You're not alone if you smile and nod 'I'm good' when people ask how you are after childbirth, even though you're not good. You're far from good - you're exhausted; emotionally physically and mentally, always hungry, angry at everything, and a bit scared. Feigning fine is a hangover of the lingering stigma around mental health, especially in motherhood. Here is my experience of postnatal depression, and why I am challenging perceptions of it.
Did you know that postnatal depression is quite common after childbirth? Many women struggle to talk about it or even realise they have it. In my opinion, the stigma comes from societal views that having a baby is supposed to be a joyful occasion, and feeling depressed about this precious new life just isn't acceptable. Well, it's not as simple as that, with the process of matrescence perfectly summing up the complex physiological and mental shifts that can result in postnatal depression. I feel a lot of women's perinatal mental health will suffer in general in the current climate, with ante and postnatal care standards falling due to budget cuts.
I'm a mother-of-two, and experienced postnatal depression after having my second child. In the years that followed I had recurrent bouts of the illness that I relate to the initial diagnosis - the symptoms always follow the same pattern, and it wasn't something I suffered from before having children. While people around me offered support, I was still surprised by what I perceived to be a lack of acceptance about my mental health and the treatment it required. Here's my experience of lingering postnatal depression, and why it often felt like a source of shame to everyone except me.
Postnatal depression - my experience
I felt quite anxious in the weeks after giving birth to my first child, and I think this must be the case for most new mums. But, I went into my second pregnancy feeling pretty confident, 'I've got this' I thought to myself, I felt like I knew what to expect, with lots of my proudly learned tricks at my fingertips to make round two run as smoothly as possible.
Except the second time around, postnatal depression hit me like a train, almost violent in its brutality. I went from being in a baby bubble with my new bundle to feeling a level of anxiety that's indescribable. I'd lay awake at night, my mind racing until I couldn't keep track of my thoughts. Everyday tasks became impossible - it was like my limbs would no longer do what I told them to do, and I wasn't sure what I was supposed to be doing anyway.
My ears rang constantly and loudly, and even noises that usually faded into the background made me want to huddle in a ball and cover my ears - the hum of the fridge sounded like a plane taking off in my kitchen. I found myself running from room to room, trying to get away from the noises. My ringing ears were the worst because there's no possible way to get away from a noise happening inside your own body.
I became obsessed with the fact I was going to contract a horrible illness and die. I even began to imagine symptoms, explaining them in great detail to my husband one day, summing up my diagnosis. I concluded this monologue by telling him I was dying and that he needed to take me to A&E right away. Totally out of his depth and unsure what to do, he phoned my mum.
My parents took the 50-minute drive to our house, where Mum swooped in and took care of the children and bustled around the house. Amongst her manic tidying, putting washing on, and doing all of the things, she took a sing-song "It'll all be FINE!" stance, while my dad sat and stared at the floor, looking awkward.
It was heading towards the evening when this intervention happened, and someone thought a Doctor should probably be called. This should've happened some time ago, but I was in no state to do it, and nobody else thought to. After being asked to describe my symptoms to a receptionist, she decided - after hearing the horrors I just described - there wasn't capacity for a Doctor to see, or even call me.
"Citalopram. They mean Citalopram. I once asked my dad when he planned to stop taking his prostate medication, but that was different, apparently."
After some pleading, we were told we'd get a phone call at the end of the day, and that was doing us a huge favour. Although lots from that time remains hazy, the conversation I had with the GP remains crystal clear. She huffed and sighed her way through the call, making me feel like I was at best inconveniencing her, and at worst, a total time waster.
I know it's not the fault of receptionists, healthcare providers, and all who work in the industry. Most of them do their very best for people in their care, under stressful conditions. But with services buckling under the strain of extreme budget cuts, staff shortages and little time for training, patients are going to suffer.
Women will be hit the hardest, as they were already (anyone who has read the Caroline Criado Perez book Invisible women: Exposing Data Bias in a World Designed for Men, will know this). Women will suffer more severely as their perinatal needs simply aren't met, and nobody should be made to feel their postnatal crisis is inconveniencing a healthcare provider.
I quickly saw my own GP, who explained my strange aural symptoms were quite normal in postnatal depression - where usually the brain filters out excess noise, the fight or flight triggered by extreme anxiety fails to do this, and the smallest sounds can sound like fireworks following you around. This made me feel a little less like I was going insane.
"It's been nearly 10 years since my postnatal depression diagnosis... I had a relapse. It usually starts with feeling uncomfortable in my own body, and I simply can't work out why."
