Mamas Mind Matters is here to inform, inspire and empower Mamas for their mental and emotional wellbeing.
2017 saw the first ever Maternal Mental Health Week, and along with the help of Mental Health Awareness Week a lot of fantastic knowledge has been spread. But still too few Mamas actually know if they have a post natal mental health problem.
So I spoke to Dr. Rebecca Moore, Consultant Perinatal Psychiatrist at the East London NHS Foundation Trust (ELFT), about the mental health signs and signals that suggest a new mum would benefit from speaking to their doctor.
It’s important to say all mothers will feel like this at some points. All Mamas have bad days, terrible days, even goddam awful horrendous days. And not only is that normal, it’s part and parcel of motherhood. Just knowing and accepting that may help you feel a bit better. However when to be concerned from a clinical point of view, says Dr. Rebecca “is when those bad days actually turn into weeks – even just two weeks and the symptoms seem never ending, or symptoms seem to be getting worse rather than better.”
Always speak to someone about how you’re feeling – your partner, family, friends, other Mamas, your Health Visitor, or get on to a Twitter chat such as #PNDHour. Some mothers will find that just talking and opening up is enough. For others more help will be needed and that’s fine too. So let’s look at this list.
1. Low Mood, All of the time, Most days
Feeling tired all of the time. Yes sleep deprivation is a virtually a rite of initiation to motherhood, but when that feeling of tiredness also comes with feeling apathetic, listless, not wanting to do the things you normally do persistently, including not eating, then this is more than what should be right now. Your doctor can help.
2. Feeling Persistently on Edge
Again it’s natural to feel anxious as a new mum. There’s so many new things you need to think about and my goodness, it’s hard not to feel a little anxious about becoming responsible for a tiny life! However if you find yourself feeling continually on edge; restless, sweaty, that your heart is racing, or you’re waking up feeling anxious every day, this is not a normal bit of anxiety and the doctor can assist you.
3. Feeling Trapped by Very Specific Rituals, Routines or Thoughts
Dr. Rebecca also treats patients with perinatal OCD. These can be obsessive thoughts about dealing with your baby or keeping her safe, made only possible by elaborate routines. So for instance perhaps being so worried your baby may accidentally fall down the stairs, that you start to only carry her down them by sitting and shuffling. OCD can leave you feeling anxious, drained, and unable to cope. “One patient of mine believed her baby’s nappy was extremely dirty and that that she could only change it using plastic gloves. It stopped her from going out because she worried other people would judge her for her behaviour. She became stuck at home, and felt worse.“ A doctor can help find a way to get out of a negative thought spiral.
4. Feeling Unbonded With Your Baby or That You’re a Bad Mother, or Wanting to Harm Yourself.
It’s common for mothers to not bond with their baby straightaway. It’s a worrying sign however, if you’re feeling for weeks, that you have no connection with your baby, or that you’re a bad Mama. Some mothers feel like they can’t carry on and may even want to harm themselves. “This can take a mum by surprise as she may have never felt like this before having a baby” says Dr. Rebecca. Suicidal feelings of course, should be flagged up straight away.
5. Replaying an Unhappy Birth Experience in your Head, All of the Time.
This could be a sign of Birth Trauma, which is similar to PTSD, and diagnosis is often missed. As Dr. Rebecca explains; “Birth is an overwhelming experience, it is profound, good or bad. So wanting to talk about it is a normal part of processing the event. But if a month down the line that’s all you can think and talk about, or you’re getting flashbacks, seek help.” It’s also important to note that your birth may have been considered a ‘good experience’ – you may have had a straightforward or unrisky birth – but if you considered it in any way traumatic and that’s affecting you, it’s an issue.
On top of these there are a few symptoms which if you’re experiencing, you should get to the doctor right away for help.
Red Flag Signs
- Dramatic deterioration of symptoms – if any of the above start to feel much worse over a course of days, go to your doctor as soon as you can.
- Any Suicidal Thoughts need to be raised immediately. I’m saying this for the second time.
- Paranoid or Odd Thoughts about Your Baby;
Postpartum Psychosis (PPP) can come on really suddenly. It can include visions, hallucinations or unusual beliefs about your baby – such as thinking the baby is not yours, has been possessed or is laughing at you. Sometimes the weirdness of these thoughts can make a Mama stay quiet but it’s really really important to talk about them. PPP is rare but it can be very dramatic, escalate quickly and require urgent medical attention. If you or a mum you know seem to believing more than the odd, throwaway bizarre thought about her baby, speak to a medical professional.
So who to turn to?
Your GP surgery is there to be a big source of help. Says Dr. Rebecca “If mothers are not comfortable with the GP, or the GP’s response when they speak to them, then they can always ask for a second opinion. Ask if there’s someone at the surgery who is a Perinatal mental health lead, or ask to speak to another GP in the team who they might feel more comfortable with.”
And what happens now?
“I really want women to feel listened to. Some women are very anti medication and some are pro and both views are of course, valid. There’s a common fear for mothers that ‘if I go to the GP they’ll give me medication and that’s not what I want’ – which stops them from seeking medical advice. But apart from very severe cases, that’s not the norm in treating perinatal mental health problems.” Mild to moderate depression and anxiety can be treated with talking therapies such as CBT or Compassion Focused Therapy. A lot of NHS money has been ploughed into this recently” informs Dr Rebecca. The GP might also refer you to a consultant psychiatrist like Dr. Rebecca for more specialised help.
“At ELFT we also look at things like diet and exercise.” Dr Rebecca likes to prescribe a magnesium supplement which can help reduce anxiety, and talk about exercise to help improve mood. Some pioneering schemes at Dr. Rebecca’s Borough of Tower Hamlets also exist, such as having perinatal specific therapists in children’s play centres and a peer support group. Unfortunately perinatal provision is patchy across the country and Tower Hamlets has a gold standard of care, so it’s not always an option. But hopefully such things will be rolled out nationally one day.