I could hear every beat, every laugh every foul, drunken, slurred word through the paper thin walls of the bedroom. All I wanted was sleep and to be any where but here, my head was pounding and the feeling of nausea was overwhelming. I was stuck in a dank horrible caravan park for the annual family reunion with a bunch of strangers that I would apparently be related to soon; and something inside told me it was going to get a lot worse before it got better. In between the brutal small talk and fake smiles through gritted teeth I found out I was pregnant; and it could not have been at a worse time.
Fault′ line` n. a boundary between incompatible or irreconcilable beliefs, feelings, or the like.
In the first few weeks of pregnancy it wasn’t the nausea, sore breasts or headaches that were giving me the most grief; instead it was the sense of discord between what the magazines said I should be feeling and the emotions running through my head. I had been with my partner for almost four years and we had been engaged for six months so there was no problem with commitment or the thought of ‘going it alone’ but I still couldn’t shake this feeling of dread. How would I break the news to my parents and what were we going to do about the wedding that was planned for later that year or my dress which had already been purchased? How was I going to finish the year of my uni course and fit in my work experience, what would my job say and how would I feel walking around my parents house with a baby bump?
Each website I visited to find out about pregnancy brought up pictures of smiling mothers to be caressing their inflated tummies and staring lovingly at their partner…it made me want to cry and quite often I did. Then I felt bad for not being over-joyed and I would cry more, but only when no-one could see or hear me because of the shame I felt. I realised that I was meant to be happy and in a way I was but the worry that swept over me when I realised the task ahead overshadowed any feeling of pleasure that I could fathom…I had this massive crack down the middle of my heart with one side trying to remind me that this was a blessing and such an exciting time for us, and the other side saying that I’d never be able to do this and everything was going to fall apart.
In my quest to feel better I enlisted the help of a psychologist from the hospital that would handle the birth. Her name was Maria Perkins and she had been working with the midwives clinic for years helping women cope with the changes faced before, during and after pregnancy. She says that although the feelings I was experiencing are rarely plastered over the cover of pregnancy magazines they are increasingly normal.
‘The reality of pregnancy and impending parenthood is that it can have a lot of ups and downs. Although it is thought of as a blissful and exciting time in a woman’s life it also heralds a multitude of changes, not just with the body but also relationships and lifestyle.’
Perkins also points out that any big event in a person’s life can cause a lot of stress. That goes for weddings, new jobs, moving house, winning lotto or having babies. Stress can make you feel down and it’s not unusual for women and men to feel down sometimes in both pregnancy and after the birth.
Suddenly it was making sense to me; I was in the middle of planning a wedding while moving out of home for the first time in my life and then boom! I’m pregnant on top of it all. Of course I was feeling down; I was stressed beyond recognition. But something was still eating at me, pervading my consciousness with every bad feeling that passed through my head…if I’m feeling blue now then what happens when the baby arrives, will it get better or worse? Statistics show that perinatal depression (which is depression that occurs during pregnancy or the postnatal period) affects 15–20 per cent of women in Australia and around 14 per cent of women will experience Post Natal Depression (PND). The staggering fact is that for around 40 per cent of the women that are diagnosed with PND the symptoms began in pregnancy.
Maria Perkins explains to me that when you are depressed it can be hard for you to tell how serious your feelings are. ‘ The best thing for a woman to do when she thinks she may be experiencing perinatal depression is to get help early; tell your doctor or midwife about your feelings so they can help you decide if your just feeling down, or if it’s something more serious’.
If the signs of perinatal depression are addressed early they can be treated very successfully and it is better to seek help early rather than risk postnatal depression later on states Perkins. ‘It is more strenuous on the family once PND comes into play and if this is not diagnosed it can lead to postpartum psychosis, very rarely but I have seen cases of it and it takes a huge toll on everyone involved’.
This statistic haunted me; not just because I was stressed, studying and completely unprepared for this but because as a teenager I witnessed my aunt suffer with postnatal depression which evolved into puerperal psychosis because it went undiagnosed.
I was only about thirteen at the time so the full story is a little vague but what is etched into my memory is the time I joined the women in the family for a weekend break down at my Nan’s holiday house. My Aunt had just given birth to her first child; a blue eyed little angel of a daughter. The baby was having trouble sleeping and was suffering from jaundice so getting sleep in a small cabin was almost impossible for everyone. One particular night the baby was screaming and my Nan went to help out; all of a sudden the baby wasn’t the only one screaming. My aunt was screaming at her mother in-law to back off and let her do what was right for the baby, to stop interfering in her life and judging her for not being a good enough mother.
I think it was then that someone should have recognised the signs of postnatal depression; the mood swings and feeling of inadequacy were right there but no one in my family knew enough about it to help or even suggest help. I remember my aunt disappearing from family functions and the distance between her and my uncle increasing. Most of all I remember my own parents going to visit her week after week when she was admitted to the psychiatric ward. I remember overhearing them speak about her treatments and the sadness that permeated the air when they spoke to my uncle and muttered words like electroconvulsive therapy. I was never allowed to visit her at the hospital, my parents refused to let us come along because, ‘She’s not the same person now.’
It took a long time for her to resemble ‘that person’ again. The even sadder thing is that by the time she came back everything in her world had changed. Her marriage had crumbled, the home she was building with her husband and daughter had to be sold and her child was being cared for by the mother-in-law she had been so adamant to keep a distance from.
