What is Postnatal Distress?

An excerpt from a new book by renowned therapist LINDA LEWIS called
“WHEN YOUR BLESSINGS DON’T COUNT – A Guide to Recognising and Overcoming Postnatal Distress”

There are three types of mood disturbance that could follow childbirth and they are frequently confused or inadequately grouped together under the heading of postnatal depression. These syndromes can be seen as existing on a spectrum where the mildest condition is the “blues” and the most severe condition is postnatal psychosis. POSTNATAL DISTRESS falls somewhere between these two and is distinctly different in terms of onset, severity, duration and treatment.

THE BLUES

The “blues” is a very mild and common syndrome that occurs within the first few days after delivery. It is experienced by 85% of women. It is caused by hormonal changes that occur during pregnancy, delivery and lactation. Typically on about the third day the mom will feel any or all of the following symptoms:

  • A feeling of sadness
  • Tearfulness
  • Clinging dependency
  • A fragile mood
  • Feeling overwhelmed with the huge responsibilities with which she is now faced
  • Exhaustion
  • Inability to sleep
  • Some anxiety

This experience, although distressing and unpleasant shouldn’t last longer than a few days and is NOT PND. If it continues for more than two weeks, it is important to consider that it may be the onset of PND and you should have this assessed by a professional.

POSTNATAL PSYCHOSIS

On the other end of the spectrum is a very severe disorder called postnatal psychosis. PNP usually occurs within the first three months after childbirth and is very rare. Only one to two in a thousand women who give birth will experience it. The most common symptoms of PNP include:

  • Seriously disturbed thinking
  • Delusions about the baby being dead or defective
  • Hallucinations about harming the baby
  • Agitation, irritability and restlessness
  • Manic behaviour

This is a very serious condition which requires immediate hospitalisation and medication, as the new mom may be a danger to herself, her baby or others around her.

POSTNATAL DISTRESS (PND)

Each mother’s experience of PND is unique. There are no two women who would describe it in an identical way. The following list covers a lot of the thoughts and symptoms that women use to describe what they are going through in the postnatal period and you may experience them on a scale between mild and severe:

  • Anxiety
  • Feeling a sense of panic which may express itself in panic attacks with palpitating heart, sweating palms, feeling as though you’re going to die
  • Agitation: inability to sit still, constantly uncomfortable in your body
  • Fear of anything and everything: from driving alone to security in your home
  • Irritability: especially with those close to you, including your partner
  • Anger: especially with your partner
  • Tearfulness: an inability to stop weeping
  • Acute sensitivity / vulnerability: from what your mother-in-law says to worrying about the beggars on the streets
  • Repetitive thoughts which are sometimes frightening or irrational: be it about something happening to your baby or not being able to get a song out of your head
  • Feeling overwhelmed: wondering how you will ever manage and asking yourself how any other mother goes
  • A lack of self- esteem / confidence: you keep questioning whether you are doing the right thing for your baby
  • Indecisiveness: for example not being able to decide what to wear or what to make for dinner
  • Forgetfulness: you walk to the kitchen to get something and by the time you get there you have no idea what it was
  • Difficulty concentrating: you can’t even read a magazine or watch your favourite show on TV
  • A constant need for company / support: you can’t bear the thought of your husband going to work or coming home five minutes late from work: you dread your domestic worker or night nurse having time off
  • You can’t face socialising or being around people with whom you need to hold up a mask
  • Feeling like you are a terrible mother and that someone else could do a far better job with your child
  • Detachment from your baby, yet still protective over her
  • Insomnia: even when your baby is sleeping you can’t sleep
  • Inability to be in the moment: continual anticipation of your day / life ahead
  • Loss of appetite: you have no desire for food and simply eat whatever is available and easy to prepare
  • Having no passion for things you’re usually passionate about, be it cooking or eating good food, shopping for clothes, watching movies, reading books etc
  • Waking up in the morning dreading the day ahead
  • Wishing you could just turn back the clock because it feels like you’ve made a big mistake by having this baby
  • Thoughts of harming yourself or the baby
  • Wishing that someone could just mother you
  • Inability to understand how other people’s lives can continue as normal
  • Inability to believe that for some moms this is easy
  • Completely obsessed with what you are going through: you could talk about it every waking minute
  • Just being on autopilot: you have to talk to yourself through the motions of getting out of bed, brushing your teeth, having a shower, feeding baby, bathing baby etc
  • The pervasive feeling is that you have lost the self that you know and can’t imagine every being the same person again.

To summarise, from having been an independent, competent woman you have become a dependent, needy, insecure mother and this is all so very different from how you expected motherhood to be.

REALITY CHECK

The big question to ask is whether “normal” motherhood is, in fact, by definition a happy and depression – free experience. After all, there are understandable reasons why motherhood may be stressful. In fact, perhaps the normal reaction to motherhood lis more at the unhappy end of the continuum than at the happy end. Having a newborn baby to care for, as well as the usual duties of looking after older children and one’s partner and performing most of the domestic chores while still recovering from the physically and emotionally draining experience of childbirth, lactation and sleepless nights, is an extremely heavy load for any person to carry. Is such a response to childbirth a deviation from the norm or merely a reflection of how the average person (male or female) would cope in a similar situation. Add to this the biochemical changes that occur in a woman’s body as a result of pregnancy, childbirth and lactation and one actually wonders how it’s possible not to lose one’s “normal” self in this period.

What you need to focus on is that this is not going to last forever. If you get the right help and support it WILL pass and you WILL retrieve your old beautiful self an, if you use this opportunity for growth, you will become an even more fulfilled and whole person. Everyone gets better. I will say that again: everyone gets better –you are not the exception.
REMEMBER: EVERYONE GETS BETTER-YOU ARE NOT THE EXCEPTION.

LINDA LEWIS is a professional who understands PND.

If you would like to contact Linda for PND support her number is 021 685 6172

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