Post Natal Depression - what is normal?

It seems that more of us are being diagnosed with Post Natal Depression these days, which begs the question: does motherhood make women miserable or are we turning a normal, if difficult, psychological transition into an illness?

In working as a post natal doula, I am in women’s homes after they have had a baby and it is perfectly normal for me to see new mothers sad or miserable or even crying.  It turns out this is one of the questions in the Edinburgh Post Natal Depression Scale, a self reporting tool developed in 1987 to help identify women with post-natal depression; something your health visitor may have asked you to complete.  Another question is “have you felt scared or panicky for no good reason?” which equally most of the women I work with in the early days of motherhood (if they were honest) would say yes to.  

Motherhood can be very very hard to adjust to for most of us, and in the struggle to get a handle on it (and possibly to realize that you will never truly get a handle on it) it is only normal to expect to be teary or feel fear.  Immediately postpartum a new mother is probably physically exhausted, sleep deprived, hormonally frankly quite mad and deeply in love with a tiny new person they feel biologically programmed to protect and care for.  She may also find herself at home alone with her baby if her partner has to go back to work and her family is not near.

Couple this with the fact that motherhood is without a doubt the hardest-easiest job in the world and you may very well find a woman who weeps and feels scared.  Intellectually, we know that a baby’s needs are so simple: food, warmth and love.  And yet… and yet… it can seem like a relentless cycle of food, warmth and love and regardless of the food, warmth and love it also seems that they cry.  A lot.  And every cry goes through you in a way that you would never have believed before it happens to you, and every fibre of your body reacts to that cry.  Sometimes a baby’s cry is hunger, sometimes it is discomfort and sometimes it just is. 

I have a client who recently told me that the minute she realized that her son just needed to be held, she was a much better mother.  She had spent the first six weeks of his life feeding him and changing him and winding him and then believing that she should put him down, in a basket or a crib or in a bouncing chair and he would be satisfied.  He wasn’t and so he cried.  When she realized that by carrying him, he was happier, she was much better able to be a good enough mother.  But it took her six weeks to figure out what she imagined she would know instinctively.  The solution she found for her baby worked for her and for her son was not something she read in a book or someone else told her to do, or even something that will work for you (although it might be worth trying!) but eventually through trial and error, she came to the conclusion that her baby would only stop crying if she carried him with her.  Pregnant with her second child, she is now preparing for her next baby to be the same.  Perhaps he will be, or maybe she will have to do all that learning again with a different child, either way she understands the fundamentals of being a good enough mother.  You try your best to find the best solution to any given situation and forgive yourself if you don’t manage it quickly.  Every mother should march to the beat of the tiny drum her baby beats for her.

There are no simple answers to motherhood, it is not an exact science.  The best you can realistically hope is be a good enough mother.  To figure out what your baby needs and provide it as swiftly as possible and understand that sometimes babies just cry.  You may find that carrying them helps, or singing to them, or walking around the park in their pram, or sometimes it could be that nothing helps and your baby is just exercising his right to shout.  A lot.  A friend says her son frequently sounds like he is being attacked by cats.  A second time mother, she spent his first week rushing to save him from the imaginary marauding felines and then slowly realized that is just how he is.   It is normal for him to cry like that - it doesn’t mean anything is wrong particularly, it is just the way he is, different from his sister before him

It is also important to remember that babies are very receptive and so,  if you feel anxious or panicked or scared, they will pick up on that.  If in the face of motherhood you feel fear (and really, I don’t know anyone who is honest who can say it doesn’t ever fill her with some sort of fear) your baby will react in a way which may make you feel even more fear and so a vicious cycle begins.  I have a client at the moment who said to me “Why is my baby always so calm when you are here?” and it isn’t because I am a magic baby whisperer (more’s the pity), it is because my being in her home means she can focus only on her baby and not worry about the washing or the cooking or the ironing or the shopping or answering the door to the post man or cleaning out the fridge or putting the flowers in water or any of those other things that distract us from our babies and so SHE can make her baby more calm by being more calm herself. 

