The things we don’t talk about: Postnatal depression, part two

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I don’t remember taking this photo.  I look through many of the photos from the first year of my son’s life, and I don’t remember them.  There aren’t many photos of me from that time, and in the ones that exist, I don’t even really look like I’m there.

In retrospect, I was a prime candidate for the development of PND.  I have a long history of clinical depression and anxiety, though I had been stable and off meds for a year prior to falling pregnant. And here’s another thing that we don’t (or aren’t supposed to) talk about: I wanted a girl.  Now, I wouldn’t give my little boy up for anything, but when we had the ultrasound that revealed we were having a boy, all I felt was disappointment.  I’d always imagined myself being a mother to a little girl, never a little boy.  I know that people will say that it was an unreasonable thing, that I was just lucky to have a healthy kid, and these things are true.  But it doesn’t change that emotional reaction.

So, how did I get to a point where I can say that I am truly past the PND?

1. Being honest.

Admitting that you’re not blissfully happy as a mother is a hard thing, especially if on the surface, everything is okay.  Your kid is healthy, even if they don’t sleep well or have feeding issues.  But it is the most important thing to do.  Do not hide that you are struggling.  Not from yourself or your family or medical team.  And if they do not believe you, then tell someone else.  And keep going until you get the help you need.

Find statistics about PND and throw them at people.  Print out blogs, read books.  People need to know the reality of this.

2. Ask for help.

You need support.  Talk to your doctor, talk to a therapist, talk to your partner and your family.  They cannot know that you need help unless you ask them.  And sometimes, I think for partners who are just as overwhelmed, they can’t always see that you’re really struggling, that it isn’t just the baby blues.

3. Medication.

It’s not going to be everyone’s choice, but I believe that anti-depressants saved my life.  And yes, you can take anti-depressants and breastfeed (Kellymom is a great resource for the uses of medication in breastfeeding).  I also took sleeping tablets, just so I could switch off my brain and get some sleep when I lay down at night.  I was worried that I would sleep through my kid crying, but I never did – the drugs were a low enough dose that I could get up, feed him, and when I got back to bed, I went to sleep straight away.

4. Don’t stop doing things.

I think this is one of the most important things, and one of the things that I see people get caught on.  Other people come in and help with the baby and the house to help out a mother who is depressed, the mother is given time to rest and eventually ends up doing very little.  Get help, by all means, but you need to keep doing things – giving up everything just feeds depression.

I didn’t do my housework for the first months of my son’s life.  My mother stepped in and helped there, and if she hadn’t been able, I would have gotten a cleaner in.  Meals were pretty much thrown together from whatever.  But I was the one who took care of feeding my son, who changed his nappy most of the time, who did the laundry.  Even when I felt like hell and like I couldn’t do anything that made him happy, I could at least take care of his basic needs.

5. Breastfeeding.

Don’t worry, I’m not going to go all boob nazi on you.  But I think if you can medically continue breastfeeding (and I know it’s not an option for everyone), it is one of the best things you can do to help deal with PND.  Even when I felt like my son hated me (and I did), I could still feed him, if nothing else.

And it was hard.  It was really hard work feeding him for at least the first four months.  I got a lot of help and support with this, and I am so glad that I pushed through with it.  I hated having to get up every 1-2 hours to feed him overnight, but I did it and I am proud.

If your kid will take a bottle, then expressing and getting someone to take one feed overnight is awesome.  If you decide that formula is the way to go, then awesome – your kid is still getting fed.  We offered Liam formula several times when I was completely exhausted from getting no sleep, but he would never take it.  He also never took a bottle of pumped milk, except maybe once.  So I didn’t get that break, but just accepted it and kept going.

6. Sleep.

Yeah, I know, this one is totally contradictory.  But if you can manage to eke out a decent amount of sleep, you will feel so much more able to cope.

Due to the kid who wouldn’t take a bottle, I was bound to night feedings until Liam night weaned (which was somewhere around 18 months, which is when he first slept through the night).  Instead, I got someone to watch him for an hour or two during the day (my mother again, who was an angel) while I napped.  At first, the anxiety was so bad that I couldn’t sleep, but I lay down anyway.  Once I went on medication, the sleeping thing got much easier.

