Miriam's casebook - The depressed mother
Christine has three children: Thomas, aged four; Laura, aged two-and-a-half; and Oliver, four months. After the birth of her first baby, she had “baby blues”, although she recovered in a few days. After her second baby was born, she was tired and dejected for about two weeks. Three weeks after the birth of this baby, Christine felt completely unable to cope. Her family doctor diagnosed postnatal depression (PND).
Early warning signs in depressed mothers
© DK
Mild feelings of depression are not uncommon for a few days after birth, but depressive feelings that deepen and last longer than about two weeks may be a sign of something more serious that needs medical treatment. Women with postnatal depression (PND) become increasingly withdrawn and lose touch both with reality and with their baby.
After the birth of her second child, Laura, she found it impossible to lose weight and in fact put on more in the first months of Laura's life than she had when she was pregnant. She felt extremely self-conscious about her size, and tried to hide her figure in shapeless clothes. She often worried about her maternal instincts.
Feelings of helplessness
Christine had experienced baby blues and expected to be sad after her third child. When depression set in it was almost a self-fulfilling prophecy. By the third day after the birth she was extremely weepy. The smallest problem was too much for her and molehills became mountains. She started feeling helpless, and then refused to get out of bed. Christine's mother-in-law came to live with the family to take care of Thomas and Laura and to help with running the house. She tried to be helpful, but Christine did nothing but criticize her efforts. The atmosphere became very tense and Christine's mother-in-law tended to leave her alone rather than risk upsetting her.
Christine and and her husband Stephen then began to have arguments. Christine wanted him to take time off work so he could support and comfort her. Stephen didn't really understand what was going on or know what to do for the best and started to become depressed himself and then his work began to suffer too.
Christine was so drowned in her own misery - she felt exhausted, hopeless, and guilty for not being able to look after her three children (especially as the two eldest had by now started to be difficult and misbehave) or coordinate the household, and worried by the tense relationships between herself and Stephen, and herself and her mother-in-law - that she could think of nothing else. She stopped communicating with her family and talked only to her baby.
After a week of this, she then found herself unable to relate to baby Oliver, and began thinking of the awful things she could do to stop him from crying. She didn't care about feeding him and she started leaving him to scream.
Seeking professional help during depression
After about two weeks of Christine's increasing depression, during which her midwife reassured her that everything would get better soon, her social worker came to see her and realized that Christine needed help. She got in touch with Christine's doctor, who visited her three weeks after delivery. He diagnosed early PND, and called in a psychiatrist, who saw Christine in her own home.
About two weeks after the psychiatrist's visit, Christine started to improve, mainly because of the advice that he gave her. First, he suggested she forget what was happening in the rest of the house. He advised her to think only about her baby and herself and let everything else take care of itself. Second, he advised her to let someone else see to her baby overnight so she could get a full night's sleep. Third, he suggested she should attend the Well Baby Clinic twice a week where she could talk to women in a similar situation. He also advised her to contact MAMA (the Meet-A-Mum-Association -), which offers advice and support.
Christine's doctor prescribed a mild antidepressant to tide her over the first difficult few weeks only. He said that he'd continue giving her antidepressants after this, and they agreed that he'd reduce the dosage gradually as soon as Christine felt able to take charge of herself and her life.
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Posted 30.06.2010
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