Experiences with health professionals for antenatal and postnatal depression

I talked to my GP. My GP was an Australian lady and I still - she is still our GP, our family GP. She was very lovely and maybe it is very interesting to know that her attitude was very different from my own doctor's attitude in Iran. In Iran the doctor just, like any other Iranian citizen, the doctor just focused on baby, "Do this for baby, do that for baby, do this for this". But my GP, our family GP in Australia, she told me, "Okay, now you have a baby and you are a mum, but on top of all, you are a woman in your life. You must provide enough care for yourself, because without you, without a happy and healthy mum, your child will not have a happy and healthy future".

"So, your child is okay, she doesn't have any problem. The common complaints that every child has she does too, so forget about it. Do something nice for yourself. Attend dance clubs". But, you know, at that stage this instruction seemed too funny for me. It seemed ridiculous, it seemed stupid. You can't understand my own language, I could have shown you because I keep notes, daily notes, that was, I can say, very eye-catching for me. What does she mean 'attend dance clubs'? How come? It was a stupid suggestion at that stage it seemed, but after a year and a half, the challenge was still over, when I was reviewing my old memories, I found that, yes, that was not stupid at all, that was the best advice I - I could ever have and the doctor was really wise to tell me that you must save yourself first and then your little one.

And now I can say yes, after that, I mean after finishing all those challenges, any of my friends who gave birth to a child in Australia, that was my first suggestion, "Okay, try to think of yourself. Attend gyms, maybe just one hour a week, but make sure that you are attending. Do something nice for yourself".

Repeating my GP's sentence, now that seems really - for me that is a very deep sentence.

I made appointments and then I would go in there. I'd be sitting in the - in the waiting room and then I'd think, 'Oh God I'll have to come up with something else, I can't tell them', and I didn't want to walk out. You know, I don't like cancelling appointments on people, so I'd say, "I've got this you know tiny little dot on my leg". Twice I did that and - a different problem each time and they were sort of like, "Oh yeah, okay", and give me something or tell me - recommend me something but I couldn't tell them either, either time.

They didn't ask, they didn't probe a little bit further?

No... Lots of times I have thought about how and why I got to the point that I got to, being so sad and disconnected and, you know, thinking that it would be okay if I wasn't here cos [partner's name] could look after [son's name] or something and I... yeah, I just thought it might be valuable to write that down and I know that lots of the thoughts that you have are irrational. I know, I know that deep down and that's sort of what keeps you going, 'Okay, just push through, just push through'. For me and not for everyone. Like, you know, I wonder if I had gone and seen a GP what the outcome of that would have been. You know - and sort of - yeah, whether they would have advised me to take some sort of medication, yeah I don't know.

I'm much more positive about it the second time around and like I said with the breastfeeding, you know, I have that experience and I have told people and I have got resources and I own a breast pump now, so you know, some of those things that just caused me so much grief at the beginning, I think - well, the first time around, won't be there.

But, in saying that, if I do and did feel, yeah I'd like to say that, you know, maybe I'd go to the GP and actually tell him this time but I don't know. I would, I would tell people at mothers group again, and certainly my husband's very attuned to it this time. He keeps touching base in terms of asking me how I'm going and feeling.

The one thing that I didn't know about the first time that I know about now is mother and baby units, where you know, they take mothers and babies that have all kinds of issues, either with the mother or the baby, and I would - if I was in that same place again I would ask for that help I think. Now that I know that those sorts of facilities are available. So if I can't get the breastfeeding together in the first couple of weeks and I want to continue to do it I would go and see someone and bang on their door until they let me go somewhere that might be able to help me more intensively.

Actually it was quite different between the two. For the first one, look I filled them out but I probably didn't actively disclose how I was really, really feeling. I thought I was just sort of showing just, just sort of the borders of it. I was sort of - and I think was just you know sort of showing a little bit of borders. And look I, most of it I probably - you know I'd say you know may be it was 80 per cent accurate or something.