I am not sure that women are more inclined to post natal depression these days myself.  I do think the adjustment we make as we transition from individual to mother is a very difficult one, emotionally and physically, possibly harder to do when older but if that manifests itself in tears or random moments of panic, then we should embrace them and ask for help.  Being alone and sad and panicked is far more overwhelming than sharing it with someone who cares for you and so much the better if that person can normalize those feelings for you.  It is right you should feel sad sometimes as a mother and being responsible for a tiny new person is also pretty scary, but grab that fear with both hands harness it and be the best mother you can be.  It is also right that you should feel overwhelming joy and discover meaning in your life that you had no idea existed.  And enjoy being a mother. For most of us it’s the best job you will ever have.

 

Posted on Friday, May 15, 2009 at 02:26PM by Registered CommenterLucy Symons in | CommentsPost a Comment | References1 Reference

Happiness at any cost…

There has been a lot in the press recently about children these days expecting to be happy at all times.  Parents, trying their best to do what is right, are challenging teachers in a way previously unknown when their little darling is “unhappy”. 

A maths teacher was quoted in The Observer last Sunday saying that he corrected a child’s homework, pointing out that a nought was in the wrong place.  The child watched as the teacher changed the answer (corrected the answer) and smiling, changed it back saying “Thank you, but I prefer it where it was.”  Mad mathematical renegade or spoilt brat?

As a parent we all want happy children… but ultimately what is really going to make your child experience long term happiness?  When do we need to step in and teach our children that they can’t always be right and that life isn’t always happy?  When do they learn that they don’t always get to be first, selected for the football team or the lead part in the class assembly?  It is a vital lesson without doubt, and one that needs to be assimilated before entry in to the Big Bad World where there isn’t always going to be a mummy to take the naughty person to task for not recognising (perhaps well hidden – or truly absent) genius.

I do understand that having a happy child is vital, but I wonder if ultimately little Johnny is going to thank you for this effort?  Research shows that children who are never corrected or thwarted actually have lower self esteem than their more robust challenged counterparts.  Life is as much about managing disappointment as learning to manage success.  Realistically, in a class of 30 children, your little darling is unlikely to come first and 29 times more likely to come second or lower.  And someone has to come last!  Surely childhood is where you learn that, safe in the knowledge that you have parents who love you no matter what and will comfort you and teach you that not being The Angel Gabriel in the Christmas production is actually not The End of The World.

If, as a mother, you beg the teacher to remark homework or add your child to the team roster or change the casting for the school nativity play making your child happy again, if only for a little bit, what lesson are you teaching your child?  Complain and you get what you want, perhaps. Is that true of life?  Perhaps a little bit, but generally speaking life is pretty much a meritocracy and if you aren’t best suited to the role, you won’t get it.  And how hollow a victory would you experience if you were in the starting line up of a big match only because your mummy made the coach put you in?  I cannot tell you how many painfully shy children I have watched squirming with embarrassment, unable to speak when called upon to do so, after their mother has negotiated them in to a role in the school play they aren’t happy with.  Surely that is a far worse fate for the child than being cast as part of a nice crowd scene where you can lurk at the back and don’t have to speak?

As a parent, you have to moderate your expectations to fit your child.  If you have a terribly uncoordinated chatter box who loves to show off… perhaps they would be selected for a part in the play but left off the netball squad.  Should you perhaps trust the teacher to make that decision for you, rather than barrel in and take them to task?  We had a situation at my children’s school recently where a mother insisted her daughter take part in the “gifted and talented programme” arguing that it would only be fair if everyone had a “go” at being Gifted and Talented.  This child was also told that she couldn’t take the exam for the grammar school (the 11+) because she was “out of catchment” although a patent lie.  The poor child repeated this to anyone who would listen and watched as people nodded their heads in pity more than agreement, understanding that an untruth had been told to her to save her feelings.  What does this teach her daughter?  Will she thank her mother when she is older? 

