Sleeplessly Singing the Blues
What an incredible joy and a blessing to be gifted with a child. There are so many precious moments and ‘pinnacles’ in parenting. However, it seems to me that being at home with a new baby can often be a challenging time for many women. The transition from working woman to stay at home mother can be a difficult adjustment for many. I feel for first time mothers. For many women, a common post-natal theme that emerges is that of ‘This isn’t what I expected.’ Often parenting is more messy, demanding and difficult than we ever anticipated (as well as being joy-filled and fulfilling). We foresee that we are going to pop out a baby and carry on with our life regardless, not realizing that it is motherhood that changes our life totally, and is in itself, the most demanding job.
These days the expectant or new parent is initiated with an influx of information, conflicting advice and theories. Furthermore, when you are expecting a baby or you have a young child, don’t people just love to be forthright with their opinions and advice. Should one have a natural birth or a medicated one? Breast feeding or bottle feeding? Sleep training or co-sleeping? Just to name a few. And there are strong opinions in both camps. But I wonder whether the reception of conflicting information is all that helpful? It’s been said that parents are less prepared for parenthood these days, despite all the expert advice readily available. And many new mothers find it difficult to trust their instincts. I know that I did. I had worked with children, but like many parents these days, I hadn’t had much experience with babies or toddlers until I had my own child, other than a little baby sitting here and there. And it probably wasn’t until my second child was born that I developed more confidence and learned to fully trust my instincts.
Recently I perused an article about post-natal depression (PND). The premise of the article is that PND seems to be more common in modern times. It’s possible that today there is more awareness of PND and other mental health issues, as well as better access to screening and services. Like most mothers, I’ve had some challenging times since becoming a parent. And in retrospect. I wonder whether I had a touch of mild PND after one of my children. But no one knew about it. I don’t even know that I fully recognized it. One can’t be objective on oneself. I could function, but I just wasn’t quite right. I knew that I couldn’t sleep. I surely had post-natal insomnia. A sleeplessness not caused by the baby but a general inability to get to sleep. It was awful. I didn’t feel sad, and I enjoyed my baby. But it was the sleeplessness that led me to finally seek help after suffering in silence for months. Thankfully I recovered quickly. Whether I had a mild dose of PND or not, a family history of depression, a husband working long hours (yet who was still very supportive), no family in town and two children under two, I was a sitting duck for it.
Many mothers have down days, but how does one determine whether it is just a few down days or whether it is post-natal depression? Mental health is a continuum. And recovery from any episode of depression is always inconsistent because of a myriad of different factors. It is worth noting however, that the postpartum period has its own set of additional and unique demands. For example, sleeplessness, hormonal influences, the constant needs of other children, the busyness of family life and the feeling of being unable to control things around us.
Postnatal depression can affect women in different ways. And it is common. Studies mainly from the developed world indicate that it is present in 10-15% of women who give birth. That means that PND is very common. And this is only the cases that are documented. Many people remain undiagnosed.
But what are the symptoms of PND?
Symptoms can start soon after giving birth and last for months or, in severe cases, they can persist for more than a year. The main symptoms of postnatal depression are:
- a persistent feeling of sadness and low mood
- loss of interest in the world around you and no longer enjoying things that used to give pleasure
- lack of energy and feeling tired all the time
- disturbed sleep, such as having trouble sleeping during the night and then being sleepy during the day
- difficulties with concentration and making decisions
- low self-confidence
- poor appetite or an increase in appetite
- feeling very agitated or, alternatively, very apathetic
- feelings of guilt and self-blame
- thinking about harming onself or one’s child, or contemplating suicide.
The jury isn’t unanimous as to what causes postnatal depression. But most researchers believe it’s the result of a combination of factors.
Who’s at risk?
Factors that can increase your risk of experiencing postnatal depression include having:
- A family history of depression or postnatal depression. Genetics appears to play a role in both of these conditions.
