How much PND do you think is a rational reaction to awful circumstances?

[DogsAreEasierThanChildren]

This is a thread about a thread really, but I didn't want to hijack a very supportive thread (or, worse, find I posted some thoughts and no-one replied!).

There's a thread in parenting (here) which started as a thread about how parenting affects mental health. I posted on there because I do struggle with parenting a small child, but increasingly I started to feel a fraud because (a) I only have one, albeit a demanding one and (b) a lot of the women on that thread aren't only struggling with parenting, they're suppressing enormous (and justified) rage and resentment against partners who simply aren't pulling their weight.

Clearly PND is a real illness and where it exists needs to be treated, but isn't it rational to feel pretty damn depressed if you're sleep deprived, isolated from adult company, spending 24 hours a day with a tiny infant who can't respond to you yet, and not getting support or understanding from your partner? I wondered, reading that thread, whether PND is overdiagnosed because it's easier and cheaper to dish out pills than to provide actual real support.

The other point that really struck me about reading that thread is how little you have to do to be regarded by the world as a perfectly adequate father. If most women opted out of the bits of parenting they don't like as easily as some men do, there'd be a whole generation of starving and neglected children and there would rightly be an outcry. But the men who behave like this get away with it. How? And how can we change that?

[Nacster]

My paternal grandmother spent years as an inpatient with PND. I think 4 years at one point when DF was a teenager. Her psychiatrist told her once that her problem was that she was essentially handling an extra child - her husband. The moment he died, she was on the road to recovery. He was abusing the children, which came out years later.

I had "PND" after DC1, when I had birth trauma, back to work at 6 weeks (I was a student and had already missed 6 months due to HG,) first full time career job when I graduated when DC1 was 6 months old. I was EBF. I was also away from family, had no friends with children and extremely poor (couldn't get MA as a student, couldn't get student loan as on long term sick, just a nightmare.)

XH will tell people my mental ill health ruined our marriage. I've been completely fine since I left him. He wasn't the worst, but I had all the responsibility. As a single parent, I have been the most well I have been in 10 years. Lost weight, doing the things I love, still poor, but that's my life choices so I'm not too worried.

[Drhamsterstortoise]

Completely agree op.Actually on first baby the dr told me that my reason for feeling so low was the fact that my partner was so unsupportive.Silly me for thinking things would be different second time round.Can't believe the amount of posts I see with women saying their partner deserves to go off for an afternoon playing sport as they have such a stressful job.Mumsnet has really opened my eyes.I used to think I'd love to be a SAHM but I'm so glad now that I have a job and a career that I can return to.Its so sad to see women who are indebted to their husbands and who feel privileged.Women who are completely taken advantage of because they are seen to be on some sort of extended holiday.Of course that's going to affect your mental health.

[vladthedisorganised]

If you look at the campaign for better postnatal care stories (over in Campaigns - can't link at the moment) there are some real horrors which would take a lot to get over. There also seems to be a cultural problem of infantilising mothers - it's not universal, but when I compare my experience of back surgery (for example) and subsequent aftercare with my experience of childbirth, they're poles apart.

When I had back surgery, I wasn't told that I 'just wasn't effective at keeping my spine healthy' - but somehow it was ok to say 'we just can't labour effectively, can we?' when I had an emergency C-section.
If I said 'my back really hurts' after back surgery, that was taken pretty much at face value. Where 'I'm having very strong contractions' was met with a laugh and a 'you don't know what strong contractions are, you first-time mums! You just can't take a little discomfort - try breathing!'
I don't think anyone ever told me that my physiotherapy exercises were supposed to be the most beautiful experience any woman could have, and that I was somehow betraying the spinal-surgery sisterhood or that it was simply 'something I was DOING WRONG' if I admitted to finding them painful. Unlike breastfeeding.

Etc. Suddenly the adult who has been treated like a fairly competent, sentient person all this time gets told she isn't doing anything right, she shouldn't trust her instincts and most of all that she's abnormal if she doesn't find every second of it the most magical and fantastic thing she's ever done.

I think the shock of that was the real trigger for my PND. It was a shock and a relief at the same time when I went back to work and was treated like a real person again.