We surely should be thinking of our children’s happiness in a much broader sense rather than immediate disappointment and upset.  To teach a child to accept the rough with the smooth and understand their own limitations is vital.  “Life is short and  brutal and then you die” was my father’s response if I ever complained about any perceived injustice – perhaps rather old school, but I got the message.  We need to celebrate our children’s achievements and I fear that when they really do work hard and achieve, the subsequent joy may be diminished by the previous devaluation.  Encourage them by all means, but be realistic and understand that you may be (should be!) slightly biased when it comes to your own little darling.  That your adoring, uncritical, maternal view of your child may be best kept in the home, though.  You can be a one person cheering squad for your own children behind closed doors, but you also need to be able to be a shoulder for them to cry on when they are unhappy.  Without sickness we wouldn’t appreciate health and without sadness we wouldn’t appreciate joy.  Everything in moderation makes for a happier more confident child in the end, I think.

Posted on Friday, March 20, 2009 at 06:38PM by Registered CommenterLucy Symons | CommentsPost a Comment | References6 References

Patience and selflessness…

Pregnancy is a time in our lives when we are forced to face up to things.  Perhaps it is the first time in your life you have been larger than a size 10; when you are going to bed at 9pm because you are so dog tired you couldn’t possibly stay up another minute; a time in your life when the very thought of coffee is enough to make you projectile vomit.  There are things at work in a pregnancy that are so much larger than we are.  You are no longer in charge, but rather slightly subservient to a tiny tyrant kicking you from within that you haven’t even met yet.

I remember giving up smoking when pregnant with my first daughter – not out of some smug desire to be a good mother – but because I could no longer inhale the smoke without hurling.  What a shock to have my behaviour dictated by something I had created deliberately.  

I meet women every day who are in a state of shock that they are no longer in charge.  Not drinking; not smoking; not staying up late; parading about in trackie bottoms or maternity jeans; suffering from a cold and unable to take anything strong and go to bed; not dying their hair; taking vitamins; avoiding the fridge because of that terrible smell…  I wonder how many of these women realise what a great preparation this is for what lies ahead?

Becoming and being pregnant is just the start.  Once you have managed to survive your nine months (40 weeks – which is actually closer to ten months, surely?) you are only just beginning to learn about being patient and selfless.  Your baby will come when they are ready – not when you are ready… and although there is a huge psychological element to that moment when you go into labour, it is your baby that starts the whole process off, not you.  You are just hanging about, like the Worlds largest departure lounge just waiting for an arrival.  And babies can be late.  Very very late.  They don’t care when the maternity nurse is contracted to start, or when your mother is coming to stay or your husband’s parents can get down to visit.  You have to follow their lead – and get used to it!  It starts now and goes on for the next – oh, I don’t know, twenty years or so.

So waiting for labour to start is a good place to learn some patience.  Don’t be tempted by the hospitals administrative desire to get you delivered “in time”.  Unless there is a grave health issue, your baby is much better off if they are born when they are ready – not when you or an overstretched maternity unit want them to put in an appearance.  Dates are illusive things and although you may have been given a specific due date – knowing when a baby is due is based on a guesstimate and not an exact science.  Your menstrual periods sometimes have a bearing on this – if you have a long menstrual period (29-31 days) you are much more likely to gestate for longer.  Likewise if you have a shorter period, you are likely to have a shorter gestation.  But there are no rules!  Most first babies are born on average 8 days later than their due date and that statistic includes the induced ones who may have stayed put for much longer if they had been left.

Once your baby is here, most mothers choose to be led by them.  If you decide to demand feed, you can expect to be feeding about 12 times a day.  Or more.  Again there is no exact science here and you will find that you will pick up cues to follow from your baby very quickly.  I have to say most of the women I work with who are happiest are the ones who can totally surrender to being a new mother.  Who forget all about themselves and are quite happy to just gaze lovingly at their baby for hours at a time, who learn to trust their own instincts and observe their baby and their new role as mother with a sense of wonderment.  Some mothers don’t need to forge a routine or wrestle any semblance of control over their new charge.  They can enjoy just being - with their new baby; in their new role; enjoying their new family.  There is nothing more important for you to do at this moment and if you can let everything else fade away for a few weeks then please do.  Let go and relish this new phase in your life when you learn to be totally selfless, enjoying that amazing love you feel for your new baby. It is a lesson for life – as most truly happy mothers I meet put their families first.  Nothing else is ever as important as this.  Until you do it all again…

Posted on Sunday, December 28, 2008 at 03:26PM by Registered CommenterLucy Symons | Comments1 Comment | References1 Reference

The Big Picture

Those first few years with babies and small children can be a total blur.  They should be the amazing, unselfish years when, as a mother, you find yourself completely absorbed in the lives and needs and of your gorgeous little creations.  It is worth trying to keep some perspective at this time, if you can, as you are setting down behaviours and patterns for the rest of your and their lives.