We also had Liam sleeping in our room for the first six months, which made night feeds easier.  Co-sleeping wasn’t for us, but if you can do it safely, then it can be awesome.  Sleeping situations are very much a matter of what works for every person, I feel, and it’s worth trying everything to see what works.

The husband and I, over time, evolved a pretty good strategy for making sure that we both got sleep.  By nature, I go to bed early, and he stays up later, and we took advantage of that – he would resettle Liam until he went to bed (if he could without a feed being needed, of course, but he always tried) and once the husband was in bed, I was the one who got up – which was much easier, having had a decent chunk of sleep.

I also pretty much napped when Liam napped – I would often stay in bed with him for an hour or two after the husband went to work.

7. Babywearing.

Because everything wasn’t enough fun, we also had a kid who hated to sleep unless he was being held.  Thankfully, over time, he grew out of this, but while he was a baby, it was really hard.  I fretted about it a lot, wondering if he would ever learn to sleep on his own.  It would have made things easier if I’d just accepted it.

Babywearing saved my sanity on more than one occasion.  Liam would nap, especially in a back carry, and I could still do things around the house.  I often bounced on a fit ball and worked on the laptop, or hung up the washing with him on my back.  It would almost always settle him.  And there’s something gorgeous about having this little bundle tucked up against you.

8. Exercise.

And yes, I know that exercise is the last thing you want to think about when you’re exhausted.  But it is one of the things that has been actively the most useful in fighting depression for me.

When Liam was young, I tried to get out with him in the pram every day for a walk.  Getting fresh air helped, the movement helped, and more often than not, Liam would sleep, which helped even more.

As he’s gotten older and less tolerant of the pram, I’ve evolved a different system – I drop Liam off with my mother for a half hour, and I get out on my own to exercise.  It means that I get fresh air, exercise and some time alone (which I need, as an introvert).

9. Working, or doing something that is purely yours.

This is one of the things I wish someone had told me before I even fell pregnant – to make sure that you have some time every day that is *yours*.  To make sure that you don’t sublimate everything into the role of mother/carer.

There are things that are me: I write, I read, I like to play with sparkly makeup.  The latter may seem like a foolish thing, but I love being able to wear colour and to see someone who looks like me when I look in the mirror.

I don’t think I wrote much at all for the first year of Liam’s life, something that I regret now.  I think if we have another child, I’ll be trying to eke out writing time no matter what.  It is something that keeps me sane, that keeps me being me, no matter what.  Other people I know return to work because that’s what keeps them sane.  I know many, many mothers whose whole lives revolve around their kids, and if that works for you, then great.  I also know many who resent it.

The husband and I have also made a point of getting out every once in a while without the kid in tow – for us, this usually involves going to the movies.  And I am aware of the privilege that we have in doing this – we can afford to, and we’re lucky enough to have grandparents who are always happy to watch the kid for a few hours.  I know not everyone is so lucky.

10. Survive.

Some days that’s all you can do.  And you know what?  That’s okay.  If you get to the end of the day, and you’re all alive, with your basic needs met, that can be a triumph.

*

 I didn’t really understand emotionally how PND affected women (and men) until I went through it myself.  Having been there, I can see all too easily how the best option can appear to be suicide or killing your children.  I don’t believe that I was ever a danger to Liam.  I know that I was a danger to myself.  I got help, and I got helped, and I am lucky, and my heart breaks for those who aren’t as lucky.

The things we don’t talk about: Post-natal depression, Part One

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Liam on his birth day.

It’s been two and a half years since I took that photo above.  In that two and a half years, I lost myself and I found myself.

There are things that we don’t talk about much as mothers.  On the internet, I’ve found that people tend to be more honest – there are plenty of “mummyblogs” who talk about the nitty gritty of parenting, but in real life, I’ve found that many of the mothers I’ve encountered are all too willing to plaster on a smile and say that everything is fantastic, no matter what.  They’ll share their kid’s latest exploits and worst nappy story, but if you ask about them, then everything is just fine, just wonderful and they don’t mind at all giving up their lives for their children.

