“I can’t fully explain postnatal depression, but I can tell you it’s the worst feeling in the whole world,” revealed Dublin mother-of-two Suzanne Brack in a widely publicised social media post just before Christmas.
Not surprisingly her no-holds-barred revelations about the shocking reality of post-natal depression (PND) immediately went viral — post-natal depression, which according to the HSE, is a condition believed to affect one in six new mothers, is so stigmatised that many women are ashamed to admit they may have the condition.
PND is not to be confused with the baby blues, which occurs around the third or fourth day after birth and can result in a mother crying, feeling irritable, experiencing anxiety or insomnia — and is a completely normal reaction to the trauma of labour and birth.
At first a new mother may feel tired, unsure and unable to cope when she comes home from hospital. This normally passes within a couple of weeks but, for mothers with post-natal depression, things don’t improve.
It’s unknown what causes PND, which can last for months and even years if left untreated but it is believed to be linked to certain factors, ranging from feelings of inadequacy to the levels of support a mother receives in caring for her baby, to the significant hormonal changes that occur after childbirth.
However, there’s still such taboo around PND that an estimated 50% of sufferers remain ‘under the radar’, not revealing their private turmoil, according to Irene Lowry, chief executive of Nurture, an award-winning Irish charity established in Skerries in 2011.
“PND in Ireland is heavily stigmatised. Women are ashamed of having the condition and they don’t talk about it, sometimes not even to their partner,” says Lowry, adding that this condition, which makes up around 50% of Nurture’s overall case-load, affects women from all walks of life.
“PND does not discriminate,” she says, adding that some women become so unwell as a result of the condition remaining untreated, that they don’t return to work.
“It is a major issue for young families,” explains Lowry, who says the organisation is planning a major expansion of its support network nationwide in the early months of 2017, in a response to strong demand for its services. Nurture makes the provision of rapid access to counselling and other supports a priority.
The taboo which surrounds PND can make it difficult for women to admit they’re not doing well post-birth, explains Co Dublin GP John Ferguson, who says that, based on what he sees in his general practise, PND may affect up to 20% of new mothers.
Women tend not to realise that they have it, he says, because they think these negative feelings are normal — some affected women don’t present with the condition until three to six months after a birth.
“It can take time for it to be recognised. It’s not spoken about very much; it is stigmatised, and it can be very difficult for a mother to come in and tell a doctor that she’s not doing well in the first few months of motherhood.”
Some experts believe PND is linked to the dramatic hormonal changes following birth, when oestrogen and progesterone levels plummet from the highs they attain during pregnancy.
However, it’s not always certain exactly what may be driving the condition in a woman, explains consultant obstetrician gynaecologist Mary McCaffrey.
“Some experts may make a link between PND and progesterone changes. However there may also be thyroid hormone changes after a baby is born,” she says. “Also, after birth, mums often feel exhausted and it can be difficult to decide whether it is hormonal in terms of thyroid or progesterone, or simply life changes — it is a very turbulent period.”
Clinical psychologist Dr Malie Coyne says that certain red flags may signal the possibility that hormonal fluctuations may be causing post-natal depression. These can include severe irritability, poor sleep and agitation.
“Generally such women would be treated for depression as with any depression — arguably you could say that any depression can be linked to hormones,” she explains.
The good news, however, is that there is increasing public awareness of the condition — Suzanne Brack is just one of a growing number of young mothers who are opening up about this debilitating condition.
Successful model and author Alison Canavan is another. In fact, Canavan, who became a single mum after giving birth to her son James in 2010 devoted an entire chapter of her book Minding Mum, to post-natal depression, which she experienced for several months. She is passionate about the need for more public awareness around the condition:
“Nobody mentioned PND when I had James — I never heard of it. The conversation is much more open now than it was even six years ago — back then there was nothing in the media,” says Canavan.
She recalls that she found herself in tears regularly. She was plagued by anxiety, and sometimes felt unable to cope. “I even had to leave a shopping centre because of it once.”
She believes there should be more focus on a mother’s well-being, post-birth: “It’s incredible in this day and age that so much focus is on the baby and so little on the mother,” she says, adding that “for some reason in the western world, self-care is perceived as selfish.”
In her case, she recalls, the condition deteriorated quite quickly — but it was around three months before she sought help. It’s important, she warns, to understand that every woman can manifest a different mix of symptoms.
“The earlier you get help the better,” she says, urging other young mothers to “reach out and ask for help”.
“Don’t wait til things get really hard.”
Former Hollyoaks actress and mother-of-two, Jodi Albert (33) experienced post-natal depression after the birth of her eldest son, Koa, now aged five.
Albert, who runs Jodi’s Boutique in Sligo as well as an online boutique, jodiesboutique.ie — and who now has a second son, Zekey, aged 19 months — believes the PND which followed Koa’s arrival may have been linked to the fact that her mother Eileen was in hospital battling cancer at the time. As a result Eileen was unable to be at Koa’s birth as had been anticipated.
“Mum had been fighting cancer for three or four years and I think this contributed significantly to the fact that I developed post-natal depression.
“I had always pictured having my mum by my side, but when the baby came she was not able to be at the birth because she was in hospital herself.” Eileen passed away in 2015.
While she adored her husband, former Boyzone singer Kian Egan, and her young baby, she recalls, she found that when she was alone her thoughts became very negative.
“I found myself crying and unable to pinpoint what was wrong with me,” she says, adding that she believes that post-natal depression “kind of creeps up on you”.
Shortly after Koa’s birth, she recalls, she didn’t want to get out of bed, get dressed, go out or even see anybody:
“I didn’t like myself. I thought I was fat and ugly and every thought in my brain about myself was negative. It’s a very lonely process,” she says.
“It was probably a good seven months or even a year before I did anything about it.”
She didn’t know anything about post-natal depression, she says: “Nobody talked to me about it.”
She eventually made the connection while watching a TV programme about the condition and later researched it and sought help from a therapist.
“The first two sessions I spent crying,” she says. But by the time Koa was around 14 months she was feeling better.
“I talked to other people about it and then realised how common it is, so I didn’t feel like a raving lunatic in my head. Once I spoke to other women there was comfort in that.”
Women should talk about it, she believes: “The more you talk about it and share your experiences, the quicker you realise that you’re not on your own and that it’s something you can help yourself with.
“Give yourself a moment. Let your body heal. Give yourself time. Women have a lot of pressure on them to snap back in a month but remember, it takes nine months to grow a baby so why would it only take a month to heal?”