It is very tempting I think, as an over-tired, stressed out mother, to take the line of least resistance with kids when it comes to food and discipline.  And no one can blame you.  But I think we all have our limits and a sensible mother will have an eye on the Big Picture as she gets from day to day in the tricky early years.

The way you raise your own family has a great deal to do with your own expectations and should you choose a totally child centred family, no one should criticise you.  BUT if you have a child centred family and struggle with the reality of that (letting children fall asleep when they feel like it, eat, wear and do what they feel like and generally dictate the terms of the family’s life) don’t expect a lot of sympathy when you complain that you have had yet another sleepless night or you find being with your children out or just with other people a struggle.

If you understand how your child and your family will (inevitably) have to fit into the larger society when you enter the scary world of school and the social necessity that brings with it, you can begin to understand the problems you may encounter.  If you have ways of dealing with your children at home which embarrass you or would seem “odd” to other people, do appreciate that sooner or later you are going to be part of a larger community and you may find that his sweet little quirks may cause him (or you) embarrassment.

I know many mothers who left dealing with peculiar loo habits until school.  I can remember a mother being loathed to accept a teatime invitation for her children and thought she just didn’t like me and was trying to give me the hint by constantly refusing.  Eventually it all came tumbling out that her child would only poo in a nappy in spite of his advanced years and four pm was the appointed hour.  Once this was out in the open, she did come for tea, armed with the nappy and all was well.  I do think for her that school was when she realised that she would have to force the issue with her five year old and sure enough a few weeks later he was pooing in a loo just like everyone else.  I think she found converting him to a normal pooer a lot easier than she had expected as well, when she finally grasped that particular nettle.  Sometimes avoiding a situation gives it a lot more power over you or your child than it should… “feel the fear and do it anyway” seems to be an appropriate battle cry for all mothers.

Food is another tricky place.  You know what you will expect your child to eat at home and with your own family and if a steady diet of strawberry yoghurt and crisps is acceptable to you, then don’t let anyone else put pressure on you to change that.  If you are aware of basic nutrition and also would like to be able to send your child to other people’s houses for meals, it is probably an issue you should deal with sooner rather than later.  Most children have a few food fads, but you – as their mother- should lead by example, and try to find a way to deal with the most extreme of them to make your little honey less socially different.  (Having said that, we have a very lovely friend who is married to a top consultant who works at a teaching hospital in London and comes to dinner parties requesting a fish finger sandwich… white bread and marge as well, none of that home made organic bread crap.  He has survived in to his forties so far and seems to be at the top of his game in spite of his lack of a well rounded diet.  His wife may tell you he is hard to take out, but he seems very happy.)

Most children are remarkably flexible when you get right down to it, but if they sense a weakness in you, don’t expect them not to capitalise on it.  If you let them peel the wallpaper off their bedroom walls or refuse to have their hair washed, they probably will keep it up for as long as you let them.  Any socially unacceptable behaviour must have consequences… if not in your home, then how is your child going to learn that we have a certain expectation of behaviour in the extended world?

Motherhood is about balance and trying to find a way to see the Big Picture without causing yourself undue anguish.  Having a child who sleeps through the night may be a necessity for most of us.  Encouraging that through incentives is a very healthy way forward.  Trying to raise a child who has a varied diet and can eat pretty much anything that is put in front of them is always convenient for travel and visiting friends and family and a lot less embarrassing in a restaurant or when visiting Great Auntie Maud.  I would rather raise balanced and socially capable children rather then cripple them with phobias and fears and psychological quirks which may have just started as bad habits.  Or worse, maternal short cuts.  I know that when I was at a low ebb and couldn’t be bothered to labour a point my kids got away with murder and could have kept it up if I hadn’t realised I was the adult and reigned them in.  My children were ghastly in grocery shops and so I tried to go when I was alone.  What I had failed to appreciate was that sooner or later I would have to do take them with me and because they weren’t used to it, they behaved worse than ever.  If I had just gently introduced the idea that we behave with patience in a super market trolley I would  have been much better off.  Instead I was stressing about their behaviour which, of course, they picked up on and played to their own advantage.  I was never going to be the mother with the child in the trolley eating crisps…  

