Identifying postnatal and antenatal depression and finding help

It was probably about two weeks after she was born that - and my parents-in-law were with us by this stage, that things started to get to a point where it was actually a maternal health nurse, first come and said, "Look, let's delve a little bit deeper into this and see what's going on. I'm not concerned yet, but there are some things that are starting to appear where maybe the best thing for you would be to get an intensive maternal health nurse to come and see you a little bit more often, and, you know, let's see". At this stage I was very much focused on the breastfeeding and how I - I was reacting to it not working quite like I was thinking and feeling guilt about switching on to formula and you know, that sort of confusion.

So at first the symptoms of the actual postnatal depression were very much physical, I lost my appetite completely, I would sweat suddenly, and I - I had a dry mouth to a point that it didn't matter how much I drank, didn't matter how much I washed my teeth, my mouth was just dry and not very pleasant [laughs], so, you know, put that down to lack of sleep, exhaustion and so on. And that was the other thing that was happening, I wasn't able to sleep, and it didn't matter if my daughter was asleep. If she was awake I was wishing she was asleep. If she was asleep I couldn't rest. If I happened to fall asleep, I would wake up in a panic thinking that she was still on my breast and I fell asleep with her and something had happened to her.

And so this went on for a few days where - not eating but exhaustion plus some of these other physical symptoms, really started to take their toll and at that point my psychological state started to fall apart. It went from feelings of, I guess grief and loss of my old life, to me coming down the stairs one morning and saying, "I want to give her up for adoption". And of course, my partner responded with, "What are you talking about?" And realised at this point that, 'Hang on, things are really - things are going wrong'.

I've never been - I've always been a black and white kind of person. So I've had to accept a lot of grey into my life as the children present [laughs]. Yeah, and so I think I've had, I know I have, and I've had it addressed. I've had a bit of depression associated with, with just me in general and what I normally would see as having a productive day, and how that's not achievable with children. And you've got to just try to change my mindset on what is - you know, it's okay to not get much done as long as the kids are happy, and they're clothed and well fed.

I was looking after the children, as much as I love it and they're great, but I don't have anything that's me anymore. It's all for the children, you know, whether it's cooking, or, whatever. There's no dad time. Even the lock on the toilet door doesn't seem to work anymore. So I don't get any moment's peace [laughs]. So yeah, it was, it was kind of a hard to thing to deal with, with that, and to try and re-evaluate things. Like instead of being upset at the children all the time because they're not doing X, Y and Z, to understand that they are children and they're not going to do X, Y and Z until they're old enough, and ready enough, and you know, mentally competent enough to do that sort of stuff.

So yeah, it was, it got to a point where I was, I was yelling at the children. And I found that I was yelling at them to try and get my way, and then when you've got little, little guys yelling back at you, you realise that you're just showing them, you know, you're teaching them what they're learning.

So I went to a psychologist again, and talked about just ways to deal with anger, and yeah, just learning to let go and not sweat the small stuff so much. I did have a, my upbringing, you know, I was from the genre of children who should be seen and not heard, and I will forever remember going and playing in my bedroom for hours with my Lego, or whatever, cars, and just wished that my children would do that. Whether it's a different sign of the times, particularly with my eldest, he wants my full attention, even when the other guys are here, the other kids.

The first time I had depression, I was on the, the Prozac, and I actually read a book. It was only a little book. It wasn't a self-help book, but it was a little book about Buddhism. And I was just realising that, you know, the answers to our problems are in our own head. You know, we create our own happiness and our own reality. So as hard as it can be, you've just got to change the way you think, and try and sort of step outside yourself a little bit and see.

So, so after that first time of depression and being on the medication, and it helping, but I don't actually think that it was the medication that like solved me, cured me, so to speak.

