety in the first few weeks following their baby’s birth. Known as the “baby blues,” these emotions are so common as to be regarded as normal, and are an almost-predictable first reaction to the onerous responsibility of caring for a baby. Like most stresses caused by fear of new situations, the baby blues soon pass, as the mother gains self-confidence and the bonding process proceeds.

Some women are very excited to have a healthy baby to care for, while others are more apprehensive. Thoughts such as “Will I manage all the changing, feeding, and washing?” or “Will I learn to love my baby in the way that all my friends love their children?” run through the minds of all new mothers.

In addition to these typical worries, new mothers, who are now often routinely discharged just hours after giving birth, are still recovering from the exhaustion and physical strain of the birth process itself. This takes its toll on her stamina. Increased tiredness resulting from the baby’s regular feeding schedule is a further pressure, and there may be additional stresses, including lack of privacy with her partner, because of visits from friends and relatives, and unhelpful comments and well-meaning advice from other people (“I don’t know how you manage with a baby screaming all the time like that.”).

Many women with the baby blues are too embarrassed to admit their feelings to their partner or friends. The image of motherhood promoted in the media is one in which the new mother sits holding a silent, contented baby in her arms, while she chats proudly to her admiring husband. It takes courage for a woman to accept that the reality of motherhood is different from that rosy picture, and to admit to herself and to others that not everything is going according to plan. As a result, a new mother may hide her true feelings and not admit her exhaus­tion. Pretending that negative emotions do not exist isn’t the answer. Denial of the baby blues won’t make them go away. So if you experience anxiety and depression—however mild—in the postnatal period

• speak candidly to your partner. Tell him exactly how you feel, no matter how irrational your worries may seem.
• talk to other new mothers. You may be surprised and reassured to find that your experience is not unique. Sharing worries with another new mother can be supportive.
• don’t feel guilty. Harsh comments, such as, “You should be ashamed of yourself, feeling this way when you’ve got a lovely new baby,” are totally unhelpful, only produce pangs of guilt, and should be ignored. This pull-yourself-together approach falls short of the sensitivity required to help some­one manage anxieties.

Postnatal depression is a more-severe and long-term condi­tion, occurring in approximately 25 percent of new mothers in the United States. Symptoms can include inability to sleep, appetite loss, episodes of tearfulness, loss of sex drive, and anx­iety attacks. The significance of postnatal depression has only relatively recently been acknowledged by professionals as a gen­uine psychological disorder.

Women who suffer from postnatal depression often say that they don’t know what it is that their baby wants from them and that they are unable to care for their baby adequately because they don’t understand what she needs. This inability to inter­pret nonverbal communication causes distress for both mother and baby. Of course, it’s not possible to say whether it’s the mother’s depression that reduces her ability to communicate nonverbally with her baby, or her reduced ability to communi­cate nonverbally that increases her depression. Either way, this breakdown in communication causes psychological problems.

Bonding between mothers and babies with visual difficul­ties can be badly affected because of their relatively poor non­verbal communication. Compared with a baby with normal sight, a baby who is blind tends to smile less frequently and less intensely, makes no eye contact, has a narrower range of facial expressions, and appears more somber and morose. This restricted level of body language means that mother and baby can have difficulty forming an emotional attachment.

The cause of postnatal depression is disputed. Most medical practitioners emphasize the role that hormones—natural chemi­cals that control bodily reactions—play in the condition. The marked chemical changes that occur throughout the prenatal and postnatal periods, claim medical scientists, are directly linked to the appearance of postnatal depression. Drug therapy aimed at resolving the hormonal difficulty is an increasingly popular form of treatment, with new advances being made all the time.

Other professionals reject this explanation of postnatal depression. Many psychologists maintain that the baby blues and postnatal depression are linked to a woman’s personality and the pressures in her life. Evidence for this comes from stud­ies that have found that many women experiencing this form of depression had a depressive nature before their pregnancy, or were subject to prepregnancy stresses (such as money worries, marital difficulties).

The true explanation probably lies somewhere in between. Effective management of postnatal depression combines both the psychological and the medical approaches, and could include the following:

• Drug treatment, prescribed by a general practitioner after detailed medical examination;
• Psychotherapy, from a qualified therapist who is able to help the mother gain insight into her anxieties and concerns;
• Contact with self-help groups, organized by other mothers who have experienced similar problems. Local health clin­ics have the relevant contact numbers;
• Sleep, especially uninterrupted sleep.

Hospitalization is necessary only in the very extreme form of postnatal depression (puerperal psychosis), which affects approximately one in five hundred new mothers. This psychological disorder causes a new mother to lose contact with reali­ty; she may become confused, thought-disordered, and almost certainly unable to care adequately for her baby. Treatment for puerperal psychosis is lengthy, and a full recovery may take more than two years.