Post-natal anxiety and depression pages

Sometimes getting out of bed can feel like trudging through snow

The transition to becoming a mum is a huge leap. For many women it is a long and emotional journey that includes joy, but also physical and emotional challenges and major adjustment. Depending on how the reality of your experience matches up to what you thought you signed up for, it might be more challenging than expected. If your journey to becoming a mum was difficult due to miscarriages like me, or due to infertility, or experiences of IVF, medical conditions or surrogacy, it would be easy for expectations of becoming a mum to be elevated to holy grail status. If so, I’ve been to Roslin Chapel, I remain unconvinced holy grails are attainable. It can be hard too if you thought you would have a wonderful water birth, and instead have an emergency instrumental delivery (like me) or a caesarean to recover from, complete with months of physical pain and rehabilitation exercises. Or, perhaps you’d thought from ante-natal classes that breastfeeding would feel easy because it’s natural, but it doesn’t, or it hurts when you didn’t plan for that. I know there’s so much I didn’t know about how to manage breastfeeding until I needed to. Or maybe you were already struggling with anxiety or depression before you got pregnant just like 1 in 5 other women, and now it feels overwhelming. Or perhaps you’re missing your friends and your social life, your work colleagues and the meaning, purpose and routine of work. And what’s happened to date night? We know from research that hormones also can wreak havoc with your mood (Harris,1994). I suppose where I’m going with this is, most women probably could relate to at least a couple of these things in their early days of motherhood and depending on our circumstances, some of us might relate to more, or even all of them. In which case, it’s no surprise that postnatal anxiety and depression are much more common than you might think. Estimates vary depending on whether we consider the baby blues or more severe depression, but for the baby blues it varies from 30% (Pritchard & Harris, 1996) to 80% (Yalom, Lunde, Moos, & Hamburg, 1968). Another factor that makes the stats unreliable though is that women often feel shame and hide their anxiety or depression rather than seeking or accepting help.

Research suggests that for women with postnatal depression, you are more likely to experience tricky thoughts that seem strange or not like your own. For example, thoughts like “I don’t want this baby” (Espen Klausen, Clinical Psychology Doctoral Thesis). The options for how to respond might include avoiding the thought and pushing it away, feeling horrified and ashamed by identifying with it, or even considering who else might care for the baby. None of these are good options, clearly. So in terms of ACT skills, mindfulness could be a helpful start – to notice that thoughts, feelings and experiences come and go, and that you can choose which to attend to and how to respond to them. If you’re feeling wobbly or fragile, I’d recommend mindful movement like a gentle walk in the woods rather than sitting meditation to keep it manageable. Then, defusion techniques are going to be really helpful in learning how to get some space for those unusual thoughts that might feel unacceptable to you. Considering your values and how you want to be as a mother is key, as you can then choose how to act and what to do next. I hope that committed action for you, if you relate to postnatal depression, might include seeking more support from your family, friends, family doctor or a mental health professional, depending on what is best for your own situation – we all have times in our life that we need therapy, and it’s OK if you need that. Perhaps the most helpful resource to look into that I have information on is Compassion Focussed Therapy. If you read that section of this website, you’ll find some great TED talks to listen to. It is helpful to think about developing your self-compassion muscles just now, to help build your relationship with your baby as you get to know each other – and it is OK for that to take some time, too.

So how can you respond to the challenges that motherhood brings while still enjoying a life with value and meaning for you? What kind of mother do you want to be? I thought I would suggest a book to try if you identify with post-natal depression or anxiety – Whittingham, Koa. (2013). Becoming Mum. Koa Whittingham is a clinical and developmental psychologist, parenting researcher and mother. The book draws on research, her clinical experience and her own experiences as a mother. It includes suggestions on how to apply ACT to miscarriage, postnatal depression and preterm birth. It includes information about techniques to cope with criticism, unhelpful advice, psychological distress and physical pain. There are also suggestions about how to keep your romantic relationship working in a healthy way and your support network strong.

For any therapists reading this who work with women experiencing post-natal anxiety or depression, here’s another book recommendation – Whittingham, K., Coyne, L. W. (2019). Acceptance and Commitment Therapy: The Clinician’s Guide for Supporting Parents. Academic Press.

Michell Cree – “the compassionate approach to postnatal depression” is also a good book to try.

For pregnant women and new parents in Scotland you could also try –

Perinatal and Infant Mental Health Third Sector Service Directory

The above link takes you to a searchable online directory of Scottish charities and third sector organisations which offer pregnant women and new parents mental health support including counselling. Also, do consult the Further Help page for a more general list of support resources out there that might help too.

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