Live webchat with postnatal depression counsellor, Liz Wise, Tuesday 17th April, 1pm

[RachelMumsnet]

Liz Wise is joining us on Tuesday 17 April between 1 and 2pm. She was introduced to us as a possible webchat guest by a mumsnetter who described how she'd 'changed her life'. Liz is a specialist postnatal depression counsellor who has been supporting mothers with PND for the past fifteen years, Having had severe PND after both her children, she has a great deal of personal and professional experience. Liz is also the PND co-ordinator for the National Childbirth Trust and sits on the committee for The Association for Postnatal Illness. She has also produced the popular DVD, Understanding Postnatal Depression.

Postnatal depression affects approximately 20% of mothers in the UK and can be a very isolating and frightening condition. Around 10% of fathers experience paternal depression. Symptoms include, low mood, anxiety, exhaustion, inability to look forward to or enjoy anything and sometimes irrational thoughts. It is temporary condition which can be helped by the right support and/or treatment. Join the discussion on Tuesday at 1pm or send questions in advance to Liz here. For more information about postnatal depression see //www.postnataldepression.com.

[swallowedAfly]

(and social pressure comes full force with everything you should and shouldn't be/do/think/feel etc)

[StrangerintheHouse]

How can we untangle the fact that having pnd or ptsd/anxiety makes you lose your grip on reality so that it is hard to tell whether your fears about admitting to how you feel (eg they will take my baby away, people will think I don't love my baby and I'm a bad mother) are in proportion or are actually part of the problem.

(Hope that makes some kind of sense, I should be asleep!)

[BellaBoo85]

Plain and simply, how do you get over it when the guilt won't go away??
The way I see it, it's always going to be there because of how (I think) it started. And if I'd not had that one particular thought/feeling then none of it would've happened. And that thought isn't just going to disappear. Even if one day I don't believe it anymore, there was a day when I did.
And that is what I can't get out of my head.

[swallowedAfly]

apologies for posting too much on here but i'm really interested in this area. i am completing my counsellor training on an msc starting this year and i am a feminist interested in women's issues obviously. i want to develop groups for women experiencing maternal distress - i think the shared experience and understanding would be massively relieving and therapeutic for women but i also want to do antenatal counselling where women can focus on preparing - working through issues that could be a problem, looking at stuff from their own past that has come up again for them due to the triggers of approaching motherhood, relationship worries etc etc.

do you think antenatal counselling could benefit women and help prevent or at least enable women to better manage depression/anxiety/mental distress? and please if you have the time could you post links to any good materials on this subject as in therapeutic approaches to dealing with and preventing this? or perhaps you wouldn't mind someone contacting you?

really will shut up now.

[ThatllDoPig]

I had pnd. 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? For me it was the opposite. My baby was perfect and wonderful, but I felt I couldn't protect her from this shitty world.

[FourYolksAche]

Do you think the crap postnatal care women receive in hospital (very frequently bemoaned on MN) is a cause of PND?

I was v close to having some kind of breakdown on that bloody ward until DH got me out of there.

[Kveta]

my mother is pretty sure she had undiagnosed PND after the birth of my younger sister - she remembers crying a lot, and trying to kill me (a toddler at the time) by beating me, throwing me in the cot too hard, at one point getting a knife out and seriously planning to use it. My sister was labelled a Failure to thrive baby, and didn't bfeed well, which mum reckons exacerbated it, and the local HV did nothing to help.

This has had 2 consequences that I can see - firstly, my sister and I DO NOT get on (and I have a somewhat prickly relationship with my parents), and secondly, I am now terrified that history will repeat itself when I have my second child in a few weeks time. I have previous history of reactive depression following sexual assault as a teen (nothing to do with parents!), so know I am prone to depression. my mother and grandmothers have all been warning me and DH to look out for it, and spent much of my older child's early life watching me like a hawk for signs of depression, which was fun... (as it was, I was never happier than after he was born!!)

So my questions are - how can my mum begin to get over this, when it was pretty clearly not 'her', it was a medical condition - she still beats herself up for my sister having various health problems nearly 30 years later, and is so overprotective of sister it's damaging her relationships with me and other younger siblings. and question 2 (sorry!) how can I avoid the same thing happening to me?

(apologies for such a personal question, I understand a single post here cannot a life time problems solve!)