Not that I think that I've ever been cured, but perhaps I'm a little morose most of the time. But I certainly thought this time to go without the medication. And I altered lifestyle aspects instead. I stopped self-medicating so much with wine and coffee, I just tried to drink a lot more water, and fresh fruit and vegetables. And I've found that more helpful and sort of - because you can get into a little bit of a cycle of, you know, stressful day, the kids are all in bed, drink coffee all day, and then drink wine at night time, and it's just no good for your body.

So yeah, I think this time that I've taken a more whole approach, instead of just a tablet and a - sort of trying, literally trying to change everything for everyone's benefit. So - and it has worked, it's been, certainly more quietly spoken than I was, and I don't yell anywhere near as much now, so...

So then we spent a long time trying for our second. But yeah, so we got pregnant, which was really exciting, but I think that all the pressure of trying to get pregnant was a bit of a - once we go there it was like, 'Oh, okay, now what? We're, we've done it'.

And, then I think that a lot of how - then everything was fine for the first bit. I was tired and mostly laying on the couch, letting my toddler run circles around me.

And then probably just after Christmas, I think I had two weeks where I felt as though I wasn't enjoying - I wasn't being - like my daughter was doing amazing, amazing things, and being so cute and funny and I just wasn't feeling like I was receiving - I think - feeling the happiness that I should be receiving from it and I felt like I wasn't appreciating her enough. And then I just felt very numb.

But yeah, so the turning point was those two weeks where I was feeling really down. I spoke to my partner about it - because at some stages I felt like- that my family were better off without me and all that sorts of things. And I - then I realised, once I thought like that and once I was like, 'Oh, it'd be better if I was dead, because they'd be better off without me', I was like, 'Oh, that's like a big red signal. Go speak to somebody'.

And it was just like, 'Oh, what's wrong with me? Why - why am I feeling like this?' And yeah, so when - I think I actually rang my midwife, rather than waiting for my appointment. I said, 'Oh look, I'm having really bad thoughts and I really think that I need to speak to someone about them because it's basically ruining my family's life'. It probably wasn't ruining my family's life as much as I thought it was at the time, but it was definitely ruining my life and impacting theirs.

But I think that I didn't do it for my sake. I was doing it for my family's sake at the time and really I should have been doing it for my sake as well. But I think that, yeah, thinking that I wanted to kill myself would be a better option than what I was going through or what I - how I was feeling and that my family would be better off without me was when I realised, 'Oh, I think my daughter needs her mum and I am an okay person, so I deserve to be her mum. So I really need to do something about it'.

But in the lead-up to when I sort of really sort of had my episode or sort of where it all became too much, I'd actually gone to the psychologist on the Friday. The family member was looking after my son, and the psychologist actually said to me, "I don't think it's a good idea for you to go back home right now, why don't you call the family member and just ask for a little bit more time, go have some time on your own, go for a walk, get some fresh air?" Which that all sounded great, but the family member wasn't able to so - which is fair enough - so I came back and I just could not function.

I was a mess, just crying, just exhausted, I guess a little bit angry. I remember calling my husband and saying, "I'm not feeling well, I'm sick, I'm not well, you need to come home".

So then I think that when we sort of all went down on the weekend after that - the weekend that that actually happened, I remember just lying in bed on the Sunday in the middle of the day, and I was trying to sort of, you know sleep when the baby sleeps, kind of thing, and baby was 5-6 months old by then, but I was still really struggling and we were all exhausted so I said let's jump into bed, have a lie down, and just relax, and at that stage because of where we were living, he was actually - he was in with us.

So he had his own cot but he was in our room, and I just remember lying there and my husband fast asleep like that and my son fast asleep, and I was just lying there, and I could hear every single breath that he was taking, and - and I just remember thinking I just felt suffocated. I felt absolutely suffocated, and that I just had to get out and get away. I just had to get out of the house. I left a note for my husband which apparently was quite cryptic but I don't recall what I wrote, and I just said that I was just going out, I'd be back later, sort of thing, and I just got in the car and drove down to the beach and just cried and cried and cried and cried, and I just didn't know what on earth was wrong with me ... crying my eyes out, just thinking, 'This is just insane. I'm - there's just something not right with me'.