A child who can sleep anywhere is a lot more portable than the one who needs to have an adult gently singing the Skye Boat Song whilst lying next to them stroking their head until they fall asleep. And you may find (as I did) that most children tend to prefer parameters; they actually like knowing the rules and are reassured that you are in charge and that there are consequences for aberrative behaviour.  So, try to be aware of limits you are may be placing on your children and, if you can, get rid of them.  You want to try your best to raise confident, happy, children who become confident, happy, adults… not strange people who can’t pee in public toilets, eat anything that is yellow or sleep anywhere but in their own beds.

 

 

Posted on Thursday, October 30, 2008 at 05:57PM by Registered CommenterLucy Symons | CommentsPost a Comment | References1 Reference

What if it isn’t always fabulous?

So, you’ve fallen pregnant and maybe it wasn’t as easy as you thought it would be.   You’ve navigated the rocky waters of pregnancy and given birth.   You’ve survived the first few weeks of hormonal madness and total sleep deprivation and have settled in to being a family.   You are managing your partner and the house and your in-laws and your family and what if it isn’t always what you imagined it would be?   What if it isn’t always fabulous?

I was part of a discussion last night about motherhood which made me think it was worth writing about those bad days we all experience.   In the group of mothers who were bearing their souls, there was a good cross section of those who fell pregnant at the drop of a hat, those who battled with miscarriages, those who relied on IVF or IUI and those who adopted.   We were variously mothers of singletons and up to a mother of four, generally straight talking articulate and opinionated women (with a few bottles of wine in us – I have to admit, it was “book club” after all).   We all admitted that at various stages of our lives as mothers we had had very dark moments when we felt we weren’t as happy as we had hoped we would be.

Most of us had found sympathetic other mothers to speak to in those dark hours (and generally it is a   fleeting feeling of “Oh my God, What have I done!” rather than anything resembling full blown post-natal depression) but what stood out to me was that those of us who had really struggled to fall pregnant and ultimately to have a baby (and had had assisted conceptions using IVF or IUI or even adopting) felt less able to voice their negative feelings.   Some admitted to actively hiding these negative moments from those around them fearing they were “not allowed” to be questioning their decision to become a   mother because it had been so much harder (and in some cases, more expensive)   for them.   “I felt I didn’t have the right to complain,” said one, a mother of an adopted daughter “and worse, I had the social worker constantly breathing down my neck asking if I was coping.   I couldn’t say I was ever having a bad day.”

I know some mothers whose husbands snap at them “This is what you wanted!” or “You chose this!” when they ask for some sympathy.   That would quickly teach you not to voice your concerns again to that particular audience.   So what do you do?   I think my best advice has to be to find some like minded and non-competitive mothers with whom to speak.   Some kind ladies who will admit their feelings.   I also think it is vital that you know, as a mother, that you aren’t going to love every day and you wouldn’t be human if you didn’t occasionally wonder what your life would be like if you hadn’t had a child.   That doesn't mean you don't love your children.   These dark days are fortunately few and far between for most of us, but it is absolutely vital that mothers feel they are allowed to have them.   Please be generous with each other and be honest about your real experience of motherhood. Being faced with someone who smugly tells you that their baby sleeps through the night, their husband never needs to have sex with them and that they would much rather scrub the kitchen floor than go to bed early is too depressing for words, but also not really true in my experience.   I am always wary if someone is coping TOO well.   Especially if they have twins, or an IVF baby or an adopted child.   Much wanted children can also be a burden some days.   By and large motherhood is a wonderful experience, but as in everything you have to experience the dark to appreciate the light.

 

Posted on Friday, October 17, 2008 at 08:52AM by Registered CommenterLucy Symons | CommentsPost a Comment | References1 Reference