Can you reduce your risk of Postnatal depression?

[Amby99]

I’m sorry if this is a ridiculous question and I hope I don’t offend anyone - I know deep down it’s mainly due to hormones but I guess a part of me really wants to try and ‘minimise’ my risk of it because I’m scared of it. Whilst I don’t have a history of depression, I am a constant overthinker, anxious person and that can sometimes lead to destructive thoughts. I’m fully aware of how bad it can be, my MIL was suicidal because of it and yet she absolutely doted on her son so I know it really can hit anyone.

Because I’m reading so much about it, I’m trying to ‘prepare’ for it so even if I do get it, I can manage and cope. I’m not sure if that’s the right thing to do.

I already know that my life will change drastically, forever, and when I found out I was pregnant it was a daunting concept but I’ve definitely accepted it and now I’m really looking forward to it. The first few weeks of pregnancy were hard, I kept reminiscing about fun times with friends, careless nights out etc etc and yes I was sad that that won’t be my reality anymore. But I’ve accepted that. Everyone grows out of that and we’re at the next stage of our life creating a family. So in my head I’ve fully accepted it and now I’m fully looking forward to motherhood and the challenges that come with it.

So I’m just hoping I can keep that mindset once baby is born and that it won’t suddenly be a ‘huge’ surprise when baby is screaming all night. I know I might not get sleep, I know it’ll be mentally and physically exhausting, but in my head now, that’s all apart of being a new mother.

I’m also lucky in the sense I have a great and supportive husband, parents, in laws which soothes me and I don’t have to worry about going back to work for a few years. I’m just worried about going through postnatal depression, and what it’s actually like. Because I look at newborns now and think ‘how on earth could anyone become depressed when they’ve created such a beautiful thing’ but I know PPD is much more than that and I just wondered if anyone who went through it, can explain what it’s like and if you thought you could be susceptible to it beforehand.

Thank you

I thought I’d avoided it, instead I became so convinced I was fine, I was lying to myself. I wasn’t really bad with it but it was there and presented itself in anxiety predominantly.

I sought help immediately though and everything was absolutely fine!

I don't know but if you do find yourself struggling, seek help. If you're not sure if something is normal, seek advice. Some things are normal eg new parent anxiety but when you're in it, it can be very, very difficult to tell when it's tipping over into something else. Take care of yourself, make sure your husband supports you to do that.

Having a good support network can help (although you can get PPD with one as hormones can be a trigger). Also just being aware of the signs.

Often it strikes months after the birth. Where I am, they will also diagnose you with post natal burnout, which I think is a really useful label.

As for avoiding it, I suspect it's mostly luck. Eat well, try to get outside every day right from the first week, even if it's just waking to the end of the street and back. Try to build a bit of a support network. Ask for help too soon rather than too late, for both you and the baby. Accept yourself and your baby, and don't compare to Instagram or other people, and don't try to do too much.

There isn’t a way to prevent PPD, there are some things you can do to try and reduce the chances though however I would say that even if you do all of these things there is sadly always a chance you will suffer with PPD anyway.

Some things to try & reduce your chances though, from my own experience (thankfully did not suffer PPD/PPA but have friends who did) and also advice I was given by my midwife:

• Look after your mental health starting now, if you have depression/anxiety already then that increases your chances of suffering so if you can seek help for your mental health in advance you can keep that in check rather than wait to see if PPD/PPA hits.
• Make sure you have good support, partner, family/friends, I know you say you have this which is great.
• Get as much sleep as you can, if your partner can hold your baby for an hour then get an hours sleep. Every minute counts & there is a reason sleep deprivation is used as a form of torture- it can be brutal and honestly you cannot possibly prepare yourself for that in advance, it’s not possible. I thought I was prepared for newborn tiredness but nothing could have prepared me, it’s manageable though if you have a good support system who can give you the chance to get an hour here & there.
• Try to get out & about, speak to people, don’t isolate yourself- everything feels worse when you’re staring at the same 4 walls on your own all day. Even walking to the local cafe for a coffee can make a huge difference, or a friend popping round for a cuppa.

