Booklet one – information on baby blues and postnatal depression

Having a baby is a time of change for you.

Having a baby is a time of change. You may experience a mixture of feelings. Perhaps you’ll feel overjoyed for a while but later feel overwhelmed. It’s normal to have unhappy or anxious feelings as well as happy ones.

It can be hard to imagine the impact that having a baby will have on you. Caring for your baby 24 hours a day, every day, is a very big responsibility. Perhaps you’ve changed from being a single woman or a couple to becoming a family; it’s quite likely that you’ll need time to adjust to this. If you’ve a child already you may be surprised by how much impact another baby has on your family and your feelings of coping. It may be very confusing if your feelings are very different to how they were last time you had a child. This is normal, each child changes your life in a different way.

Spending a lot of time alone with the baby can be all-consuming and isolating. It can seem difficult to find the time to get dressed, let alone be able to organise yourself enough to be able to go out – and yet going out and meeting other people including Mums can be very helpful. Make it a priority to do what you can to stop you feeling isolated.

It’s important to remember that everything is more difficult when you’re deprived of sleep. Feelings of tiredness and confusion are normal human responses to having less sleep than you usually would. Be kind to yourself, and seek medical advice if prolonged.

Stress

The impact of stress on the body can be surprisingly alarming. Dizziness, racing heart, sweatiness, shortness of breath and shakiness are normal body symptoms of stress. These body symptoms are natural and safe reactions to stress but when severe they can interfere with our everyday lives. You can reduce your stress by tackling the things that are worrying you and/or by learning techniques to manage feelings of stress.

The baby blues

About half of all Mums experience the ‘baby blues’ which are feelings of sadness, tearfulness, confusion and anxiety which come on a few days after the birth but goes within a week or two.

Postnatal depression

It’s normal to experience anxious or low feelings some of the time. Whilst official statistics suggest 10-15% of mums are diagnosed with postnatal depression, around 50% of Mums say they have experienced some of the symptoms of post natal depression (PND) (Netmums.com, 2004). This is where you experience a number of difficult feelings repeatedly over a few weeks or longer. Often these symptoms are mild to moderate and this guide can help you deal with them. For some the feelings can be severe and more upsetting. Making contact with your GP or health visitor can mean getting the right sort of treatment to help yourself cope better.

The feelings associated with postnatal depression can include:

• Numbness
• Blaming yourself unnecessarily
• Feeling as though nothing is good enough Feeling unable to cope
• Guilt Sadness Tearfulness
• Feelings of panic
• Thoughts of harming yourself
• Feeling unusually irritable or unable to see the funny side of things Difficulty sleeping because you feel so unhappy
• Feeling unfriendly or not bothered about a loved one Strong worries about everyday things like leaving the house Difficulty concentrating or making decisions
• Worrying thoughts about a person or situation Unable to look forward to things

Potential Triggers for Post Natal Depression:

Difficulties in relationships, for example, with your partner Isolation / loneliness; or lack of regular contact with family or friends Unrealistic expectations about what motherhood would be like History of depression or anxiety problems
Realisation of the responsibility of parenthood Lack of support from your partner, family or friends Childhood experiences
Recent stressful event e.g. the birth, bereavement or moving house Changes in hormones.

Asking for help

If you (or someone close to you) are worried about how you’re feeling talk with your Health Visitor, Midwife or Doctor. They will be able to discuss with you what could be done to help. This may include talking to a therapist, various support or social groups or antidepressant medicines, all of which can help you to feel more able to cope with your difficult feelings. Asking for help is best for you and your baby. It can help you to feel more confident and enjoy being a mother. Asking for help can feel like failure. Facing a fear of failure is always brave, it could be the first step to changing the future.

Whether you feel a little low or you’re wondering whether you’ve postnatal depression it’s important to take care of yourself. It can feel as though there is no time to do this because the baby comes first but taking care of yourself will make things better for you and your baby.

Rest and breaks

Rest is vital for keeping you healthy, both body and mind.Take time to do something for you – a bubble bath, a trip out, see a friend… it’s not selfish and everyone can benefit.
Even short rests can leave you feeling much better. Plan to stop and rest for ten minutes every couple of hours. Maybe listen to your favourite radio show or walk around outside.

Relax

Wear warm clothes and make sure you’re sitting or lying comfortably. Start by breathing slowly in through your nose and out through your mouth. Often when we’re not relaxed we breathe quickly. Slowing our breathing can gradually help us to feel better. To help check how deeply you’re breathing place one hand on your stomach and one on your chest. As you breathe in feel your stomach swell outwards, filling with air and try to keep your chest still. Repeat the deep breaths three times. Close your eyes and begin to visualise a calm scene. See the beauty of the colours of the sky, there is no wind, no sound, complete calm. Allow your mind to create this scene for you, it may be somewhere you know or a place you’ve created. Allow yourself to relax with this image for 10 minutes, keeping your breathing deep and slow. Then stretch your fingers and toes and allow yourself to become aware of the room you’re in once again. Do not get up suddenly. Take your time to come round.