- A personal history of depression, postnatal depression or other mood disorders, including depression or anxiety during pregnancy.
- Experiencing complications during pregnancy (ie, gestational diabetes).
- A difficult or traumatic delivery.
- Physical health problems following the birth, such as difficulty breast feeding.
- Being a first time mother. However, having two or more children also puts you at risk for PND.
- Being a younger mother.
- Being a victim of domestic violence.
- A lack of perceived social or family support.
- Relationship worries.
- Money problems.
- Physical health problems following the birth, such as difficulty breast feeding.
Even if you had a text book labour and birth, having a baby can be a stressful and life-changing event that can sometimes trigger depression. People often assume they’ll naturally take to parenthood like a duck to water. However, it can take months before you begin to cope with the pressures of being a new parent. Sometimes it can also take years to develop confidence as a parent. This is true even for those who already have children. And some babies are easier than others. Some assume that it is only mothers than have ‘difficult’, fussy or colicky infants that develop PND. But this isn’t so. A mother can develop PND even if she has a ‘dream baby.’
Is it the hormones?
It was once thought that changes in hormone levels during and after pregnancy were the sole cause of postnatal depression. This is no longer thought to be the case, although changes in hormone levels may still play a role. One theory is that some women are more sensitive to the effects of falling hormone levels after they’ve given birth. All mothers will experience hormonal changes but only some mothers will be affected emotionally.
Postnatal depression can also affect men. A 2011 study found that like mothers, around one in 10 fathers experienced after the birth of their child. Having a baby can be stressful for both parents, and some fathers feel unable to cope.
Seeking help for postnatal depression doesn’t mean you’re a bad mother (or father) or that you are unable to cope. It is important to seek help, as when postnatal depression is untreated it is associated with adverse effects on the infant, especially if the mother is unable to engage with the baby.
But, it’s not all black and white.
What are some other factors that increase the likelihood of developing post-natal distress or depression? A friend who suffered severe post-natal depression after her second child, feels that there is so much judgment placed on parents today, and that mothers in particular feel that they cannot meet the expectations of those around them. Furthermore, she also feels that many mothers carry a burden that would be best shared by wider family.
It seems that parents, and mothers in particular, are judged if they do and judged if they don’t. A prime example of this is the popular debate over work outside the home. I read a research article recently that stated that many stay at home parents are more likely to be depressed than working parents. It doesn’t surprise me, although most of the time I’ve enjoyed being at home with my children. I have however, grappled with the loss of a career, and the isolation and lack of mental stimulation that accompanies caring for young children fulltime. Furthermore, today women are expected to do everything, and although we have many more opportunities, there are perhaps more pressures. No one person can do it all. I’ve always thought that the ‘mommy wars’ were not particularly helpful when you consider that all mothers are working mothers, and that every family has different circumstances. Parenting can be challenging enough without the ‘mommy wars’. Some coffee groups can be fairly competitive and sadly mothers can be hard on one another. But what would our world look like if mothers were able to be more supportive and respectful of one another’s choices? But when did being a fulltime parent become so devalued and disrespected? Perhaps that is one reason why depression may be more common in fulltime mothers, as well as the financial strain that being on one income places on some families. And mothers don’t just feud over the issue of work. I’ve often observed a divide between ‘younger mothers’ and ‘older mothers’ with both groups labelling each other with unhelpful stereotypes and hurtful generalisations. Younger mothers are not always struggling financially, frustrated because they have missed out on a career or partying with friends. Nor are older mothers always exhausted.
Many of the older generation express the belief that parenting seems to be harder these days. Does this contribute to post-natal distress? Some of the pressure placed on families today is perhaps economic. In this difficult economy the cost of living is increasing and just to pay basic bills and a mortgage on a modest home, two incomes are often required. And women have felt the need in these modern times to reclaim home making as a valuable occupation. However, one criticism of the trend towards 1950′s style home making so popular on sites like Pinterest is that it adds to the burdens of women.
