Postpartum Depression

Most of what follows here, I just wrote as a response on Facebook to a friend who posted something from a nurse at a baby clinic. The nurse was defending her position, by pointing out that in Tipat Chalav (baby & infant clinics in Israel) they have new mothers fill out a questionnaire that enables them to identify potential post partum depression.

 

All this comes in the wake of a horrible tragedy earlier this week, where a young mother of 4 allegedly strangled her daughters, before setting their apartment on fire, and then hanged herself on the balcony. While the story sickened me, what upset me far more was the handling of it by the media. Headlines such as “Heartless Mother” appeared the next day in the newspapers, and all I could think was how cruel that headline is.

 

We are so open today in society about so many things – LGBT issues, political affiliation, religious affiliation, yadda yadda yadda, and yet when it comes to depression, and psychological issues in general, people still turn a blind eye.

 

While details are still emerging about what happened to this poor family, it appears that the mother was suffering from some type of postpartum depression, or possibly psychosis. The youngest of her children was just 11 months old, and PPD can begin to manifest up to 6 months after birth, and without proper treatment will not just go away.

 

So while nurses, social workers, midwives & gynaecologists are all trained to see the symptoms of PPD, the problem still is that women are raised to believe that motherhood and having a new baby is the height of perfection, and that those days are supposed to be the happiest of our lives. For many, many women, if they aren’t feeling that euphoria that they’ve been told they should feel, they simply feel like a failure. So they hide it – because no one wants to be seen as a failure. They put a smile on their face, they go about their business, pushing the stroller around, letting everyone tell them what a beautiful baby, is she a good baby, does she sleep at night, are you breastfeeding, oh why not, oh you are, that’s so good but so tiring, giving unsolicited advice, baby is dressed too warm, too cold etc. Very, very rarely do people ask about Mum, beyond the “you must be exhausted”. And frequently, PPD doesn’t start to properly manifest until a month or more post partum, and people’s concern for new mums generally starts to wane, right around the time when they probably need it most.
The stigma attached to any kind of depression needs to go, but especially for PPD, when women are vulnerable anyway, at the mercy of their hormones, possibly dealing with post traumatic stress if their labour and delivery didn’t go as they imagined, and ended up with some kind of emergency. I believe that tipat chalav nurses, social workers, midwives, even gynaecologists are all trained to “see” PPD and that potentially they could all help, but they won’t see what mum doesn’t allow them to see. Mothers are better than anyone else at hiding things – we spend our lives just doing what has to be done, while we are sick, while we are sad, while we are angry.

This is a subject very, very close to my heart – I am very open about the fact that I had postpartum depression after my son was born. But I was extremely lucky – I recognized in myself that my symptoms were not simply exhaustion and baby blues. I knew something else was going on, and while I did feel like a failure, I had 2 babies to take care of – my daughter was only 16 months when my son was born – and I took myself to the doctor immediately. Even with the right care PPD is tough to deal with, because you need the support of your family – from your husband to your parents and in-laws – and your close friends. I do not take for granted how lucky I was back then. My husband was my rock, taking over whenever I needed him. His grandparents made themselves available to babysit at all times, often at very short notice (and what a special thing that is, to have great-grandparents who are both willing and able to care for their great-grandchildren). My own family was on another continent, but I had their support in other ways.

As I started to get the right treatment and care, and to feel more like myself again, I looked around me and I saw similar symptoms in other women that I knew. So I began talking about having PPD. I told anyone who asked me “hey, how are you?” – “Well, I’m doing better now thanks. I have postpartum depression, but I’m getting the help I need now, and I feel so much more like myself”. The number of women whose eyes widened and said “oh wow, you know, I think I may have had that too, but I didn’t know what to do, and I didn’t want to disappoint anyone” told me that something had to be done. So I started a local support group, called JOMINOS – Jewish Observant Mothers In Need of Support. For a very long time we met monthly. It was a safe place for women who needed to talk about being mothers, who perhaps didn’t feel that bliss when they had a baby. We had information available for women who felt they needed help beyond a support group. Above all, we didn’t judge, and we all learned to spot the symptoms of PPD in others, so that we could try  to step in where help may be needed. Sometimes stepping in can be done directly with the mother – a simple “Are you really doing okay, or are you at your limit?” can often be the catalyst to let it all out. Other times, it needs to be done through a close family member – husband, mother, sister, mother-in-law – “I’m worried about X, she is showing some signs of PPD, and I’m concerned that when I try to talk to her about it she won’t talk”

If you have a friend who has given birth recently, watch them. Keep calling them regularly, offer to come by for a coffee, or to meet them somewhere, look into their eyes as they talk and see if there is more going on than they are letting on. Learn to spot the signs of PPD http://www.postpartumprogress.com/the-symptoms-of-postpartum-depression-anxiety-in-plain-mama-english

And for anyone reading this, I am ALWAYS available to talk. I’ve been there, done that, and thank God, lived to tell the tale.
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