Exercise

Gentle exercise can help you to feel less lethargic and sleep better. Taking the baby for a walk in the pram is good for you both, e.g. just going out for 10-15 minutes can be enough on busy days. Also, ensuring you’ve a balanced diet can help to reduce feelings of depression, especially if you’re breastfeeding.

Share your concerns

Sharing your worries and difficulties can relieve the pressure they put on you. This could be with a friend, family member, Health Visitor, Midwife, Doctor or Counsellor.

Accept offers of support or help

If others offer to look after the baby or help with household jobs let them help, this will relieve the pressure on you.

Baby massage and groups

Your Health Visitor, Midwife or Children’s Centre will be able to tell you about your local group. Baby massage aids bonding and is something you can enjoy with your baby. Building a network of other Mums allows you to talk to people who understand about the experiences you’re having and will help you feel less isolated.

Express your emotions

Notice the emotions you’re having and think of ways to express them healthily. Perhaps let out frustration by physical exercise or by doing some chores. Cry if you need to. Some people find writing can help. Laugh if you can – laughter lifts your mood and eases tension. Sometimes it may not be easy to laugh and you may have to make yourself. But the more you laugh the more easy you’ll find it becomes. As your child becomes older they will benefit from you being able to laugh.

A good tip can be to “Tarzan yodel” – this can let out your frustration and anger without frightening others or by you being unpleasant to others.
Ideally take yourself off into another room but if that’s not possible say what you’re going to do: “I’m going to Tarzan yodel out my frustration, it’ll be loud but don’t be worried”. Then Tarzan yodel. Don’t use words, you’re letting out your feelings not punishing or blaming others. Then let out a deep breath.

Sleep when your baby sleeps

Sleeping when your baby sleeps is a good way to top up, and occasionally letting your partner or family look after the baby over night can let you get a much-needed full night’s sleep.

Communicate

Talking with your partner, friends or family members about how you’re feeling can help your relationships. Using ‘I’ instead of ‘you’ statements can help; e.g. saying ‘I think I am doing more than my fair share’ could be more productive than ‘you’re not doing enough’.

If you’ve a partner… Share and be together

If you’ve a partner talk with him / her about who is responsible for which household and baby jobs to reduce the risk of feeling resentful towards each other. Also, by accepting help from other people you and your partner can have a chance to be alone together to enjoy each other’s company. If you cannot talk to your partner it’s important that you’ve someone you can confide in, maybe a family member or friend.

Start afresh

Treat each day as a new day…Look at each new day as an opportunity to start afresh, especially if things have been difficult or overwhelming the day before.

Here a mum talks about her experience of PND:

“I have recently been diagnosed with Post-Natal Depression, and over the past few months have struggled on not knowing the cause of my mood swings, anxiety and new found compulsive behaviour. I had always thought PND was where you neglected the Baby, or felt like life was not worth living, in my case my daughter is my whole world, it’s the rest of my life that I am unable to cope with!

I felt that I didn’t want to admit that I was finding it difficult to cope. I thought they might just see me as a bad parent and take my daughter away.

My family live almost a 2 hour drive away from my new home, having moved here to be with my partner just over 2 years ago, and I had no friends in the area with children until I attended a group.

I made a support network of new friends in similar situations, and was given the confidence to talk to them and having realised that I am not on my own, or a bad mother, and not going mad, I had more strength to explain things to my partner and my family about how I was feeling.

It was through children centres that I am able to admit this now, as I didn’t know where to look for help, and when I was initially invited to join their groups I didn’t have the confidence to attend, but they kept asking, and visiting me too! I can now see that making those first few steps, and attending that first “Mums the Word” meeting was the most positive step I’ve made so far, they helped me get onto a post natal group, and gave me the support I needed to contact my Health Visitor (who was actually quite supportive after all).

I’d like to tell other Mums who feel like they need extra support, not to be afraid to ask for help, it’s not a sign of failure – and if they don’t feel they can ask family or friends check to see if they have a children centers office or similar network group in their area to get in touch, it may feel like you’re jumping in at the deep end, but like me, I’m sure you’ll find that they’ll be there to make sure you don’t sink!

I have still got a long way to go, but I can already see a change in the way I am getting through this. There’s a small light at the end of the tunnel, but it wouldn’t be there if I hadn’t asked for help.”

If you’ve access to the internet you may find it helpful to look at the “Netmums” website at www.netmums.com. The site provides information on parenthood and also provides access to other Mums and Dads in your local area. Building a network of other parents is extremely valuable; using this site may offer you some of the support you need, especially if you’re feeling isolated at the moment.

Women who have had babies talk about the impact it had on their lives…

Counselling

Evidence shows that counselling can be helpful in adjusting to the birth of a baby and mild to moderate postnatal depression. There are many different counselling approaches but the basic values behind each approach are warmth, honesty and respect. Counselling is based on a contract between you and the counsellor which will be used throughout your sessions. In the contract the counsellor agrees to give you support in confidence in a set time.