[swallowedAfly]

just ftr kveta i think depression is a very rational response to a traumatic experience like that and i don't think it means you are susceptible to depression - i think it means that you had an extremely traumatic experience. does that make sense?

[AnAirOfHope]

PND affects the whole family but its only the woman that gets counciling. What can be done to "mend" the family as a whole? or at least consider it when the women is ready.

[StrawberrytallCAKE]

Are there any measures that you think a woman can take during pregnancy that may lessen the chances of pnd occuring?

[thunksheadontable]

Hi

I am 32 weeks pregnant with my second child and slowly coming to terms with the fact that I have mental health issues related to pregnancy and the postpartum period.

I will be very interested in what you have to say about the medicalisation of PND and how it lays the causes for maternal distress in chemical/hormonal imbalances in the mother with little apparent public recognition of the role of past experience and current social support. The preventative side seems totally absent, is this true in lots of cases?

I think my case is probably pretty typical. I grew up in a chaotic abusive (yet solidly middle-class) home with a cruel alcoholic father and a distant, neglectful mother. I have a pretty typical psychological profile of a first-born child from this type of background: I am ultra-high achieving, perfectionistic and relentlessly self-critical with a deep sense of shame and the idea I am responsible for just about everything in the world. I've had counselling/therapy on and off and more or less manage really functionally but in pregnancy my defences lower and my desire for control and certainty, plus tendency to see threat in anything I can't control, goes haywire.

There is also a family history of mood disorders, puerperal psychosis and PND.

I had antenatal OCD and depression in my first pregnancy but never sought help. All was well during labour and birth (for which I prepared as if it were a marathon) until the second stage, when my large post-dates induced baby got stuck and there was a panic and brutal rotational forceps delivery. In a state of absolute horror at his birth and how I had "failed", I went into an anxiety state and remember nothing of his first 72 hours apart from brief, brutal flashes of an incredibly nasty midwife who basically did her best to humiliate everyone on our ward (e.g. "what do you mean it hurts? Silly girl, of course it hurts, if you think this is the least pain you will feel as a mother you are very naive indeed").

Cue a very typical story of the inevitable breastfeeding problems following this type of birth leading to "intervention" from the NHS which consisted of asking me to feed 10-12 times every 24 hours, expressing and refeeding after every one: baby losing weight, immense sense of failure, battling on regardless. Distressed, hungry baby screaming 24-7. No family support other than my husband (we live abroad). No friends available (none had kids, all drifted very fast after giving initial gifts etc). A deep snowfall combined with severe postnatal perineal trauma which meant I couldn't walk also kept me housebound for nearly 7 weeks as I couldn't drive....

It's hardly rocket science that in these circumstances, and with a history that makes me prone to anxiety and depression, I started to slide... and it's hardly amazing that now, at 32 weeks pregnant, my anxiety levels about after the birth are sky-high.

And yet, despite having a label of moderate OCD and depression, there is NO plan for my labour. I have had health professional after health professional try to terrify me with stories of how badly wrong an elective section could go (despite never asking for one) and I have had several almost promise me a wonderful, calm second birth (which they can't, and shouldn't).. I had the supervisor of midwives say "listen you may think you are, but you're clealry not one of the mad ones" . There is no CBT available despite NICE guidelines and my initial referral to the Perinatal Mental Health team happening at 6 WEEKS PREGNANT.

I just feel that the chances of a recurrence of PND/PN-OCD etc are absolutely MASSIVE and that there's good awareness that it might be worse this time.. and yet the whole approach is, well, let's wait and see. Go on the meds. We will just let you labour the same as any other woman despite the fact you are terrified and anxious and that doesn't augur well for your delivery, and despite the fact a poor delivery might psychologically damage me further. It's very much hands-off and "watchful waiting" just to see do I totally and utterly lose it. It's also very frustrating to have been asking for help to avoid a recurrence for this whole pregnancy and to have nothing more in place a few weeks ahead of the birth other than a handful of antidepressants. There must surely be more cost-effective ways of preventing mental health dysfunction than just letting people at it because they aren't in a total heap (yet).

I would love someone to help me plan my birth without trying to terrify me. If only they realised the extent to which I live in terror every day.. a cs is nothing in comparison but they have now successfully added it to my list of things to freak out and obsess about so that I feel totally out of control thinking of having to birth this child. Great planning, NHS.

