healthscotland.com

Talking about postnatal depression (reprinted 2010)

Understanding post-natal depression

Once a woman recognises she is experiencing post-natal depression, she's likely to ask 'why me' and look for reasons. However, there are various explanations of what causes it and a number of things may work together to trigger it off. The cause can differ from one woman to another, and sometimes there may be no clear reason. At particular points in your life you may just be more vulnerable. Or difficult events in your past may make you more likely to experience post-natal depression.

Here are some of the explanations suggested:

• the birth itself may have been distressing or seriously disappointing. This can leave you with a sense of violation or loss, which may bring on post-natal depression
• your baby may be very demanding. Or perhaps he or she was born prematurely or has a health problem or disability. All these can put unbearable stress on you as the mother
• you may be under a lot of pressure generally. Perhaps there are money or housing problems. Maybe you get little support from your partner, or don't have one. Possibly you're isolated and lonely with no-one to provide support or help
• our own experiences of being mothered can influence how we cope as mothers. Painful memories of events in our childhood?the loss of loved ones or separation from them, physical or sexual abuse?may return when we face motherhood ourselves.
• society has a very mixed view of motherhood. On the one hand, we are regarded in a rosy light as selfless sources of love and caring. On the other hand, society makes little attempt to meet the needs of mothers and young children. Taking a baby out anywhere can be an enormous effort. Public transport and many public places such as cafes and shops are still hard to get around with a small child in tow
• being a mother is regarded as instinctive, as something we all know how to do. Yet very often we will have had little or no experience of caring for small children before our own baby came along, and no chance to prepare ourselves or learn the skills needed
• we can easily end up feeling isolated and ignored. If we've given up work, we may well feel resentful at being cut off from the adult world and at losing our income
• the effects of hormone changes after giving birth. Some doctors support the view that changes in hormone levels lead to post-natal depression, although not all doctors agree on this.

Very rarely, a woman may develop a serious condition called post-puerperalpsychosis. This can lead her to behave in highly excitable and uncontrollable ways. She may have strange or bizarre beliefs or may hear voices, and will need medical help and support.