Yeah, no it was definitely a lot of anxiety and my partner was working late so I was left alone with my daughter quite a lot and ... I just started to have funny thoughts, lots of strange thoughts about the harm that could come to her. And then it just sort of [sighs] - that just became an obsession, and I was just thinking over it a lot. And then it - it stepped into territory where I was thinking that I would - you know, I could, you know, not only accidentally cause harm to her but purposely cause harm to her. And I think I just didn't know that that's a fairly common experience.

I had no idea that intrusive thoughts can be a characteristic of postnatal depression, never ever heard of it. So I was started to get plagued by this and they were getting more and - it was almost like a 24/7 thing and trying to suppress them and push them away and not saying a word about it to anyone.

I just had no idea that it was a symptom, I thought it was a kind of madness and an indication that I didn't want to be a mum, or that I really actually did want to cause harm to my daughter. So I was just engaged in this huge self-doubt, and self-questioning about my motivations behind becoming a parent. And because these intrusive thoughts were so overwhelming, I guess I was just trying to think, 'Well how can I get out of this? I don't know how to get out of this. Is this what it's like to be a mother? No joy'.

I mean, because I hadn't heard of this phenomenon of intrusive thoughts, I just assumed that there was something really wrong with me. And probably because of my mum's illness. So, you know, it felt like a kind of madness. And it was going in that direction. So I just didn't - that's right, because at the antenatal classes the midwife was talking about postnatal psychosis, and I was worrying that I was getting into that territory. And I thought, 'Oh this is just, you know, I don't want to be a psychotic mother. I've got one, I don't want to be another one for my children'.

So I rang [sighs] PANDA and spoke to a counsellor. Spoke to a counsellor on the phone who was fantastic and they kind of talked me through it. Sort of asked all the requisite questions about you know, "Are you suicidal, are you going to cause - do you want to cause harm to your baby?", those sorts of things. And you know it was all sort of, 'No'. And [she] said, "Go and see your GP".

And that's how I felt about the situation is that I had done a bad job of labour and a bad job of birthing and a bad job of pregnancy. And so it just followed that I thought that I'd do a bad job of mothering and I did do a bad job of mothering in the beginning because I was angry.

I loved her and I cuddled her but I got really frustrated with her and I was very rigid and very like, 'Oh, I can't get her into any bad habits', and people would say, "Oh, but for the first 12 weeks it doesn't matter", and I'd be like, 'But that, how can that possibly - how can she hit 12 weeks and go right, don't do anything bad now because my habits are going to start to form. How will she know when she hits 12 weeks?'

All these things that people were telling me didn't make any sense. So the reality was it was total chaos and I was a ball of self-doubt and self hate and confusion and conflicting everything, and it was messy. My house was messy and I was messy and I didn't like either of those things [laughs].

And so at the time how was your partner? What - how was she?

She was amazing. She was like this solid rock of coping and she was exhausted and she was going, she only had about five days off work in total and then had to go back to work because we couldn't afford for her not to and the industry that she's in is quite unpredictable, and she was amazing. If it wasn't for her we wouldn't have got through. I would be, have been, in a mother baby unit for sure.

I don't think that I had postnatal depression but I think I was probably very, very close to going over and not coming back. Just over that depression line.

And that's also something that I didn't - I think - that I didn't realise is that line of post natal depression is so grey I think, and that line of coping and not coping is just - I thought it would be I would wake up one day and be coping. That would be the day after I got home, I'd be coping ... And then if I wasn't coping I would know that I'd crossed the line of not coping but it, it was just all blurry.

By the time we, in six weeks, at six weeks it was, I rang up a sleep school in tears. I'd got it from maternal health, she gave me a pamphlet and said, "Ring up this place, it might take you a while to get in". So I rang up at six weeks, in tears, saying, "I don't know what to do, I don't know how to get him to sleep, I'm not sleeping. We're arguing because I'm not sleeping. My mother's working full-time, she can't help me during the week". I said, "I don't know what to do". So they put me on the sleep school waiting list. But we didn't get in until he was three months old.