There are other things but I’d say those are really the main ones. Just keep communication open with your partner, family, midwife/HV, there is lots of support available if you need it. Good luck x

Thank you so much - great advice, and yes I actually recently got in touch with my therapist to have sessions. I struggled with the changing body (I got to a point where I was hysterically crying about it) and I knew it wasn’t healthy and so I’m seeing her next week to talk about the changes I’m going through which might help with the transition to motherhood - and maybe it’s worthwhile seeing her when baby is born too, talking about stuff definitely helps! X

From my experience (3 DC, only very mild symptoms, worked hard on prevention) there are several things that are under our control and can help.

• being outside everyday, best in nature or a green area; if it rains I put on a rain jacket and cover for the pram.
• having some respite, handing over the baby to other family members.
• exercise - I exercised through every pregnancy and went back to (adapted) exercise quickly after birth each time.
• breastfeeding - evidence is mixed on this one, I have no comparison as I breastfed my DC till they were over 2.
• good birth - I have become a master of refusing unnecessary inductions and other interventions suggested by trigger-happy HCPs. I would only agree if there were clear medical indications. Had three very positive birth experiences, including two homebirths.
• using support network to the max, especially if that includes getting out of the house. I’ve been to every free mother and baby group in my area, yoga with baby, pilates with baby, swimming with baby, you name it. Even if I get 4 hours of sleep I still go. It’s about meeting other adults, having to put on fresh clothes and making myself look presentable. Fake it till you make it.

BTW I am an overthinker too and suffered from anxiety in every pregnancy. To some extent it’s normal (hormone-induced). It’s great that you take a proactive approach.

I was really really worried about getting PND, as I had a history of depression. Maternity and HVs were totally useless - I should have been referred to perinatal mental health support, but because I didn’t know that existed, I couldn’t ask for it, so I wasn’t. I should have had that support antenatally, and then postnatally, but didn’t. So be really firm
and clear to midwives and HVs that that is what you need.

I did end up with severe PND, and we had a really tough time. The amount of support you have makes a difference - my DH is amazing but we had no other support. Knowing what I know now I wish we’d paid for the support we didn’t have eg a maternity nurse would have saved a lot of problems, using childcare for a few hours a week from six weeks would have provided a break.

Other things that helped were:
getting into a routine prioritising my sleep,
having regular breaks from our baby - once DH was back at work I had three hours a day when I wasn’t on call and he was fully responsible.
Combi-feeding. EBFing was disastrous for my mental health, should probably have switched totally to formula, but there was so much pressure to BF!
Getting out in the fresh air every day - I walked miles pushing the pram!
Ignoring “advice” from people with a vested interest. The midwives and HVs were under pressure to increase EBFing rates and couldn’t care less about my mental health. Following their advice to stay in bed and feed feed feed was the opposite of what I needed (it meant ten hour days of just me and the baby).
Toddler groups were a surprising find. It turned out most have a baby area, so you can go, put your baby in the area or hand them so someone else, drink tea, have a cry on someone who has been through it already and, most importantly, get out of the house and see people.

Good luck!

Avoid is the wrong word. I would say it’s more about detecting and speaking out.

I had it very bad with my first - but I was oblivious to it, it wasn’t as spoken about as it is today. I spent 6+ months struggling to bond with my baby. But I kept quiet. I never really got the help, but my support network had to help me get out of it.

With my second, I was equipped. Thankfully I didn’t get postnatal depression but I did get prenatal depression which shocked me as I didn’t think I could feel depressed while pregnant! The difference between my first and second pregnancy was that I was more open with my feelings to both my partner and midwife and others around me, so when they pointed out that I wasn’t quite myself, I seeked help. It took a few months to “get out of it” and looking back I wish I enjoyed my pregnancy abit more, but I’m glad that I didn’t get to the point where I spiralled, as I did the first time. And I’m glad that although I spent so much of my second pregnancy at home, as I really lost interest in everything - I had a support system that helped me find small pleasures in daily activities - even just cooking or taking a walk.

Id say don’t be fixated on it, but pay attention to yourself. If you do not feel right, or if someone close to you seems concerned, don’t be scared to ask for help.

Good luck and enjoy every moment x