I have been most interested to read recently, in a number of UK newspapers, about a screening blood test which has been developed to predict Postnatal Depression (PND).
Having read quite widely on the available published information I am intrigued. In the Guardian, a report (http://www.guardian.co.uk/society/2013/jul/02/postnatal-depression-blood-test-breakthrough) states: “Researchers believe that changes in oestrogen levels make pregnant women more sensitive to the stress hormone cortisol, and those with the genetic variations are unable to correct the hormonal imbalance after giving birth”. This is quite fascinating and offers a different explanation about the causes of PND compared to other research I have read. Understanding that a genetic hormonal imbalance can cause PND will be a great comfort to mothers who, having experienced PND, are often subsequently filled with feelings of self-doubt and loss of confidence. Many women, having struggled their way through a year or more of misery, enduring their baby’s first year, are reluctant to embark on subsequent pregnancies.
But what none of the reports seem to explain exactly is what is to be done for these women who are predicted high risk factors . Are they to be supplemented with, for example, oestrogen (which would not be good for breastfeeding as it would certainly inhibit lactation)? Or are they to be taught coping mechanisms through, say, cognitive behavioural therapy before the baby is born? Or, as a client of mine once encountered, will they be given anti-anxiety medication to commence on the day the baby is born? In this client’s case the Dr told her it was “extremely likely” she would get PND as she had a previous history of depression. Not the most empowering strategy, in my opinion!
Whilst this new screening test sounds exciting and promising, I am also puzzled. I have worked with hundreds of mums with PND and in the majority of the cases I deal with (which admittedly is not a total sample) there is one common factor: a need or desire to exercise a high level of control. It could be suggested that this is due to high levels of postnatal oestrogen but most of the women I encounter admit to the same tendencies prior to conception. So are they more prone to hormonal imbalances after childbirth or is it already part of their genetic makeup?
Birth and oestrogen levels may well exacerbate the symptoms but surely the best prevention method would be to PREPARE women for the realities of mothering. Society tends to romanticise parenting and the reality can be a huge disappointment. For most of us the transition is truly exhausting, boring and challenging beyond anything we have ever encountered!
Top Tips which may help prevent or reduce the effects of PND:
- Accept there is no such thing as the perfect mother.
- Accept any help YOU want but decline help you don’t want.
- Exercise as soon as your Dr gives the go-ahead to stimulate endorphins.
- Look after yourself. Eat well, shower daily even if the baby is crying.
- Meet other mothers but only if they make you feel good about yourself.
- Don’t believe the crap people tell you about how quickly their baby slept through the night, rolled over, read the newspaper! They have poor memories or are delusional!
- Share the work-load with your partner.
- Don’t follow strict parenting guides, they contain too many rules and not enough love and cuddles.
- Breastfeed your baby, it is empowering and good for bonding and almost always makes you feel good.
- Sleep when the baby sleeps.
- Talk to so someone you trust about how you feel.
- Get help if you continue to feel anxious, sad or angry.
- Be prepared to laugh at yourself.