But by three months it was okay, it was just that first three months. And the sleep school sent out the survey that you had to fill out before you went, and some of the questions were, 'How do you feel about having a new baby?' It was husband and wife, you both had to fill out separate surveys and send them back in. And, 'Do you regret this decision? Do you feel you are financially worse off?' Those sorts of questions. And I put, 'Yes I regret it, yes I feel we are financially worse off,' and I just thought of the negative parts that this is taking on our relationship. My husband had answered positive for every single question, they were completely different views.

And that's not the questions that you got at maternal health. The maternal health questions were, 'Are you depressed? Do you feel you can laugh as much as you used to?' 'Yeah I can laugh as much as I used to, but under different circumstances. And when I'm filling out the survey, no I'm not depressed 'cause I'm happy, you're weighing him, I've gone out of home, I'm not having to try and get him to sleep'. You know, you answer questions where you are in the context that you're in at that, that time, I think. You don't think of the overall situation. But obviously I was upset enough to ask for the sleep school thing, I said, "I'm not getting enough sleep". And I could see I was getting angrier at home, but I didn't link it to anything because I didn't think I was depressed, as such.

It's just when you look back and you're like, 'Well other people didn't feel that way, they don't regret having their child the minute their child's out -that's the happiest thing that's ever happened to me'. I didn't think that. I didn't kiss him until he was almost two days old. I didn't even think. Then my husband grabs him and he's kissing him on the head and I'm, "Ugh, he's covered in blood, ugh, why are you doing that?" I just, it never even occurred to me.

It was really difficult making the decision to go and see a doctor about how I felt. It was - it was like an admission that something wasn't right, and I remember making the first phone call to my GP to make the appointment and I just got off the phone and burst into tears, because you're - feeling inside like you weren't coping and - and saying it to someone in the outside world were two very different things. And I've - and I probably knew in myself that something wasn't right for a long time and didn't do anything about it because I didn't want to admit that there was perhaps something wrong, that I needed some help from someone else.

So I went to the GP and I said, "This is how I'm feeling, I don't know if this is just what normal mothers go through, you know, or whether - you know, I have - have depression", and - so we did the tests and we did the - I think it's the Edinburgh Postnatal Depression Scale and I was off the charts I think. Like I was - it was quite a high score. So we talked about how I wanted to approach things. We did some blood tests just for iron deficiency, vitamin D, other things that could explain my fatigue and how I felt. And again, I was very keen for it to be something that wasn't a mental health related issue. I was so keen for the blood test to come back and say, 'Oh yes, you're low in iron. That must be why you're feeling like this so we can fix that'.

And I guess I felt there was a stigma attached with having a mental health issue as opposed to a physical health issue. I was very happy to be vitamin D deficient, very happy to be iron deficient. I wasn't very happy for someone to say, "You have postnatal depression", because it felt like a personal failing, and coming from a high achieving background, doing well at school, doing well at uni, getting a good job and then - all of a sudden you fall in a heap and you have to say, "Actually, I'm not coping". That was - it felt like a personal failing, like there was something that I wasn't doing or something that I was doing wrong, that led me to where I was.

So I resisted treatment for a while, went on iron tablets, went on vitamin D tablets and said you know, we'll see how that goes for a few months. And there was no - I was a little bit iron deficient, I was a little bit vitamin D deficient but I don't think that was at the crux of what was going on. So after a few months we agreed that I'd try some antidepressants, and [pause] - they didn't seem to make a huge difference and I think one of the problems with antidepressants is they're not a next day solution, it's a six - you know, they say give it six weeks to see if there's any improvement and six weeks is a long time to wait and see whether you feel different and, and something that I found with my depression is you don't always trust your own judgement in how you feel.

