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  • Q&A with Australian Health Practitioners

    Do I really still have post natal depression?

    Related Topics
    Depression Mental Health Postnatal Depression
    My only child is 2 and a half years old. My Edinburgh Scale today is 20. I've spent many months and four attempts getting off medication I felt I no longer needed which has also meant 20kg of additional weight. Eight weeks after getting off Lexapro I'm wondering if I really do need the medication because of the way I am feeling and behaving. My initial post natal depression was much more about the stress of dealing with a breach baby, inscrutiatingly painful breastfeeding and being a motherless mother. I loved my baby we had a beautiful relationship but I saw her death in every thing we did and was petrified of even driving the car. These days I work most days, my child is in childcare and healthy and happy, but I'm moody, quick to anger, negative, overwhelmed by life, sensitive and I cry easily. Is this really still PND? We'd like to have another baby, but I'm in my forties. Today I broke down realising I'm in no shape to have another baby and I'm not willing to give up yet.
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  • 1

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    beyondblue

    beyondblue is a national, independent, not-for-profit organisation working to address issues associated with depression, anxiety and related disorders in Australia.beyondblue is a bipartisan initiative of … View Profile

    Hi there,

    It certainly sounds as if you may be experiencing some difficulties, and some of the symptoms you describe may suggest postnatal anxiety as well as depression (these will be reflected in high scores on items 4,5,and 6 on the Edinburugh scale you refer to.  

    You mentioned that you were taking medication, but did not indicate whether you had any psychological treatment also.  In particular cognitive behaviour therapy (CBT) can be very helpful to address depression and anxiety, particulalrly for those experiencing mild to moderate depression and anxiety.  In the case where this is more severe, medication may still be required.  

    Did you have any psychlogical treatment?  this will provide you with really useful strategies to help you manage the symptoms of depression, particulalrly the anxiety and negative thinking that accompainies these conditions.  It can also help with preventing relapse when you come off medication and for the future (to prevent future episodes of depression and anxiety).  

    There are even some good online, free CBT programs.  The beyondblue website has a directory of these.  In the meantime, i would keep an eye on your symptoms, perhaps go back to your GP and let them know where you are at so they can do a thorough assessment.  Under medicare they can also develop a treatment plan and refer you to psychological treatment.

    I can certinly direct you to some more information, including the beyondblue clinical practice Guidelines.  We are currently in the final stages of developing materials from these which are easy to understand, but nonetheless the clinical information is in there regarding the effectiveness of different treatments for mental health problems which may be experieinced during pregnancy and following.  

    Kind regards,
    Nicole

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  • Felicity

    HealthShare Member

    Hi, just wondering if you can provide more info on diagnostic features of PND vs MDD - if initially diagnosed with PND, does this diagnosis change to MDD at any time or does the PND diagnosis stand if the initial onset is during or after pregnancy. I am a clinicial looking for clarification and there is surprisingly little on the clarification of maintaining diagnosis after a significant period of time. Many thanks.

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  • Anonymous

    Thank you Nicole. I got some really good counselling in the early days, but I find it very draining as I re-live everything. They always want to know about my childhood etc and that's a pandora's box. My daughter wasn't a good sleeper and we went to a couple of sleep schools, one which really impressed on my husband the need for me to get help, and the other an in hospital program where PND was a pre-requisite. I totally lied to the psychiatrist. I didn't like him and I didn't want medication. I was very depressed when I needed to go back to work for financial reasons with bub only 7 months old. Stuff at work was a massive trigger and I just had to keep working. I had a massive relapse after my daughter reached the age I was when my mother died (15 months) but resisted medication until my daughter gave up breastfeeding at 18 months. I just couldn't take therapy which required me to keep going over and over my life and what I've been through. I'm decluttering at the moment and in the room I was cleaning up yesterday I couldn't even touch the bags and boxes that contained my breastpump paraphenalia. I have boxes and boxes of clothes that I probably don't need anymore and I can't give them away or sell them because everything I touch is full of intense emotional experiences. I have no family or really close friends around me and found mothers group a trigger for PND with all the comparisons etc. I've recently reconnected with some mums whose kids go to the same childcare centre, but these are not strong links and both are pregnant again. I also suffer from chronic pain, from scoliosis, injuries and fibro, which can be a trigger for depression and I struggle to do what I need to do to manage my pain. I often feel guilty for not wanting to be a stay at home mum. I always thought I would be, but I found it so isolating and boring that I honestly still want to be at work more than I want to be home alone with my daughter. I am so lucky with the wonderful carers at childcare. They have probably given me more help with where my daughter is up to and what I can do as a parent than anyone. I am a smart woman who is basically clueless about parenting. Between childrens homes, foster care and a father with untreated bipolar disorder I just didn't experience the basics. The only thing I am totally confident of is how much I love her. My husband also didn't have good role models as he grew up with estranged parents and a very violent home. We are both very strong in wanting our daughter to have a good life that is very different to what we experienced, but sometimes we struggle with the challenges and myself I often lack confidence to make decisions about our daughter. Everything I've read about PND puts a time limit of about 6 months on it. So when's the point at which I start just calling this depression rather than PND?

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  • 1

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    beyondblue

    beyondblue is a national, independent, not-for-profit organisation working to address issues associated with depression, anxiety and related disorders in Australia.beyondblue is a bipartisan initiative of … View Profile

    PND is technically no different to depression, it is the same condition, it is just that it gets it's own name as the event of having a baby increases the risk of developing depression at this time. So, whether you have depression or pnd, the only consideration when it comes to treatments is which medications are safe to use if pregnant or breastfeeding. Psychological treatments are the same, so I wouldn't get too caught up on the name.

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  • 2

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    Anonymous

    Thanks for the reply. I now have a referral to someone who can deal with whole kit and kaboodle of issues I have. I wasn't keen to go back to the very excellent service I went to for PND, because they can't help me with things like pain management and I really don't want to go see yet another motherly woman who doesn't understand what it's like to be a motherless mother. Lovely though they are, it's just not helpful. I'd rather see a guy.

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  • 1

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    Dr Melanie Strang

    Counsellor

    Hi there

    just wanted to add that there are various places around that run groups called Motherless Mothers to help mums manage the pain associated with being a mum and having lost your mum.
    Don't know where you are but here is a link to one such group in Melbourne:

    http://www.grief.org.au/grief_and_bereavement_support/bereavement_support_groups/for_women/motherless_mothers

    Just Google “Motherless Mothers” and the location where you live and hopefully there will be one close to where you live.

    Hope this helps.

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  • 1

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    Brigitte Safrana

    Counsellor, Hypnotherapist

    I created Surfing The Blues and Surfing The Baby Blues Counselling & Hypnotherapy services in order to help individuals and couples restore balance in their … View Profile

    One of the first question that i would ask you is: how did you get off the Lexapro? Did you wean yourself off over a few weeks? Depending how you did it could make a major diffrence with your brain chemistry and therefore your state of mind.  This being said, I am not quite sure whether we are dealing here with PND or a depressive state. One of the issue that may you could look at is the motherless mother state and this you should do with professional help, ie; a psychologist or a counsellor.

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