[kickassangel]

If you think about it, the indicators for PND are all based on situation, therefore making it obvious that it is at least partly caused by circumstances not just hormones. So a cure should address both.

I had awful ante-natal depression. As I was pregnant I couldn't be given pills but the community mental health care worker was at my house within 24 hours.ALL she spoke about were the circumstances and how these make people feel and how to work through that. It helped a lot, and if I had spoken up sooner I am sure would have been fantastic.

Amazingly, giving birth was a miracle cure. But then it also cured the morning sickness other things which contributed to my misery.

So could have been hormonal, situational, or both.

Showing respect for the patient and listening to them should surely be the first step, before deciding whether counseling or medication (or both) are needed.

[SkaterGrrrrl]

By the way I post as an ardent feminist who is currently taking anti depressants for PND.

I am minded of 50s housewives who were given valium to soothe their stifled boredom!

I am fortunate in that my local council is also supplying me with a 12 week course of CBT which is really helping.

[SkaterGrrrrl]

I think this is an excellent question OP, ir gets tight to the heart of how women are perceived and treated.

I agree that poor mental health can be a sane response to an insane society, or a stressful situation.

For example, anorexia is the mist logical thing a young girl can do, when she is told daily by society 'We will value you if you see thin'.

A woman who is used to having a career, independence, travel etc can experience being stuck at home with a tiny baby as massively stressful and miserable. Women in times gone by or in other cultures now raise babies in big extended families with grandparents and aunts and uncles sharing the load. The isolation of the nuclear family is something new.

[betterthanever]

So gps can carry on dishing out pills but until we demand and get some respect for having and raising children nothing will change. I needed to read something like this tonight, that is exactly it and it fits every situation, good, bad or no partner.

[DogsAreEasierThanChildren]

RL got rather demanding for two or three days and loads of people have posted since I last looked! Some very good points above. I agree that treatment / understanding of mental illness generally is shockingly bad, but I was focused particularly on over-diagnosis of mental health problems in women who are having a natural reaction to life being suddenly awful at a time when the world is telling them they're supposed to be overwhelmingly happy. Which is not to say that there are no women who don't have genuine mental health issues triggered by pregnancy and birth, because of course there are. But personally, if I were a HV and someone was clearly struggling and very low and had an unsupportive partner, I'd assume general exhaustion and entirely rational misery before I jumped to the conclusion that she must have PND.

NiceTabard, I notice that you say that your partner does stuff when asked, which means that there's a whole area of domestic labour that you're doing and your partner is not, namely thinking and planning what needs to be done - which is something a lot of us don't even think of as work, because we do it automatically. If you haven't read Wifework, do.

I was also focused on women who do have a partner in the picture, at least notionally, and why we as a society give those partners a free pass to be crap in a way we just don't for women. The issues for women who choose from the beginning to be lone parents are different, although a lot of the wider points about lack of support from health services and society more generally will still apply (particularly some of ledkr's points about lack of respect for the work of bringing up children).

working9while5, I'm so sorry. Your experiences sound appalling.

[Ledkr]

When I had baby no 1 27 yrs ago I stayed in hospital for five days, had help with bf, visitors were limited and people left you in peace when you went home.
Similar story with the subsequent four.
Fast forward to dc5 now 2. I had a section, (major surgery btw) had two nights in hospital with endless exhausting visitors. Had to literally "fall out" with pil who thoujght they would be staying for the weekend despite being told no several times so my first night home was a total nightmare with people only wanting what's best for them, no regard for me or baby.
I ended up very angry, bitter and depressed.
I feel that there is this pressure on us to sail through pregnancy and birth never admitting you might be tired or in pain. Women telling competitive takes of giving birth and being at the school gates two hrs later or back to work in a week. Selfish relatives who just want to muscle in with no thought for us and husbands and partners not having an inkling of what their partner is going through because they've heard all the super mum stories too.
I feel that is where the rot sets in and women feel that they have to soldier on bearing the brunt of it all with no complaint.
Men go back to their normal lives pursuing hobbies and careers while many women put all that on ice.
Sleep deprived mothers doing it all as " the menz" need their sleep for their important jobs or kick off if woken.
Women being asked to breast feed in train toilets or to leave restaurants if the baby is crying. Being tutted at when pushing a buggy or trying to get on a bus.
Need I go on?
So gps can carry on dishing out pills but until we demand and get some respect for having and raising children nothing will change.