And for some people this is absolutely true.  I do know some mothers who sail through parenting, for whom it does come easily.  They can cope without sleep, they can ride out tantrums.  Hell, my mother is one of them – she raised three kids while barely batting an eyelid.  Her personality and patience just worked for mothering, when it came down to it (and it still does, even though we’re all adults).

For me, it didn’t come easily.  Looking back, there are a whole host of factors which fed into me developing PND (which I will talk about in a later post).  I always wanted to be a mother, and I was ecstatic when I fell pregnant.  The pregnancy was easy medically speaking, the birth not so much (but neither was it horribly traumatic).

I should have known in hospital that there was something wrong, really.  I gave birth, and I couldn’t eat.  Massive nausea whenever I tried to force something down, and my appetite had completely fled (which is a very, very rare thing for me).   It was eventually bad enough that I needed anti-nausea drugs just to be able to force anything down.  Breastfeeding was extremely difficult, since Liam wouldn’t latch and I had a massive oversupply and was in severe pain from engorgement.  My body reacted really weirdly to the hormonal changes, and I was having massive sweats, cramps and cold shivers constantly.

One thing that I am eternally grateful for is that I persevered with breastfeeding.  Every feed in hospital I had to get a midwife in to help get Liam latched, which often took up to 30 minutes.  One absolute angel of a midwife on my last night there spent half the night with me (alternating with the woman in the next room, who was having just as many issues), and eventually got me to use a nipple shield, after which I could at least latch Liam without a hassle.  After that, even if I felt look I could barely do anything for my son, at least I could feed him.  I am so, so grateful to that midwife and to the Australian Breastfeeding Association, who helped me out later at home.

And so we came home, and I thought everything would be fine.  Liam was feeding, and everything else would just fall into place, wouldn’t it?

Not quite.

It turned out that Liam was not one with the sleeping thing.  I was waking, it seemed, every hour to feed him, after which it took what felt like hours to settle him again.  He had reflux, and he spat up and he just didn’t sleep.  For the first two weeks we tried – the husband was a champion, even taking Liam out for a drive in the middle of the night to try to get him to sleep.  I was exhausted, but most of the time even when Liam was sleeping, I couldn’t.  I ended up hallucinating several times.

I was coping okay in hospital, apart from the nausea (which was chalked up to hormonal changes) and the feeding difficulties.  I don’t blame them for missing the developing PND – after all, I was only there for a handful of days, and I was cheerful and optimistic.  I do blame our community nurse who did a home visit and focused only on the fact that Liam had reflux and barely noticed that I was a mess.

My parents are the ones who noticed and who saved my life (and I mean that literally – if I had gone on the way I had been, I know that I couldn’t have coped).  The husband was doing everything he could, in case anyone decides to point any fingers there.  In spectacular timing from the universe, he’d just started an amazing new job, and was being pulled in every direction possible himself.  In better timing, my mother had a doctor’s appointment booked for other reasons, and made me take it instead.

I can only imagine how I looked to my doctor.  I have huge gaps in my memories from the first six months or so of Liam’s life (something that makes me angry and sad now), but I do know that I cried through most of that appointment.  My doctor was and is amazing, and spent a very long time with me, and diagnosed me with PND.  I went home with anti-depressants and sleeping tablets, and started on both that day.  I was very wary of the sleeping tablets, but I found that a light dose meant that I actually got to sleep when I went to bed, and was still able to wake up to Liam, rather than lying there awake waiting for him to wake.

And it got better.  Very slowly, it got better.  There is a lot of stuff packed in that sentence, stuff that I’ll get to in later posts, but for me, the medication was absolutely key.  I needed to get chemically stable before I could do anything else – before I could eat properly, before I could sleep, before I could exercise, before I could go into therapy.

And it wasn’t magic, not by any means.  I suspect I was still clinically depressed for much of Liam’s first year.  I don’t remember a lot of that time still.  I do know that I didn’t feel really bonded to him until he was about eighteen months old.  That makes me so sad to type, but it’s the truth.  Now, at two and a half years of age, I am constantly amazed that this little boy is my son.