There is research for everything, and there is literature to demonstrate that modern parents may experience significant daily stress related to the busyness of life. The more children one has, the busier life seems to become. Some busyness is unavoidable in life, there is the 24-7 needs of young children and their myriad of different activities, a relationship to maintain, a household to manage, a garden, perhaps a job with ever increasing demands and expectations. Perhaps there are aging parents to care for, not to mention time for seeing friends, hobbies and keeping fit. But some busyness can often result from what we choose to put our hand up for. And is there any honour in being busy? I’ve had to learn to say no and to move beyond people pleasing.
Many people are parenting in isolation these days. A supportive community of friends is wonderful and I’m very grateful for the supportive friends that I have. However they are functioning at almost full capacity with young families themselves, and it is not the same as having biological family on hand (providing they are supportive). My family are wonderfully supportive from a distance and thankfully we live in an age of technology and skype. But if it takes a village to raise a child, then where is the village?
Then there are some that aim to professionalize motherhood. Perhaps this is because motherhood is sadly seen as a low status occupation in our society. And while you are doing the most important work of your lifetime when you are going about the daily aspects of childcare, it can be difficult to see the small yet significant areas that one is achieving in. But I wonder whether a danger of professionalizing motherhood is that it may put one at risk of depression. It seems to me that women with perfectionistic tendencies may be sitting ducks for post-natal depression and anxiety. Life with children seems to be easier when one can relax and go with the flow, which is not easy for those individuals who may be used to being in a predictable job or profession that is structured and orderly, and one that has given the individual a sense of achievement. Nurturing your child is the most rewarding yet challenging and important job there is. Just consistently caring for one’s infant affects the architecture of the brain, providing the building blocks. I’m not just changing a nappy, I’m having an interaction with my infant that is fostering a secure attachment and setting her up for a life of learning and emotional health.
It seems that society often places unrealistic expectations on mothers of young children, and in response to this it can be a challenge to live counter-culturally. I once read the advice of someone in a magazine which really resonated with me. He suggested that until your child turns three, meeting their basic needs, cooking the dinner and doing the washing is a fulltime job. Anything else is extra. But most of us do more than those basics. There are many additional expectations placed on mothers, and some expectations are those that we put on ourselves.
I’ve learned to stop comparing myself with others and to have more realistic expectations of myself and others. Parents of young children can feel like they have to be perfect, but guess what? No one is a perfect parent. We all make mistakes and perhaps we need to be more vulnerable with one another and open about our failings, in order to normalize normal parenthood. And we all know that supermum doesn’t exist.
How can we support those who may be suffering from distress in the post-partum period?
I’m passionate about raising awareness of PND. It;s an area I’d love to research or work in. Interestingly, it’s not just mothers of newborns who develop depression. Parents of young children (under five) are also at risk of depression. My family doctor tells me that she sees depression in parents of young-ish children all the time. Mothers who haven’t had PND or any experience of depression themselves or in someone close to them, may struggle to understand. And that’s ok. But we can all learn some do’s and don’ts when supporting someone who is suffering. Don’t say to the person ‘Get over it’. Just like asthma or arthritis, depression is not something that someone can snap out of. Many heroes of the Christian faith, suffered with depression. Consider Elijah, the apostle Paul, Jeremiah. Don’t give advice, even if you have been there, but do encourage the person to seek professional help earlier rather than later. There are many evidence based effective treatments for post-natal depression. Anti-depressant medication and cognitive behavioural therapy can be beneficial. Exercise, good nutrition and baby wearing can also help (see my post on baby wearing). Attending a support group or sraft group may also be therapeutic. Do offer to help them with practical tasks such as meal preparation or laundry. Offer to help with baby sitting. Be there, listen attentively and maybe offer to pray. Encourage the person that:
My friend with her ten month old son, discovering the joys of baby wearing.