Maybe subconsciously I knew something was wrong but I didn't want to know. I didn't want it to be that. I just wanted it to be that it was hard work and you know I'm just going to have to deal with it.

I, physically an illness to me is something - was, you know back then was something physical, it wasn't something mental, mental. It just was something I couldn't approach or probably deal with, that that might be the case. I think it was definitely, I was definitely conscious of making those ticks on those boxes when I was doing it. Yeah, I'm pretty sure I was definite about that.

But that's actually interesting. The second time round, different mental health nurse who I just seemed to get along. The first one was an old lady. Didn't have children. I didn't really relate to her, nor did many others that I know of. I don't think - you know just there was, there was no connection there, so there was no real free talk and I think I felt that if I'd say something to her, I'd be showing signs of failure. And you know I just - may be with her I just couldn't do that. It was just like almost talking to my mother or something. Like, I can't show signs of failure. Not that I ever felt that I you know couldn't with my mother, but you sort of feel like an older person you don't want.

You know, you've got a new child, you're a new mum, you don't want to be a failure. With my second child, different maternal health nurse. Younger, lovely, had a great rapport with her, beautiful lady. And got along with her really well and was able to open up to her. Sort of straight away we went through the test. I answered that truthfully rather than emotionally, rather than organising where my answers were. I answered it truthfully and I talked to her. And actually she wrote a letter for me to say that you're suffering from postnatal, could I also - at that time the older daughter was in creche - could we have - she organised some extra funding so the older daughter could go to creche a little bit more.

Instead of only three days a week I think she organised it for may be four days a week, umm or two to three. I can't remember.

So she actually wrote the letter and organised it and had a letter for me to give to my GP as well. So she was right on to it, and I was able to be open with her and say, "Yes I am. Yeah I am suffering from it".

Maternal and child health nurses I think would be better called child health nurses. I think the - for me anyway, the primary focus was certainly on the health of the baby and not on the mother's health. I think at one point we did the postnatal depression scale, and the outcome from the one I did was just that, "This tells me that you have some good days and some bad days and okay, now let's get on to measuring the baby".

I don't think there was very much time at all focused on, "How are you feeling, how are you coping, talk to me about what's going on". You know, the baby was very healthy and that was the endgame. If the baby's doing well: "Well great, see you next time". But I think perhaps in defence of the health nurses, and it's something that I did a lot, you know, you put your mask and your smile, your happy face and you say everything's going well, and it's something that I did with a lot of people so it's perhaps very difficult for the health nurses to get below that and to really see what's going on if you're not prepared to put yourself on the line and say, "Actually, I'm not coping very well". It's much easier to smile your happy smile and say, "It's going well", and just deal with not coping in your own private time.

We ended up going to see a psychiatrist and we had to organise that privately, because it doesn't really exist in the public system around here. I went to stay with my aunt - both her and her husband are mental health nurses and she used to be a mothercraft nurse as well.

She's not in this area, which I think is different, because when we probably had the biggest crisis, maybe the second biggest, with my mental health, and I went to stay with her, the services that were available up there, she couldn't believe what wasn't available here. She couldn't understand why there was nothing around us.

You can go as an outpatient back to the hospital and you could stay for two weeks and have a mental health plan and mental health team. And they'll come to your house to visit you and that. They will phone you every second day and through the public system you can access a psychiatrist and all this sort of stuff. Whereas around here there's one mental health nurse for, I guess, postnatal and early childhood and she works - some days she'll drive five hours to get to where she needs to be for work.

So, you know, it's really hard to feel like you're, I guess, important to these people because they've got so many people to look after. So you have to go private, or you don't get the care. There's one just opened, a private mental health hospital. And that's only opened probably four months ago. And you can go and stay there. They're really good up there, but they're always really busy too.