[NiceTabard]

Oh BTW I found my care, during birth with DD1 from midwife, and subsequently from another organisation I sought help from to be fucking appalling.

I would advise anyone who asked to steer clear of those types and if they are struggling see their GP, who IME have more common sense and less "I will report you and They will Take your baby" vibe.

[NiceTabard]

While I very much agree with the points raised on the thread, and what everyone has said,

I want to say that I have a very kind, caring thoughtful partner who does stuff (when asked!) but that I suffered from MH issues from my first pregnancy. For me, I never had MH issues until I was pg and there is no argument but that the whole thing was kicked off by pg, and once started continued for a few years, all related to the children. Meanwhile my DH did everything, keeping the house going while working full time and having a basically bonkers unresponsive mad partner. He frog marched me to the GP in the end and I got some ADs (4 years later) and am pretty much better now.

But still - yes I agree that a lot of the probs are caused by massive change in life circs/isolation/sleep deprivation etc. But to say that sometimes it is a direct consequence of being pg/having a baby and not to put that aside entirely.

[betterthanever]

This is such a great thread and so much has been said I wanted to comment on - too much really, very insightful posters.

I didn't realise just how much my issue with `did I have PND or not' still troubled me, until reading this.

I was terrified of saying how I felt to the HV as her exchanges were similar to above, I was on my own with a baby and scared they would take the baby if I mentioned anything.
I had gone through almost the same emergency section hell that dreaming had, was dealing with a threatening and abusive exp and I guess is why I have chosen not to have any more DC, it was not the wonderful start to being a mother I had wanted/thought I was going to have.
Eventually after my father also became ill and with problems at the hospital, him sadly dying and work trouble I hit the deck... months off work anxiety and all kinds. Did it just build up - did I have PND for a long time, at all.. I have often wanted to untangle this mess - I still can't. If I had to say I would say it was a natural reaction to the circumstances as I don't think it was hormonal but some could have been?
I did the PND test on paper twice - I tried to cheat I wasn't really helping myself was I?
Should I have asked for more help? - praise to the person who went to the GP I was terrified.

Working my CBT man saved my life.

The care in France is really interesting. This is a feminist issue as this says it exactly: I feel like it's a feminist issue because I strongly believe men would not be forced to cope with such physical demands with so little support. I thought just that at the time and even more so now.

[SugarandSpice126]

This is such a fantastic thread, and it's so so true. I don't have children yet so no personal experiences to comment on, but I'm sure it will help mothers reading this who are suffering so many of these 'symptoms'. Sleep deprivation, for example, has such a detrimental effect on the mind that it's used as a torture tactic fgs! I have such admiration for all of you who have got through such tough times...it must be incredibly hard (as well as being amazing) to have a tiny person suddenly dependent on you for all their needs 24 hours a day.

Also vesuvia, I found your comments regarding male and females using different suicide methods, and therefore having different outcomes, very interesting. Things really aren't black and white when it comes to statistics.

[SolidGoldBrass]

Quite a lot of 'mental health trouble' in women is actually 'abusive man trouble'. And men who do no housework and childcare are abusive.

[HoleyGhost]

My HV was wonderful. However I had the mad scaremongering in hospital. Foe example, as the HCPs never once woke me when they promised they would, I used my phone alarm to wake me for feeds on SCBU - a midwife caught me and claimed I could cause babies like mine to die. I was so exhausted I believed her. Even though the SCBU was on the other side of the hospital, several floors up.

[curryeater]

working9while5, all that practically has me in tears. Well done for getting through it - and for complaining.