Then followed months of therapy, regular health visitor visits, and starting and adjusting medication. I took the children to playgroups and other activities because I didn't want them to miss out, but found attending quite hard going. My husband attended social events without me - that was one step too far for me.
My cousin had a baby not long after me, and when I was feeling better, we met at my mum's house to introduce the babies, along with more of my cousins. I overheard my aunt asking my mum how everything was going, and mum replied in a tight hiss "Not good, she's had some sort of postnatal... thing. Like, erm, you know..." Understanding this code, my aunt hissed back "Oh, should I tell the girls?" She was referring to my cousins, who already knew - we're in regular touch and I'd told them all about it.
I put my mum's failure to use the correct terminology and speak at a normal volume about my mental health, down as generational. One of my mum's brothers sadly died in childhood, and I was told that after his death my Grandma "went away." Presumably, she spent time in a psychiatric unit, but nobody will talk about it because - you guessed it - of the stigma surrounding mental health disorders.
My husband's parents wanted to visit, and we'd been putting them off for some time. I assumed my husband had told them why it was best to wait, but he'd been making excuses. I always left my medication next to the kettle to remind me to take it, otherwise I'd forget. When his parents visited, I found my husband rounding it all up and shoving it to the back of a cupboard. When I asked him why, he replied that he didn't want them to see it, because "they wouldn't understand". I felt winded.
It's been nearly 10 years since my postnatal depression diagnosis. Around two years after I started taking antidepressants for it, I felt well enough to come off them. I've now fallen into a pattern that I call my "cyclical PND." Around two years after I stop taking the medication, I have a relapse. It usually starts with feeling uncomfortable in my own body, and I simply can't work out why.
Then I go through a phase of almost agitation - I feel fidgety, unable to sit still, and feel an overwhelming need to be constantly busy. Then the nighttime anxiety starts, with the racing mind, inability to sleep, and poor focus. The lack of sleep gives me a warped sense of what's going on around me - I'll withdraw from friends and chat groups, believing I'm a terrible friend and nobody wants me around.
Sometimes the ear ringing reoccurs, or it will be something different - one time I thought I was standing on uneven paving because the floor felt like it was moving beneath me. When I double-checked, it wasn't. All this then generally gives way to sadness and a depressive state. I restart the medication, and the cycle starts again.
Each time I need the antidepressants again, I'm greeted with similar feelings from those around me. My husband wonders if it could be his fault, like he's done something wrong when he hasn't. If his parents visit, it's not to be spoken of, and all traces of mental illness are hidden. My parents would say "you don't need those things again, do you," or "how long will you be on that stuff this time, then?" Citalopram. They mean Citalopram. I once asked my dad when he planned to stop taking his prostate medication, but that was different, apparently.
"The second time around, postnatal depression hit me like a train, almost violent in its brutality."
I've mentioned to our families that there's plenty of openness and conversations going on in the modern world about mental health, and there's no need to be ashamed of it. However, it's easy to go on TikTok and throw buzzwords around but not actually change your behaviour. Do these so-called open dialogues really change people's attitudes? I'm not entirely convinced.
I've found what makes me feel centred, and my mood levels high. I need to keep seeing friends and not withdraw, no matter how difficult I find it. I need to eat really well, lift heavy weights, and do cardio until I feel high. I can't do mindfulness, I'm sorry. I've read the research and know it would work if I did it, but I just can't get on board. Funny TV shows, and even nostalgic ones help too (Gladiators reboot, anyone? Harking back to easier times and great childhood memories!)
I was never ashamed of my diagnosis. I've learnt to live with it, and living those experiences when they get really tough are the hardest parts, not admitting they're happening. I understand a lot of the familial feelings surrounding it are of their era, and can't be helped. I can't change how other people view mental illness, and that's just part of the learning curve of all of this - and what I've learnt about myself has been invaluable.
Where to get help
- If you feel like you're struggling with your postnatal mental health, get in touch with your midwife, health visitor or GP.
- The NHS have a helpful page covering symptoms, self help, and who you can contact.
- PANDAS have a huge range of free resources, from helplines, social media and online groups, WhatsApp and email support.
- MIND has a dedicated perinatal mental health section, containing useful contacts, and an explanation of possible causes, treatments and support other options.
Parents also have to deal with mum guilt, a whopping increase in the mental load that comes with having a baby, and the often untold trials and tribulations of breastfeeding. We've spoken to mums who have gone through it, and experts who can help, so we can all feel less alone in motherhood.