[Brandnewbrighttomorrow]

Thunksheadontable no wonder you're stressed! I've had three sections, one emergency following 35 hour labour and two elective. I think if you are that anxious about a natural delivery then an elective cs would make complete sense. It's much calmer than an emergency section, you can plan childcare for your older child and express a preference for various factors like type of anaesthetic (I'd recommend a combined spinal/epidural) discovering sex of the baby, skin to skin contact. You can find out which consultants and midwives are on for your date and express a preference for who you get. All helps to make you feel a bit more in control of the process. It's likely to take longer to recover physically though.

I'm reading with interest to see what the response is to where does normal reaction to becoming a parent end and pnd begin.

[abdc]

Given that this is such a common condition, why is there not more Antenatal support for women? With a history of depression I know I am predisposed to PND, and was questioned closely by my mw at booking in. This was very reassuring at the time but since then it seems to have just been lip service - there is no actual Help that the mw can point me in the direction of. I believe I have since experienced antenatal depression, but just been told to see my gp, who I think just sees me as another hormonal pregnant woman and dismisses my anxieties. A ten min appointment is not enough time to discuss the extent of my anxieties and feelings, and so it builds up and gets worse when what I want is someone to talk to - why are there no counselling or helpline type services? Surely this could help some women to not go on to develop such severe pnd or at least know where to get help. Depression is not just tiredness, it is a mindset rut and I believe that antenatal support would help postnatally.

[bjf1]

Hi Liz
my question is, if untreated, can PND and even pre natal 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 dissipate of it's own accord?

[Shakey1500]

LIZ, I'd also be interested in the answer to bjf1's question.

I am certain I had PND but did not go to my GP (I'd had a bad mental breakdown the year before and the counselling I received after being discharged from the psychiatric hospital was utterly appalling so I had/have zero faith). My son is now 4, is it still possible to have PND? How is it differentiated from "depression"?

Thanks

[hunkermunker]

Hi Liz

What a brilliant webchat for MN to be doing - this will help a great many women.

My question is this:

How do you cope, having had a traumatic time yourself, Liz, with being so immersed in making things better for other women? Do you ever feel like you would rather not be so close to something that was a source of such heartache in your own life? Or have you managed to work through your own issues in such a way that you use them to inform what you do, but you're distanced from the feelings you had at the time? If so, how did you go about that process?

Thank you - and thank you for what I know will be a really valuable webchat.

[PinkFondantFancy]

I'd like to reiterate puddlejumper's question. I have had very broken nights for 7 months now and my mood is often very low. My GP thinks I'm 'just' tired - how can I tell the difference? Is there one anyway?

[ReallyTired]

Do you think the use of positive pychology (Ie. resilence training or the human givens theory, mindfulness, teaching of relaxation techniques) could prevent postnatal depression in at risk women?

I went to a postnatal depression group that actually made my depression worse. Do you think there should be more critical assessment to see what types of councelling/ medication works for a particular individual?

[Thaleia]

Hi Liz,
Is it more likely to get PND after a c-section as it's harder to bond with the baby (lack of Oxytocin) and bfeeding might be more difficult in combination with feeling a failure for not able to do it naturally?
Thanks, Thali

[lagoonhaze]

A couple of friends have suggested i have PND but I think it's just pure exhaustion as my baby has been very high need although luckily we are turning a corner.

How can you determine between the two and know when it's help you need?

Since having my first child I've become really aware of risks and sometimes don't go out as i can't bring myself to drive. This had improved but since the birth of my second has got worse again.

[MaryChalloner]

I have a question.

My relationship has broken down while I have been pregnant. I had also moved to a new city with my husband shortly before this. I am due to give birth alone and am feeling fairly isolated in my new city. I have no family support. I feel concerned that I am at risk of PND once the baby is born (coupled with sleep deprivation, no support, older children to look after etc etc) although I have not had depression in the past. I wonder if there is anything I can do to minimise the risk of being hit by PND once the baby is born. It isn't an option in the time available to move house or suddenly acquire a group of local friends!

Many thanks

[GleeClubClassof2008]

Hello Liz!!! (massive wave!!) I have name changed especially to say hello!

Wow, you are on Mumsnet, fantastic!

I came to one of your groups after the birth of my DD, I don't know what I would have done without it. Thank you.