I had a HV who harrassed me about things that might go wrong. I was marked as at risk for pnd because of previous depression. So I was surprised that she was so awful and doomy. First she told me "You should not have had your baby at home. She could have died. That was a very selfish choice." But the midwives advised it! Where I was they are very pro home births for low risk pregnancies because they get good outcomes. In fact I said no the first time it was mentioned and they talked me round over the millions of ante natal appointments. (It was lovely)

then we had a series of exchanges like this:

HV: do you smoke?
me: no.
HV: your partner? Anyone who comes to the house?
me: no, nobody smokes.
HV: second hand smoke is a serious risk to small babies. [long spiel about babies dying, which is of no value to me, because she cannot dissuade me to do something nobody does anyway]

HV: where does the baby sleep?
me: in a moses basket.
HV: co sleeping in a very serious risk to the baby. [long spiel about babies dying]

HV: never leave your baby on the changing table, your bed, or any other item of furniture [long spiel about babies dying]

HV: you need to take the baby to the GP and have her breathing checked [long spiel about babies dying]

HV: your baby is gaining weight and feeding well but sometimes dehydration can be a problem with breastfed babies [long spiel about babies dying]

I think it was all pretty depresso-genic.

[HoleyGhost]

Working - I am truly sorry to read that.

I have been told that I had post natal PTSD, rather than PND. It makes sense given that I had a traumatic birth experience and a stay on the post natal ward that was beyond my worst nightmares.

I sometimes wonder how much money the NHS might save if it worked out the cost of dreadful maternity care in the longer term.

[dreamingbohemian]

That's horrifying, working

I feel like mental health is treated in such a black or white manner -- either people completely discount your problems, or they pathologise them into something much worse than they are.

I also agree that it is part of a broader problem with mental health services. But as noted earlier, there is also a lot of continuity with the way women's issues have been treated in the past, so you have to consider it from a gender point of view as well.

[working9while5]

I agree. Just been discharged from the Mother and Baby Unit but I am sceptical I was ever "ill" in the sense they would see it as.

I grew up with chronic alcoholism and my mother couldn't cope so was very frequently absent either physically or emotionally e.g. she did some really weird shit like taking a girl in the year above me at school on holiday because she had such a "difficult family life" and taking her for walks/meals out and ignoring my suffering entirely, when we used to fight when I was a teenager she would drive off in the car with me begging and screaming for her to come back, blah blah Angela's ashes etc.

There are generations of poor parenting in my family, violence and abuse and all sorts of weirdness and when I had my children I was VERY anxious about realising that I had no "template of normality" and this was heightened by the constant stream of professionals coming into my home to tell me I wasn't getting it right (ds1 and 2 both had serious issues with breastfeeding which we later realised was tongue tie related.., as all my family had breastfed but were otherwise shit I made the leap that I had already failed my children and became depressed).

But let's look at this differently:
I was living with my husband in a different country with no family
My best friend effectively dumped me as soon as I got pregnant as she found it so hard as she was having serious fertility issues
I was told I was going to lose my job
We were having financial difficulties
My father went into a coma and I hadn't been speaking to him
My grandmother who raised me was critically ill
I threatened miscarriage all through the first and second trimesters - literally experiencing labour like pain every few weeks with no cause found
I had morning sickness until 29 weeks
I had been raped as a young woman and found my initial forceps birth had triggered a lot of strong feelings around this that made me super-anxious about birth.

Things that have been said to me by "professionals":

Well all women worry about their babies but yours is definitely at the disordered end of the spectrum.
I spoke to your GP and he was really surprised you had OCD as he thought you seemed quite competent!
No one thinks there is anything wrong with his tongue but you - you have to consider what this means (no one had looked inside his mouth and I am a speech therapist with training in the anatomy of the mouth!)
Worriers like you always find the aspects of childcare other women find easy difficult but that's just your nature
Your problem is that you overestimate the importance of your own thoughts
There is nothing to worry about but you are interpreting your experience as though there is something to worry about which is what is making you ill
It must be very hard for your husband to live with your anxiety
Your husband sounds as anxious as you, you might want to consider what this means for the future if you get help and he doesn't.


Even better, the experience of being in appointments where people spoke about the most shaming and private experiences such as my father defecating in my room and forcing me to sit in a chair while he shouted at me until I "admitted" I had done it, my father screaming at me for three hours in a crowded dining carriage that I was a useless narcissistic bitch etc as though I wasn't there... and when I said these things, there were sage nodding professionals humming and hawing over how I fit to the literature.

