Coping with PND: Accept Help When It's Too Hard.

You’ve just had a baby. Everyone around you tells you that you ‘should be happy’– but you’re not.

If this sounds like you, it could be that you’ve got the ‘baby blues’ – a mild form of post-natal depression, which affects nearly 80% of new mothers. You may feel tired and tearful, anxious and mildly depressed, often for reasons you can’t quite identify.

Symptoms of mild depression after birth are quite normal. They’re certainly not pleasant but they’re unlikely to be harmful to you, your baby or your close relationships. So it’s important to make the distinction between the ‘baby blues’– which can emerge around four days after the birth and persist for several weeks – and the persistent, deeper unhappiness, which goes on for much longer.

Moderate depression, which affects around 15% of women, can be difficult to distinguish from baby blues, especially in the early days. It can be more difficult to shift and have a deeper affect on your life. While it can respond well to self-treatment, especially in a supportive home environment, help from your doctor, community nurse or a counsellor is strongly recommended. Severe depression after birth is rare (occurring in only 1-2% of women) but may put both mothers and their babies at risk – it requires professional help.

What’s causing you to feel depressed?

Over the years, scientists have attempted to discover the cause of post-natal depression but have been unable to make absolute connections between it and things like hormone levels, socio-economic status, age or the difficulty of the birth.

It may be that depression has a real and valid role to play in the early days of motherhood. Depression, as experienced by so many women after birth, can for instance be part of a legitimate emotional process.

In 1996, psychologists from the University of the West of England, Bristol, discovered that post-natal depression may sometimes be a form of grieving for a lost lifestyle. During interviews with new mothers suffering depression, the researchers found that all the women missed the freedom of a child-free existence and, in some cases, missed their old body image.

Most of these women felt unable to share the reasons for their depression with family or other women, because they felt ashamed. This is not uncommon. In one study, published in the Journal of Reproductive and Infant Psychology in 1994, which looked at what women say and do for themselves about depression, nearly 60% of women who felt depressed did not seek medical attention.

When asked how they helped themselves, and what advice they would give to help others, half of the mothers said that finding someone to talk to about your feelings was the most important thing.

Taking action

In truth many women can, and do, deal with the baby blues and even moderate depression quite effectively. If you are feeling down after birth, consider some of the following suggestions to help you cope:

Eat well. Keeping your blood sugar levels up will stave off the hypoglycaemia which can make symptoms worse. And while you may be anxious to get you figure back as soon as possible, a recent study in Nutrition Review (April 2000), confirms that strict low fat diets are linked to feelings of depression and even suicide. This may be especially relevant if you are breastfeeding, and using up more calories than normal. High caffeine and sugar intakes are also associated with higher rates of depression.

Supplement. If you can, supplement with 1000mg EFA’s (essential fatty acids) such as flax seed oil. Twenty years of research suggests that supplements of B vitamins are most useful. Most often implicated in depression are low levels of folic acid, B2 (riboflavin), B1 (thiamine), B12 and especially B6. A daily supplement containing around 50 to 100mg of the major B vitamins may be very effective. Increasing vitamin C, magnesium, and potassium, can also lift depression.

Rest. Sounds easy but many women find it very hard to rest with a new baby in the house. In the early days of parenthood you need to find a new rhythm for rest and give yourself permission to sleep when you baby sleeps, even if this means that occasionally dishes and other chores don’t get done.

Movement. Regular exercise, especially of the aerobic kind, can aid depression in several ways. It can help to release natural mood lifting hormones known as endorphins. It can also aid better, deeper and more regular sleep.

Talk about it. Depression after birth sometimes has its roots in events before birth. In 1988, a major Norwegian survey of women who gave birth in hospital found that 64% reported feeling a loss of control during childbirth. More than two-thirds of these women exhibited signs of depression soon after birth. A high rate of depression is also associated with emergency Caesareans and instrumental deliveries. Being able to talk about your birth experience with an experienced counsellor can be an important way of addressing depression.

Warning – use herbs with care. Most people think of St John’s wort – the ‘sunshine herb’ – when they think of natural cures for depression. For some it can be a very effective mood lifter, but it is only appropriate for mild to moderate depression and only if depression has its roots in an imbalance of brain chemicals such as serotonin. If depression is the result of fatigue or low thyroid function after birth, then St John’s wort is not for you. St John’s wort should not be used if you’re breastfeeding. If in doubt always seek the advice of a herbalist.

Aromatherapy, especially when combined with massage, can be a very effective way of lifting a dark mood. The right essential oils appear to play a significant part in the success of aromatherapy massage. For instance, citrus fragrance can raise both mood and immune system function. In one study, published in the journal Neuroimmunomodulation in 1995, citrus fragrance was shown to be more effective than conventional antidepressants. Likewise, lavender Roman camomile, clary sage and neroli are known to have proven sedative and mood lifting effects.

Getting support

For more information and tell tale signs visit these sites: Better Health Channel, One Woman’s Story, Beyond Blue.

If you or someone you know is suffering from PND please call PANDA on 1300 726 306  or The Gidget Foundation 9am to 7pm (AEST) Monday to Friday 1300 726 306 or contact your local GP.