by Tamryn Sprunt, counselling psychologist
The month of May highlights the important issue of mental health and, since 2016 MATERNAL mental health has come into more focus.
Most expectant mothers fantasise that the birth of their baby will bring them immense joy and fulfilment.  They hope for the picture-perfect magazine experience which normalises an instant bond with their new-born and hours of blissful cuddling. The reality often looks different and can be very distressing and disappointing. Â
Becoming a mother is a major life change which demands adjustments in all spheres of life: mentally, emotionally and physically. A baby alters every aspect of a mother’s life.  She is on a constant roller coaster of emotions – from exhilaration to overwhelm; contentment to frustration and even resentment.  Having these emotions momentarily is very normal for new parents and it takes a couple of weeks to adjust and find a new rhythm as a family.  Parenting is definitely the hardest job we will ever do!
But for some new mothers the negative emotions and difficult days begin to outweigh periods of happiness and excitement. They have persistent feelings of sadness or anxiety that they cannot shake with a good night sleep. They often lie awake at night with their minds churning with worries and fears.
The percentage of new mothers who struggle in the post-partum period is higher than many might expect. About one in 6 women can develop Postpartum Mood and Anxiety Disorders (PMAD) during the first year of their baby’s life. Onset is usually gradual and may coincide with events like weaning or going back to work. But there are cases where mothers slip rapidly into a clinical depressive or anxiety episode only a few weeks after birth. Sadly, the research cites that only 20% of those affected will seek help often due to societal stigma and feelings of shame and guilt.
To be diagnosed with a postnatal mood disorder there needs to be 3 or more symptoms present, more or less daily for 2 weeks.
Caution: before a mother is diagnosed it is recommended she has bloodwork done to ascertain the symptoms are not organic. For example: hypothyroidism and anaemia can mimic depression.
Physical symptoms include:
- Lack of energy
- Restlessness
- Sleep problems
- Decreased concentration
- Significant appetite changes
- Body aches likes headaches
- Muscles soreness or stomach upsets
- Not able to take care of her physical appearance.
Emotional symptoms include:
- Deep and persistent sadness
- Weepiness
- Decreased motivation
- Uncharacteristic angry and rage
- Irritability
- Not being able to make decisions
- Emotional numbness and unable to bond with baby
- Afraid to be alone with baby
- Thoughts of harming herself or baby
- Anxiety and panic attacks may develop and some obsessive thoughts about safety and hygiene
- She will likely withdraw socially and lack self-confidence
- Overwhelming sense of hopelessness and pessimism for the future.
Recommended treatment options:
Left untreated the likelihood of suffering from PMAD with successive pregnancies goes up by 50%. It is crucial to get a diagnosis early to mitigate the effects of unsuccessful bonding between mom and baby.
A 3-pronged approach has been shown in research to be most effective:
- Medication (anti-depressants) from a supportive doctor
- Individual psychotherapy to help mom navigate the emotional symptoms and possible birth trauma and
- Group support with other mothers.
From my years working in this field, I would add a physiotherapist to support her physical body changes, a lactation consultant and a caring paediatrician.
Being diagnosed with PMAD does not make you “weak” or a “bad” mother – in fact the opposite is true – acknowledging you are not coping and reaching out for help shows enormous strength of character.
The mother is the hub that the rest of the family revolve around, if she is not well it has ripple effects for her family members but also generations to come.
Tamryn
Note from Carmen: I feel it so important to point out that the symptoms listed above do not ALL need to be present. Sometimes, the signs and symptoms can be so subtle that you don’t feel like you check the boxes, of feel that if you don’t check the most “severe” box, then you are fine. I would encourage regularly checking in with yourself honestly, by using an objective questionnaire, to see how you are really coping!
If you would like access to these questionnaires, please see the links below:
New Mom Mental Health Checklist: https://postpartumprogress.com/download/new-mom-mental-health-chec
Edinburgh Postnatal Depression Scale https://www.fresno.ucsf.edu/pediatrics/downloads/edinburghscale.pdf
You’ve got this XX