Feeling crap about having been abused = "ruminating about the past". Worrying that your child might be at risk as you appear to be having labour like pains and had a shit first birth = "catastrophising".
Saying hey, I feel really well today = "minimising the severity of your illness".

As if that weren't enough, I missed ONE appointment when my son was 6 weeks old and had to endure endless discussion about whether this represented disengagement WHEN I was attending weekly therapy from the time he was 10 days old which involved me having to get to the session on public transport when I was terrified that he would get germs from being on the bus. Apparently I "didn't really want help" and I had to realise that my condition would become chronic if I didn't do what was suggested.

When I eventually complained IN WRITING, I had a response saying that they wished to meet me - the entire care team and me, no advocate so four of them, one of me - to discuss "the challenges faced by everybody in your episode of care". When I said I didn't care about the "challenges" they faced by me missing ONE appointment when I was ill with a SIX WEEK OLD, they said I was trying to "control" and "manipulate" the situation and that I needed to realise their "experiences were as valid as mine" and "there were rights and wrongs on all sides".

What? To miss ONE APPOINTMENT out of, perhaps, 30? Thankfully I had a CBT therapist I was seeing weekly who helped me realise and not take on responsibility for this but in the review meeting, everything I said as challenged and dismissed until my therapist could "vouch" for the fact that actually, you know, I was working pretty hard at pretty much everything.

My experience has been a disgrace. Thankfully I am nearly at the end of my complaint about it now but it was VERY sobering and eye opening about how women's distress is pathologised and made intrinsic to them rather than a product of life experiences etc.

[LurcioLovesFrankie]

"Women who choose this path cannot then complain about the pressures of bringing up a child alone."

Thanks for that! So I'm never allowed to have a bit of a whinge? Thank heavens my friends in real life (of both sexes) have never been anything other than entirely supportive of both my decision and the fact that it's not always the easiest decision to have made (and who, whether in a relationship or not, can honestly say, hand on heart that they knew how hard bringing up children would be before they actually had their own?)

On the general topic of this thread, I did want in those early months to have a t-shirt which said "it's not post natal depression, it's a rational reaction to intolerable circumstances." Because extreme sleep deprivation and a baby that cries all the time is pretty intolerable whatever your circumstances and whether you chose those circumstances or had them thrust upon you. Looking back, it's possible I had mild PND too, but it would be difficult to establish how much was circumstance and how much hormonal.

Luckily it got steadily easier after the four month mark, DS was a remarkably easy toddler and is now a delight as a primary-school age child. (By the law of averages, I suppose I'm in for the teenage years from hell - though I do realise that's an instance of the gambler's fallacy).

[Thurlow]

I agree, definitely.

DP works long and often anti-social shifts and none of our family are near enough to help out on a day to day basis, so I was alone a lot during maternity leave, looking after the baby from the moment she woke up until the 11pm dreamfeed. I was tired, struggling with the house, often quite lonely and, quite frankly, rather bored (babies are not intrinsically interesting a lot of the time). So while DP wasn't deliberately being unhelpful or useless, he just wasn't there and at times I illogically resented him for it.

I was fortunate not to have PND but there were many days when I was tired, grumpy and distinctly down. I felt able to understand that it was because, as you say, I was sleep deprived, isolated from adult company, spending 24 hours a day with a tiny infant who can't respond to you yet, and not getting support or understanding from your partner. I assume that it was because it was fortunately not PND that I was able to at least appreciate why I felt so shit a lot of the time.

[OctopusPete8]

I find this interesting, I had PND with both of mine.
First time round I had a big support network but felt undermined and judged by essentially 3 different generations all telling me what to do and feeling weak from a haemorrage.

Second time, horrendous birth think I've spoken on here before,I was so traumatised I began smoking again.

[namechangeguy]

Lunatic, no. I was referring to the OP, who alluded to men not doing enough to alleviate pressure on their partners, which could lead to pnd. Others have mentioned absent fathers as increasing pressures on women as lone parents. Whilst I agree that men who don't take responsibility for their children are, in essence, scum, I also think that there are women who choose to conceive without ever planning to include the father in the child's upbringing. Women who choose this path cannot then complain about the pressures of bringing up a child alone.