One of the most satisfying aspects of my counselling role with the Australian Breastfeeding Association is supporting new parents with their transition from couplehood to parenthood. When I think back to the birth of my first baby in 1998, I remember expecting life at home with a baby to be all rosy and wonderful but the reality was much different. While I loved my newborn son, there were many aspects of being a mum that got me down, like the extra weight I had gained, and the feeling that I was no longer a worthwhile member of society because I didn’t have a fancy job title or income.
And what I was feeling is not unusual for new parents. While society expects us to be happy after the birth of a baby, we can forget that most parents will find some aspects of life with a baby to be difficult. Many of the changes that come with parenthood can create a sense of loss and grief for both partners. Adjusting to these changes can cause some challenges and strong feelings – this is a normal part of becoming a parent BUT if there is a feeling of being consistently unhappy, distressed or anxious then it could be an indication of postnatal depression (PND).
We tend to think of PND as being a women’s problem but a surprising fact is men can also experience PND. It has been said that for every two mums suffering from it, there will be one dad. If one partner is depressed, this can put extra stress and responsibility onto the other partner placing them at risk of depression and anxiety as well. Some experts believe that PND is a MAJOR UNRECOGNISED factor in the breakdown of many relationships as the problems are often due to the depression rather than the relationship itself. If this is the case, then it would make sense for any couple contemplating separation or divorce after the birth of a child to consider being assessed to see if PND is contributing to any relationship difficulties.
And it can be hard to know if you have postnatal depression as you may find other excuses for the way you are feeling or resort to self-blame. Some may suspect they have PND but will find it difficult to admit it or seek help due to the stigma attached to mental illness. Even the most skilled health professional can miss a PND diagnosis as new parents put on a brave face and try to be happy and cheerful when they are with other people.
So how can you tell if you or a friend has PND? The PND support group PANDA lists the following symptoms for both women and men:
PND SYMPTOMS IN WOMEN:
Sleep disturbance unrelated to baby’s sleep
Changes in appetite
Crying – feeling sad and crying without apparent reason OR feeling like you want to cry but can’t
Feelings of being overwhelmed, out of control, unable to cope
Negative obsessive thoughts
Fear of being alone OR withdrawing from family and friends
Memory difficulties and loss of concentration
Feeling guilty and inadequate
Loss of confidence and self-esteem
Loss of libido
PND SYMPTOMS IN MEN:
Tiredness, headaches and pain
Irritability, anxiety and anger
Loss of libido
Changes in appetite
Feelings of being overwhelmed, out of control and unable to cope
Tendency to take risks (affairs, gambling, reckless driving etc)
Changes to sleep patterns, especially a lack of sleep
Feelings of isolation and disconnection from partner, friends or family
Withdrawal from intimate relationships and from family, friends and community life
Increased hours of work as part of the withdrawal from family
Increased use of drugs or alcohol instead of seeking treatment for depression
SUPPORTING SOMEONE WITH PND:
There is a wonderful new parent wellness support group in Brisbane called Peach Tree who encourage expectant parents to ask two important people in their lives to become a “Parenting Partner”, someone who can monitor their emotional wellbeing. What a fabulous idea! New mums often tell me that they get lots of attention from friends and family when their baby is first born but then everyone just expects them to “get on with things” after that. It is so important to have that special someone who can check in on the new family’s emotional wellbeing – whether it is days, weeks, months or even years after the birth of a child.
If one partner is diagnosed with PND, it is important for family and friends to support BOTH partners (the non-PND partner often has to pick up the extra workload of running the household and caring for the baby).
TIPS FOR FRIENDS AND FAMILY WANTING TO PROVIDE SUPPORT:
Learn more about PND so you can understand what they may be going through
Ask the couple how you can help
Offer to look after the baby/children
Offer to help around the house “Here, let me unpack the dishwasher”
Let them know you are there for them, even if they don’t feel like talking
Offer to take them for a regular walk or to a support group like the ABA or Peach Tree
TIPS FOR PARTNERS WANTING TO PROVIDE SUPPORT:
Support their treatment and ensure they have ongoing consultations with their medical team and attend regular support group meetings.
Try not to take it personally – it is the illness that is causing your partner to be withdrawn and/or negative.
Reassure your partner that you understand if they are not interested in sex (low libido is a PND symptom and a side effect of some antidepressants) – it would seem the number one advice is to not take it personally!
PND is an illness, it does not help to say “snap out of it” or “get over it”, if it was that easy they would! Let them know you understand that they feel down but reassure them that with the right support and treatment that they will recover.
Encourage them to express their feelings and not bottle them up.
Encourage and support their achievements, no matter how small, comment in a positive way about their relationship with the baby, notice the good things they do and let them know.
Be aware that they are not being lazy if the housework or other jobs are not done (fatigue and lack of motivation are common PND symptoms). Rest is important for recovery.
Reassure your partner that you are there for them as they may fear that you will leave the relationship.
If a mother with PND decides to wean her baby, provide your support for this as her emotional wellbeing is the most important factor. However, it is also important to support her to keep breastfeeding if this is what she wants to do – for some women, breastfeeding is the only thing they feel they are good at.
Go for walks together, exercise can help them to feel better.
Help with the housework and babycare as much as you can.
Accept help from family and friends, allow them to help with housework, shopping, cooking dinner or picking up takeaway food.
Pay for household help if finances allow it.
Take care of yourself while you are supporting your partner as the extra stress can lead to exhaustion and feeling overwhelmed. Remember that having a partner with depression can put you at risk of developing it so find someone you can talk to about your concerns and feelings and don’t feel that you have to do everything yourself, get a friend or family member to take over if you feel you need a break.
Always trust your instincts if you become concerned about your partner or the wellbeing of your children, seek medical assistance if there is talk of harming themselves or the baby, strange thoughts or speech patterns, doing something dangerous, behaviour that seems odd or out of character, severe change in mood, withdrawal from all social contact, extreme despair or obsession with morbid ideas or statements like “they’d be better off without me”
Avoid blaming yourself as PND is an illness, you wouldn’t blame yourself if they had been diagnosed with diabetes.
Thankfully with early detection, support, counselling and treatment, it is possible to recover from PND and enjoy life again.