Counselling offers an opportunity to:

• Explore your thoughts, feelings and responses.
• Express, or come to terms with emotions.
• Think about what has happened in your life and how it may be affecting you now.
• Recognise your own strengths.
• Explore relationships.
• Talk freely in a safe and confidential environment.
• Develop awareness, options and skills for managing or overcoming your difficulties.

A counsellor won’t:

• Tell you what decision to make.
• Tell you what to think, say or do.
• Take sides in a troubled relationship or family disagreement.
• Make you do things you don’t want to do.

Cognitive behavioural therapy

Cognitive Behavioural Therapy (CBT) is an evidence based approach thats supports you to reflect on your thinking and your doing (behaviour) to improve how your feeling. Used to treat anxiety and depression ilnesses. Spending some time with a CBT therapist, to explore these patterns, understand the consequences of your patterns and then decide how you might interrupt these cycles. Your therapist will support you with identifying your goals, and will work with you to achieve them. You will talk about how you are feeling, but you will also be encouraged to empower yourself with skills so that beyond therapy you can continue to build on your knowledge. CBT is a structured time limited therapy where you are in control of the changes you want to make.

For more information please go to: https://www.nhs.uk/mental-health/talking-therapies-medicine- treatments/talking-therapies-and-counselling/cognitive-behavioural- therapy-cbt/how-it-works/

About antidepressant and anxiety medicines

(Information taken from www.nhs.uk)

Medication can be used to treat postnatal depression and anxiety. Most women are prescribed anti-depressants. These medications work by balancing the chemicals in the brain that alter our mood. A course of antidepressant medication usually lasts six months. If symptoms start to get better, the dose may be reduced. Antidepressants take two to four weeks to start working, so it’s important to keep taking them even if you don’t notice an improvement straight away.

The type of medication you’re prescribed depends on whether you’re breastfeeding. Tranquillisers are recommended for short-term use only. Lithium (a mood-balancing drug) may be used to treat severe PND, but it’s not suitable for use while breastfeeding.

In women who have a history of PND, GPs sometimes prescribe the hormone, progesterone, as a way of preventing depression. This is a fairly new treatment, but early results show that it can be helpful. Your GP will be able to give you more information.

If you’re interested in ‘talking therapies’ or medication, your GP, health visitor or midwife will be able to talk through the various options available to you.

Groups

Groups can be very helpful They can give you a chance to meet other people, make friends, get support, share experiences and get information – they can be a place to enjoy yourself. People often find that belonging to a group can help them realise just how normal their feelings are. Whilst the thought of attending a group may make you feel nervous they’re worth the effort, particularly if you’re feeling isolated or have noticed that you’re socialising and going out less often.

A quote from a member of the “Just Had a Baby Group”:

There are many different types of group which may fit what you’re looking for. Your health visitor can tell you about services and groups near you. Family Information Service can tell you about children centres www.bradford.gov.uk 01274 437503

Your Midwife, Health Visitor or GP can give you information on a free counselling or art therapy service in your local area. Your Doctor can also give you advice on antidepressants.

If you’re experiencing sexual, physical or mental abuse talk to your Health Visitor or contact Women’s Aid on the following numbers:

Staying Put 01274 667104
Bradford Women’s Aid 01274 666241
Domestic Violence Services Keighley 01535210999 Bradford Rape Crisis & Sexual abuse 01274 308270 Emergency 999 or Police 101

Family Hubs

Advice, support, groups and activities for families with children under 4. Bradford’s Families Information Service
01274 437503 for the number of your local Family Hubs.

The Association for Post Natal Illness

Support and information for mothers suffering with post natal depression.
Tel: 020 7386 0868
www.apni.org

The National Childbirth Trust

Information, support, local branches offering groups. Website: nct.org.uk
Support Line: 0300 3300700 Option one: NCT Infant feeding line Option two: NCT course bookings
Option three: NCT membership, volunteer and general enquiries. Email: enquiries@nct.org.uk

Relate

Relationship advice and counselling, family counselling, sex therapy and youth counselling (10-18yrs).
Relate Bradford: 01274 726096
information@relatebradford.com
Relate Cross Pennines: 01535605047
info@relatecp.org.uk

Baby Centre website

Information for Mums and Dads on pregnancy, birth, parenthood, health etc.
www.babycentre.co.uk

Mothers Matter

This website provides information to families about mental health issues
Mothersmattercic.co.uk
01443548590
info@mothersmattercic.co.uk

Tax Credit helpline

Information, guidance and contacts about tax credit.
Tel: 0345 300 3900
www.gov.uk

Netmums.com

Website providing access to a network of Mums in your local area. Information on groups, activities and many other issues related to parenting.
www.netmums.com

Bradford Survive and Thrive

08082800999
womencentre.org.uk

Mind

Information about mental health and support General Enquiries: 01274 730815 www.mindinbradford.org.uk

Gingerbread

Provides information to single parents Helpline: 0808 802 0925
www.gingerbread.org.uk/what-we-do/contact-us/helpline/