We did qualify for a health plan, some sort of thing. And we decided against it, because someone, like a childcare worker, would come to our house for from nine to five every day and I didn't really want to have someone here. I probably would have rather that there was like a support group, or if you could access less hours for someone. I think that might be helpful for some people, but we didn't think it would be helpful for us. So that's why we didn't go for it. I mean, if we'd just decided to take that and someone else might actually need that - we didn't feel like we needed that.

I now, and still two years on, surround myself with professionals, rather than just going, "Okay, it's over, I'm fine, I'm back to you know being totally in control", I'm not afraid to ask for help. I don't see that as a weakness anymore. So I still see a psychiatrist once a month, I'm seeing a psychologist to work through some of the emotional issues. I have been very lucky in that I took out income protection insurance before - well, before any of this happened. And was only after the relapse that I actually thought, 'Well, you know what, maybe I need to take things easy, I need to allow myself time to heal', and the doctors thought exactly the same.

So I actually went ahead and applied for a claim and usually when you talk about insurance companies it's hell, these guys have just been fantastic, they've offered me some courses in mindfulness, which is something I would have never thought about before.

I'm hoping that will never happen again, but I'm open to the possibility that it might. So by opening myself up to that, I do what I can to put steps in place to make sure that I do what I can to prevent it from happening. So surrounding myself with professionals, and thinking things through, not letting things get to me too much allowing myself to recover rather than just rushing back to my old life. I'm not back to my old life, I'm working part-time and at the moment that is what's needed and I'm comfortable with that rather than just beating up - myself up about, well, 'You're fine now, why aren't you back at full time work?' or "Why aren't you doing this?" or "Why aren't you doing that?"

And one night we just rang the maternal helpline, the 24 hour one. I tried everything to get him to sleep and he just wouldn't stop screaming and talking to them I said, "Look I've tried this, this, this, this", and she said, "Try this".

So we tried that and as she was talking to me she said, "Well look the fact that you know what to do, you know what to try, you know, you sound like you are quite reasonable", and she said, "Do you think you might be suffering from a bit of postnatal depression?" I said, "Well I'm not depressed, I'm not sad". I started to get a bit, you know resentment towards her and angry and I said to her, I said, "What? Why?" And she said, "Look", she said, "Depression isn't just feeling sad". She said, "Anxiety, anger". She said, "It's more having feelings that you don't normally experience and you're not knowing where they're coming from".

And as I was talking to her I thought, 'Oh okay', so I thought, 'That would be great if' - in a way I thought, 'That would be great if I did have it because then at least I would know why I was doing this'. So - and she was wonderful. She put in a call to my maternal health centre. She gave me a whole lot of numbers and everything. She emailed them through to me so I didn't have to worry about writing anything down. She talked to me about seeing my GP.

So that was a Sunday night, so the next day I rang my GP, made an appointment. The maternal health nurse had rung me because she had a message left for her straight away from them leaving a message and she rang and she said, "Come down and see me today".

So I went and did that. Just before I left to see her someone else from the council rang and she was from a division which actually deal with a support group for mothers and postnatal depression, and she said, "Oh I was going to come out and see you". I thought, 'Geez that would have been so much easier'.

So when I went to my first appointment with the GP I was angry with everything. I had been on all the websites and it was probably overkill, but I knew about postnatal depression, but as I said, I thought depression was just sadness so - and I really wanted that to be all that was wrong to, to explain why I was feeling like this.

I hadn't bonded with my son. With my daughter I was loving being a mum and with my son I was sort of hating being a mum. So I really just didn't understand. I was constantly screaming at my daughter, "Just don't talk to me". I rang my husband at work and abused him for not bringing the bins in because that was one extra thing for me to have to do. What sort of person does that? You don't ring your husband at work and abuse him for not bringing a bin in.

So I just knew there was something wrong and I was really hoping that someone could explain it. To me it was more than just lack of sleep. You know lack of sleep with me I was tired and irritable, not angry, not resentful.

So the GP, I did all the testing and I was up pretty high. So she sent me off to a clinical psychologist and also put me straight onto medication, and of course I was then reviewed every couple of weeks.