This story is sad and terrifying and with the experience of motherhood just around the corner it makes it all the more real to me. Whether we like to admit it or not the reality is that 1 in 7 Australian women will suffer from some form of postnatal depression and for these women the expectations of how they should feel about motherhood and the actual experience of it is a major fault line that is breaking their worlds apart.
This was the case for Abigail, a 31 year old teacher from Sydney who suffered with severe postnatal depression for several months after the birth of her son Jai.
‘At the time I just couldn’t believe how terrible I felt, especially as I had been so elated when I found out I was pregnant. My husband and I had been planning this for so long and we were in the best stage of our lives to welcome a new addition with secure but flexible jobs, enough savings and a good support team around us.’
Abigail said that things started to change about a week after bringing Jai home from the hospital.
‘ One day I could not stop crying, I moped around the house like an extra from a zombie movie and I felt so awful just as though my body was weighed down by this incredible feeling of guilt and shame. I had nothing to be crying over and that made me feel even worse.’
Abigail’s husband Jacob was a big support during the weeks that followed but even that wasn’t enough to change Abigail’s frame of mind. She says that looking back she remembers one particular night sleep deprived and desperate she yelled at him to leave her alone and was sick of him and the baby.
‘The weeks after that were the worst, probably my lowest point and it was when I got so angry that I almost shook Jai that I realised there was something severely wrong with me. I was a hazard to myself and this beautiful little life that was relying on me, I needed help and quick so I rung my mum.’
Luckily for Abigail her mum was only a couple of hours down the coast and could drive up to be with her that afternoon. Abigail remembers crying uncontrollably when her mum walked in, after the baby was taken care of Abigail was taken to a GP who diagnosed severe postnatal depression and admitted her to hospital.
‘my mum moved in with us to look after Jai and my mother-in-law was a major help while I recovered, making meals and also supporting Jacob through the mess because he was so worried and still trying to work and support us through it all.’
Abigail responded to treatment well and within a month she was ready for a second chance at motherhood. Before she and Jacob settled back in to family life they attended some counselling sessions, this enabled them to understand that this wasn’t their fault or a reflection of their parenting skills but a natural part of life.
‘It was reassuring for us to realise that so many people experience postnatal depression, I think the figures were about one in seven which is much more common than I thought. To be told that most people who experience it get through without permanent damage to their relationship and family was a relief.’
Abigail and Jacob survived postnatal depression and were finally able to bond with Jai, with thanks to their support group of family, friends and medical professionals they weathered the storm and went on to have another baby with the knowledge that they could handle the rollercoaster ride.
After hearing Abigail’s story first hand I was feeling much better about the prospect of coping with motherhood and the changes it brings about.
Maria Perkins believes that all women should be educated about the changing feelings and emotions that occur during pregnancy and how this will affect them after their bundle of joy arrives. ‘The difference between postnatal depression that is recognised and treated and postnatal depression that is brushed off as the blues can be huge. With the correct support and treatment it can be just a minor stumbling block but without it these women and their families can be adversely affected and cause lasting damage.’
This is evident in the case of Abigail and my Aunt who both experienced the effects of postnatal depression but had to deal with it differently due to their knowledge and support teams.
My first antenatal visit included the basic weigh in and medical history questions that would be expected of any hospital visit, what I didn’t expect were the confidential questions about how I was feeling and whether I had any problems with abuse or anxiety. I was later told by the midwife that this was to check for early signs of depression that may lead on to problems later on. This is a great initiative which needs to be adopted by all health professionals in order to overcome the prevalence of postnatal depression and remove the stigma surrounding it.
Another positive influence on helping the fight against PND is the increasing number of high profile names admitting their battles with it. In an interview with Good Housekeeping magazine, Hollywood actress Gwyneth Paltrow admitted she had suffered from post-natal depression after she had her son, Moses. She described feeling like a “zombie” which was similar to Abigail’s experience and said it made her feel she was “a terrible mother and a terrible person”. The interesting thing she added was that she thought postpartum depression meant you were sobbing every single day and incapable of looking after a child.
‘But there are different shades of it and depths of it, which is why I think it’s so important for women to talk about it. It was a trying time. You don’t want anybody to know that you’re depressed or crying all the time.
‘There’s this shame that we bring to it and it’s incredibly debilitating and scary and you just don’t feel like yourself.’
Despite a cultural stigma against discussing motherhood in less-than-glowing terms Paltrow has come forward and let women know that postnatal depression is real and doesn’t discriminate. There are also Australian celebrities such as newsreader Jessica Rowe who have battled with the disease and now help associations such as Beyond Blue and PANDA or Post and Antenatal Depression Association which are helping raise awareness through workshops, social media and community education.
But the most important thing for people to realise is that the person closest to you may be suffering in silence. Look out for the signs and if you think your sister, friend, cousin or wife is struggling then reach out because the difference between saying something and doing nothing could be vital.
References
• Agnes, M. 1999. Webster’s New World college dictionary. New York: Macmillan.
• Figo.org. 2013. Post-natal depression ‘still has stigma attached’ | International Federation of Gynecology and Obstetrics. [online] Available at: http://www.figo.org/news/post-natal-depression-still-has-stigma-attached-003171 [Accessed: 9 Oct 2013].
• Hochman, D. 2011. Gwyneth Lets Her Guard Down. Good Housekeeping.
• Lovestone, S. and Kumar, R. 1993. Postnatal psychiatric illness: the impact on partners.. The British Journal of Psychiatry, 163 (2), pp. 210–216.
• Prendergast, M. (2006). Understanding depression. Camberwell, Vic.: Penguin Books.
• Robinson, J. (1965). Having a baby. Edinburgh: Livingstone.