Why it's OK


I was reading an article written in the Sydney Morning Herald, ” Mothers with postnatal mental illness need all the help we can give them.” and was moved at how severe Hoa Pham’s symptoms were after she gave birth to her first baby.  Hoa is well educated, a Psychologist, and author.  Mental illness does not discriminate who it affects after the birth of a child, with higher incidences after a woman’s first child.  Hoa was lucky enough to have insight into her feelings to recognise that she needed help and needed it fast.

Postpartum Psychosis according to PANDA ( Perinatal Anxiety and Depression Australia. http://www.panda.org.au) is described as :

The term psychosis is the name for a group of mental illnesses where there is a loss of contact with reality.  With time and careful management, most people do recover fully from these episodes – many never having another episode again.

Unfortunately, a woman is most at risk of developing a significant mental illness during pregnancy or in the first year following birth.  Of these, postnatal depression is the most common, but postnatal psychosis, although relatively rare, is the most dramatic and severe requiring emergency, specialist treatment by mental health professionals in an in-patient psychiatric unit.  Postpartum psychosis is considered to be a psychiatric emergency, as the safety of the mother and her infant may be at risk.  Whether the mother and her infant are cared for together or separately will largely be determined by the severity of the illness, the mother’s symptoms, an individual needs assessment and/or the availability of mother baby unit beds.  Not all places have mother baby units, so the options for in-patient treatment may differ depending on where the mother lives.

So while Postpartum psychosis is rare, what is not, is post natal depression which is now affecting 1 in 3 mothers.  PANDA describe PND as :

Symptoms of Postnatal Depression

The severity of PND depends on the number of symptoms, their intensity and the extent to which they interfere with normal functioning. PND tends to be characterized by a combination of the following symptoms. The combination and severity of symptoms will be different for every woman, resulting in many different appearances of PND.

  • Sleep disturbance unrelated to baby’s sleep needs
  • Appetite disturbance
  • Crying or not being able to cry
  • Inability to cope
  • Irritability
  • Anxiety
  • Negative, morbid or obsessive thoughts
  • Fear of being alone or fear of being with others
  • Memory difficulties and loss of concentration
  • Feeling guilty and inadequate
  • Loss of confidence and self-esteem
  • Thoughts of harm to self, baby or suicide

Some women sum it all up by saying “There is no joy in anything any more”, and “I feel like I have lost myself”.

Post Natal anxiety is also of high prevalence and may also exist with symptoms of depression.

You don’t need to have a major psychotic episode to seek help. The sooner you get some help, you may find that the treatment you need is simple and effective.

Many new mothers feel that they should be able to cope with the arrival of their new baby.  While we  all expected change and things to be different and a little difficult,  many new mums are overwhelmed by the new sense of great responsibility to care for their baby around the clock. The tiredness, oh the tiredness, to the point of exhaustion with no end in sight.  To battle breastfeeding  and the pressures both internal and external to master this .  There are never ending photos of  beautiful mother and baby shots, of an adoring mother gazing down at her breastfeeding baby, looking so natural easy.  What you don’t see are the ‘before’ shots, of bleeding and cracked nipples, heavy and throbbing rockmelonesque breasts. The screaming, insatiable baby that when you can finally get them to attach to your nipple, has a few sucks and pulls off again and you have to reattach, over and over again with ever increasing pain and frustration.   At having to position yourself through this attachment dance so that your swollen bum or tender abdomen are not made to feel even more uncomfortable while you try to feed. That upon returning home, life goes on. Meals to prepare, washing piling up.  Friends and relatives all keen to see your new baby, but turning up just when your baby finally goes to sleep and the only chance you may get to rest before 4am tomorrow morning.  Is there really a world going on outside my front door?

I was lucky, I had my babies in Perth where my parents and parents-in-law both lived very close to me. My husband while self employed and didn’t have any paternity leave, was home each evening and weekends.  I had friends and support close by.  Even with all of this help around, I still felt overwhelmed and out of my depth.  None of my friends had children, they didn’t get it.  It is one thing to say your tired, it is another to feel it.  I had an unsettled and difficult baby, and still struggled with this each day.  I had expected things to be tough and they were.  I had the love and support of my family and had sought help by the time my baby was 11 weeks old. It didn’t instantly fix things, but it opened up a range of support to me and I didn’t feel so alone in my struggles.  Although my baby had breastfeed well, he was so unsettled I had made the decision to artificially feed.  As a Midwife I knew understood all the benefits of breast feeding and really wanted to do this, but I couldn’t continue like this anymore.  My baby screamed day and night, barely sleeping.  Some days it was a competition between us to see who could scream more and sleep less!  I took the flak of comments of me, a  Midwife bottle feeding her baby.  While a little hurtful, I was beyond caring. It allowed my husband and Mum to be able to help me a little more.  It helped us to work out if he was hungry, overtired or in pain. While it didn’t help his sleep at all, I felt I could breathe a little, just a little but it was a much needed breath.  It was a turning point the same week of changing his feeding and reaching out for help.  While I can now see that changing his milk source,  didn’t help my son much, it was reaching out for professional support that made a difference.

You don’t need to have a major psychotic episode to seek help.  The sooner you get some help, you may find that the treatment you need is simple and effective. You may just find reassurance that what you are experiencing is normal in the immediate post partum period, but you will establish a link that you can come back to if things deteriorate or change. Someone to monitor you if you lose the ability to reach out.  Give yourself permission to care for yourself.  You are the anchor of your family, without you being in good physical and mental health, you family ship is in for stormy weather too.  We need to remove any stigma of being affected by mental health after the birth of a baby.  Whether the condition was pre-existing or brought on by childbirth, you still need care and acceptance to be the best mother you can be for your child.  If you won’t do it for you, do it for your baby and any other children you may have. Do it for your partner.  Many partners also feel overwhelmed and are traumatised at seeing their usually strong and dependable partner, floundering too.  A strong mother- baby connection is needed for your baby to survive, and strong family unit will make it thrive.  As women, we need to be nurturing and caring to new mums, not judgemental and rude.  Confidence is one of the first things to take a nose dive in a new mother in unchartered waters.  Criticism and judgement from others, particularly other women, is crippling.  Things may be said with good intent but not helpful.  I have been known to offer to hold a screaming baby in a checkout or offer to put a struggling mother’s  shopping on the conveyer belt while she feeds or consoles her howling baby.  They are strangers to me but in need of a kind face and helpful solution not a scorn or a tut.  They smile with such gratefulness, they touch my arm with a quiet thank you.  It was nothing out of my day, but a big thing to my fellow shopper who was supported in her time of need and not shunned. I too have walked in your shoes.  Ask your friends, sisters and neighbours if they are ok, no really ok.  Ask how you can help, drop off a meal, hang out the washing.  Entertain the toddler in the backyard while Mum feeds the newborn or just takes a shower.  Make her a cup of tea or just listen while she talks.   Just be present.  Just be.

If you think you need help here are some websites that can assist you or contact your health professional.




Check out the Sydney Morning Herald article ” Mothers With Post Partum Illness Need All The Help That We Can Give Them,”  here

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