You think, 'I don't know, I don't know what a normal baseline is. Is this just a mother having a bad day?' So it was hard to judge for myself how I was feeling and how that compared to what a normal person might feel like. So there wasn't a huge change and then I went back to the GP to talk about it a bit more. They had initially suggested that I go and talk to someone, see a counsellor or a psychologist and again, I had resisted that because that would be admitting to someone else that there was a problem. And in my head I had always - I had never seen myself going - needing to go and speak to a psychologist or again, that admission of something not being right or - so that was brought up again by the GP and I agreed that that could be a good thing to do, so I started going to see a psychologist.

So it's like oh, okay, and you know probably a couple of months after that I sort of thought, 'Geez, I wonder. You know I wonder if the difficulty is - is this everybody's? Is it this goddam hard for everybody? Is it because I thought I was career orientated and this is not, everything not working the way I wanted it to? Or have I got postnatal?' But nobody had ever picked it up. Nobody had really. You know, some, one doctor may have mentioned it but - or maybe the maternal health nurse may have and maybe I filled out a form. But you know I sort of went, "Oh no, that's not me, that's not me, that's not me. No, no, I'm fine".

And I think maybe, I think actually I may have filled out the form at maternal health nurse, and maybe I might have been borderline, but I said, "No, no, no. No, I'll be right, I'll be right. I'm finding things easier". So I sort of, I didn't want to go there. It wasn't somewhere I was mentally prepared to go.

Then we decided to try for another child. And then probably about six months later, we were pregnant with the second one, which was all fantastic. Then you know that was all fine. The other, the first one was doing okay. And had the second one, which was fine.

So back on the [laughs], back on the one hour sleep cycle ever three [laughs], it was doing me in. And then you know I was just getting through it. I had a school reunion come up when she was probably about oh, three months old. Yeah, it was probably just before three months old. I was struggling through, and I know my - I think I'd done the maternity test of - you know the postnatal one. And I sort of thought oh, again I think I was borderline. I don't know if I was answering them correctly, I probably answered them enough to probably set alarms bells for somebody to start monitoring, but maybe not for them to say, "You have postnatal". So I think I was, I was enough ready for someone to say, "We maybe keep an eye on you", but not to say, "This is what you've got", where you are.

So you know and I was maybe a little bit more - you know I kept saying, "This is hard, this is hard, this is hard".

So they always ask, you know, when you - well, once you've had a baby and you go to the child maternal health centre all the time when the baby is very young and they often do the Edinburgh scale thing and I - I would have - I always thought I was answering truthfully but the questions for me, no disrespect to Mr Edinburgh who obviously invented it and thought it was great but, I'm like, 'Yeah well of course I'm not enjoying life as much as I used to, I mean I've got a new baby'.

Like I thought that the answers were so silly that you couldn't really determine of- like - so I'd say, 'Well, given that I have a new baby I guess - I guess life's okay', and so I'd sort of tick no, I'm okay, I'm okay, I'm okay, because I assumed that what I was feeling was okay given that I had a baby but, I mean if the question was, okay is it like how it used to be well, god damn no but - you know, so I just - I never - I just walked away thinking, 'I don't - I'm not, I'm not lying on those things but I don't think it really indicates how people feel,' but then you read plenty of things where someone has been picked up as having - you know, being recognised as being low or having a noticeable change as a result of those scales.

I wasn't sort of intentionally lying but certainly I didn't think that the scale was really - or the questions were really representative of digging in to how you felt, you know, but ...

And then with my son, once we got him home and everything he ended up with silent reflux as well. And he was exceptionally colicky, he just would not sleep and he was constantly sitting up and arching his back and - so you know and I couldn't sleep during the day, you know you sleep when the baby sleeps, you can't when you've got a toddler.

So the lack of sleep was even more horrendous than with my daughter which I couldn't even imagine and we got him on medication for silent reflux. So of course I'm thinking, 'One week he is going to be - I've just to get through one more week, he'll be fine,' and it didn't happen because he was so colicky.

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 sort of said, "Well look the fact that you know what to do, you know what to try, you know, you sound like you're 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".