WebChat With Postnatal Depression Counsellor Liz Wise.
Postnatal depression counsellor Liz Wise hosted a webchat in April. She answered your questions on PND, including treatments, recognising the symptoms and talking to your GP.
Liz is a specialist postnatal depression counsellor who has been supporting mothers with PND for the past 15 years. Having had severe PND after both her children, she has a great deal of personal and professional experience. Liz is also PND Co-Ordinator for the National Childbirth Trust and has also produced the popular DVD, Understanding Postnatal Depression.
Preventing postnatal depression
Q. My relationship broke down while I was pregnant, and shortly before this I moved to a new city with my husband. I am now due to give birth alone and feel fairly isolated in my new city. I have no family support and I feel concerned that I am at risk of PND once the baby is born, although I have not had depression in the past. Is there anything I can do to minimise the risk of being hit by PND once the baby is born?
Liz Wise: I'm sorry to hear that you're feeling very isolated in a new city and don't have family support around you. I think it would be a really good idea for you to talk to your doctor about your feelings, so they can try and get you some ongoing support. I wonder if there's any practical support that a charity such as HomeStart could offer you? Again, your GP or health visitor should know about this. It would be a good idea to talk to someone that you totally trust about your fear of getting PND.
Q. Do you think the use of positive psychology (resilience training, human givens therapy, mindfulness, teaching of relaxation techniques etc) could prevent postnatal depression in at-risk women? Do you think there should be more critical assessment to see what types of counselling/medication works for each individual?
Liz Wise: I definitely think the use of positive psychology and cognitive behavioural therapy (CBT) could help prevent PND in some women. However, it would be important to learn this before, as getting a grip on it when you are depressed is very hard. Yes, I think it is important to assess individual mothers to know what type of treatment and/or support is needed.
Recognising the symptoms
Q. I suffered from severe postnatal depression after the birth of my daughter. My husband realised this pretty quickly and encouraged me to seek help but I was convinced that it was just sleep deprivation. How do you differentiate between a woman 'just' being sleep deprived and it being PND?
Liz Wise: Sleep deprivation definitely contributes to PND and tiredness certainly makes it worse, however there are mums (most, in fact) who are sleep deprived but are not depressed. Sleep deprivation would not usually be a factor on its own to cause PND.
Q. Where does 'normal' life after a baby end and PND begin? Is there any link regarding prenatal depression/anxiety and postnatal illness? Is it a case of one or the other or is it mix and match? And how do you think diagnosing PND years after the birth fits into all of this? Are prenatal and postnatal depression just a way of saying a woman with children is depressed.
Liz Wise: Around 10% of women have some symptoms of depression/anxiety whilst pregnant and two-thirds of mums with PND have had some symptoms prenatally. However, it does not necessarily mean that if you have antenatal depression you will have PND. PND is depression after childbirth, not ongoing depression
Q. If untreated, can PND, and even prenatal depression, just stay with a woman for the rest of her life? Is it possible that a mother can still be suffering from this 10 years or more after the birth of a child? Or, over time, does it sort of go away of its own accord?
Liz Wise: That really depends on the individual and their own circumstances. I have met women in their 50s and 60s who say they had PND which was not treated, and they have gone on to have depressive episodes. However, I have also met women who have not had any treatment or support who have made total recoveries. In my experience, mums who have it recognised and treated recover quicker and more fully.
Q.To me, the whole area is a muddle of psychological, physical and social issues. It has sometimes struck me that there's "acceptable" PND (hormonally related in a woman with no history of mental health problems and treatable with antidepressants) and the altogether more "messy" sort. Are they two separate disorders?
Liz Wise: I would agree that there's a real muddle of disorders and there are many women who have PND who have no history of mental health problems. I myself was one of them. It would depend on the mental health issue as to whether you would see them as two separate disorders. Someone with bipolar or schizophrenia may well be treated with different medication and support than a mother who does not have an existing mental health issue.
Q. I had PND, and it frustrates me so much that people still always assume that this means you don't bond with your baby. Why is there is misconception and what can be done to challenge it?
Liz Wise: It is a myth that if you have PND you don't bond or love your baby. Many mums I work with have no problems with bonding, even though they have PND. Unfortunately, for some mums the severity of their depression doesn't allow them to feel the bonding or feelings of love for their baby. However, as the depression lifts the feelings will start to emerge