We need to watch for women who may be suffering.

By BENISON O’REILLY

Last Thursday night I sat at my computer in a grumpy mood, feeling overworked and underpaid.  Into my Inbox pinged an email which literally took my breath away.  At once my petty problems took on the perspective they deserved.

The email, part of which is reprinted here, is from a man we’ll call John.  All names have been changed.

In February this year my only daughter Sarah died from SIDS at 4.5 weeks of age, and 22 days later my wife Cathy left in the middle the night and took her own life. Cathy had not coped well with Sarah’s death; however we were receiving counselling from SIDS and Kids and Cathy had also been seeing her GP weekly, our obstetrician, and she was also seeing a hypnotherapist to help her cope with the feelings of guilt that she was having. Cathy had put Sarah down to sleep when she died and had tried to revive her before the ambulance arrived and blamed herself for Sarah’s death.

At her most recent GP visit, Cathy had been prescribed a mild antidepressant and had been taking sleeping tablets (with limited success) immediately after Sarah’s death. The day before her death, Cathy saw the hypnotherapist and that evening just wanted to be cuddled while lying on the lounge. She told me how much she loved me a couple of times but I didn’t think it was anything unusual because we always told each other how much we loved the other. We both went to bed, but when I woke in the morning she had gone and left a series of letters behind. I immediately called the police; however, she had already suicided before I had woken up. Before she died she had sent me a text message saying how much she loved me, but I didn’t wake up.

Postnatal depression (PND) was not part of my world until I was asked to co-write a book, Beyond the Baby Blues, about it a couple of years ago.  It wasn’t part of my GP husband’s world either, until a young mother who attended his medical practice took her own life one day. Now the practice screens every new and expectant mother (depression can occur during pregnancy as well) who crosses its threshold.

John was seeking answers from me, but the help I could offer seemed woefully inadequate. I have referred him to my friends at The Gidget Foundation; an organisation named in honour of another young mother who one day found it all too hard.

Tragically, suicide is now one of the leading causes of postnatal maternal death in the developed world.

To tease out what causes PND — and anxiety, because the two frequently go hand in hand — is difficult and varies from individual to individual.

The following have been identified as risk factors:  genetics, previous anxiety or depression, perfectionism, social isolation, poor relationships with spouse or mother, stressful life events, a bad experience of childbirth, breastfeeding problems, colicky babies and twins.

As you would expect, baby loss through miscarriage, stillbirth or early newborn death are also common triggers for PND.

A recent analysis found that many new mothers who died by suicide had previously diagnosed mental health problems and/or babies admitted to neonatal intensive care.  Some, like Cathy, had lost their babies.   But that doesn’t paint a complete picture.  Gidget’s sister, Simone, wrote in Beyond the Baby Blues, ‘We had no idea what she was going through. There is no history of mental illness in our family.’

So what drives a woman with PND to suicide, to leave behind her child?  In Cathy’s case it’s perhaps more comprehensible —her baby had died— yet she left a loving partner and, with time, the chance to become a mother again.

This is the answer I offered John:  Depression is much more than a condition of low mood and apathy, of ‘feeling down’ — it messes with your head.  Serious PND is frequently accompanied by feelings of shame, guilt (as Cathy felt), ‘failure’, even anger.  In the toxic environment of a severely depressed mind, disordered thoughts can masquerade as rational ones – like the fact you’re a burden and your family would be better off without you.

One mum, who fortunately sought help before it was too late, described it thus:

I thought if I killed myself, my husband could find someone else, someone better. I thought that he deserved a better wife, and my baby deserved a better mother.

The tentacles of PND stretch wide. Untreated, it can morph into chronic depression. About 50% of spouses will eventually succumb to depression as well.  In extreme cases, children of severely depressed mothers can develop attachment disorders, entrenching problems into the next generation.

But in this, Suicide Prevention Week, let’s keep the focus on the beautiful young mums who have left us and the grieving dads and children left behind.

John graciously offered his story in the hope it might raise awareness and help others.  If you suspect a new mum is not coping please ask her.  Some women put up brave front, so keep your antennae tuned.

And if you feel like you’re stuck in a ‘dark place’ or ‘fog’, or your days and nights are disturbed by anxious racing thoughts, please speak to someone today. The organisations listed below have trained counsellors.   With the right help and treatment you can emerge the other side.

Benison O’Reilly is co-author of Beyond the Baby Blues: The Complete Perinatal and Anxiety Handbook (Jane Curry Publishing). Beyond the Baby Blues is a comprehensive Australian guide to anxiety and depression occurring before and after childbirth. Combining practical advice and personal stories, it’s designed for anyone struggling with the condition or those caring for them.

For help and advice contact:

Lifeline 13 11 14

The Gidget Foundation   www.gidgetfoundation.com.au

PANDA (Post and Antenatal Depression Association)  www.panda.org.au

Please share this post with your circle. It’s time that we start having an open conversation about post natal depression – so that we can all provide support for women who might be suffering.