What I’ll say to Adele……
Posted by: Sue Atkins
I’m honoured to be speaking at The House of Commons again.
This time I’m speaking on ‘The Effects of PND on Family Relationships And The Importance of Parenthood Education.’
I love Adele and seeing her live in Concert is on my Bucket List.
I’m really glad that she has spoken out about suffering from PND but I’m also a bit disappointed actually that she hasn’t used her experience to raise awareness about the complex issues arising from PND and she is quoted in the press as saying that she now feels “too scared” to have another child.
Adele as a huge celebrity and has a massive platform to educate, empower, influence and to change perceptions and awareness around the whole area of PND.
She really could encourage women to speak out about the illness and let people know they can and do get better.
I work with Mums who initially ring me up to chat about their toddler climbing into their bed at night, or their 6-year-old who won’t do as they are told, or their 13-year-old who won’t listen.
Dig a little deeper and often the issue stems from way back when the mother suffered from PND and has suffered enduring GUILT throughout all of those years, about not being ‘good enough’ or fully ‘present’ during those early weeks and months, and has been too lenient in their discipline or boundaries to over compensate.
I also work with parents together, as of course PND has a big
Impact on the partner:
Living with a woman experiencing PND is difficult. Partners need a lot of support too and are known to be at risk of developing depression themselves. They often feel confused, lost and helpless.
They can be the target of their partner’s distress and irritability as the Mum attempts to make sense of what is happening to her. Not only is the Dad expected to stop being the ’cause’ of her distress, he is expected to know how, and when to listen to her, support her, and to know exactly the right things to say.
The relationship between the parents may become very stressed or even threatened by the conflict created by the mother’s distress and intense needs within the relationship, and the Dad struggles to know how to support his partner and often it’s not easy for a man to ask for help.
Important cracks in the relationship can begin to develop due to PND. It’s not necessarily true that a difficult relationship causes depression; rather that depression can cause problems in the relationship in my experience.
And that of course is not good for the children.
The partner’s workload can increase enormously as he attempts to continue working to provide their income, but he may also need to take on more of the household work and the care of the children if his partner has not been able to manage during the day.
In addition to this he may be feeling very anxious about how his partner is coping at home with the baby, especially if she rings distressed during the day, and also trying to manage his own distress and frustrations as to why his partner is not getting better.
He may be feeling very isolated and lonely.
Again this is not good for the children.
I believe it is very important that partners be included by the support services and health professionals treating women with PND.
Partners are much more supportive if they understand what the problem is and what they can do to help, as well as needing support and encouragement themselves.
Of course, there is a great deal of research on PND and the Impact on the mother-infant relationship
And whilst not true for all women PND can interfere with the behavioural and emotional interactions that are now recognised as being necessary for a successful mother-infant relationship.
Mothers with depression might be less sensitive to the needs of their babies, might feel less close to their baby, or could be less responsive to their baby’s communications. As a result the mother may be withdrawn, or overly intrusive, with the baby as she tries to care for them.
The mother’s feelings towards her baby may come and go as the symptoms of depression fluctuate. Sometimes the feelings make the mother feel numb, as if she has nothing to give. Sometimes the mother may feel overwhelmed or trapped by the demands of the baby and resent the baby. Or she may not be able to relax or switch off from the needs of the baby, needing to be constantly vigilant about his/her well being.
These things are not reflections of the mother but rather the symptoms of depression.
Women experiencing PND benefit from gentle reminders and frequent reassurances that this will not last forever.
The mum needs to be encouraged to make eye contact with her baby and to try to make faces and noises in interaction with them, even if she doesn’t feel like it. The baby’s father, and other family members, need to understand the baby’s need for interaction and to support the Mum as she builds her ability to do this.
That’s why I see the role of Home -Start one of the leading family support charities in the UK to be of great value, as their volunteers help families struggling with post-natal depression, isolation, physical health problems, bereavement and many other issues, to receive the support of a volunteer, who will spend around two hours a week in a family’s home supporting them in the ways they need.
I think it’s important that the mother’s efforts to care for her baby are supported, rather than taken over by others helping to care for her baby or other children. Small gains and huge efforts to interact with, or care for her baby, must be acknowledged and encouraged by her partner and family members, reinforcing her special role as the baby’s mother.
Many women with PND I have worked with, who have experienced these difficulties, have found that positive relationships have been re-established over time with gentle and sincere support.
We know the
Impact on Infant Development where difficulties in the mother-infant interaction over extended periods of time (especially untreated long term PND) may compromise many aspects of the infant’s development and can impact on the child’s later cognitive and language development, social competence, & behaviour and can also result in long term parenting difficulties.
I see, and pick up the pieces of, the parent-child relationships that have been damaged, due to the mother’s withdrawal or volatility, or the parental conflicts and arguments and the inconsistent parenting.
But I also see by working with me, using EFT or Emotional Freedom Techniques the successes around reducing or eliminating the guilt associated with having had PND.
The impact of PND on family relationships could be viewed as having an enormous ripple effect.
Parents, siblings and extended family members are all affected by the presence of PND.
Often a woman with PND will not tell members of her family about how she feels because of the response she feels she may receive.
It takes an enormous amount of energy to hide PND but usually family members can identify that the woman has changed, is not her normal self or doesn’t seem to be coping or enjoying life. These changes in the mother can cause conflict in her relationships that she struggles to deal with.
Efforts by family members to enquire about or to support the Mum may come across as critical or intrusive, especially if the mother is feeling highly sensitive or distressed and families don’t know what to do for the best.
For some family members PND may trigger strong responses of distress or concern because of their own associations with depression or parenting.
Others may not understand PND and may not be open to learning more about it.
Most family members wish only that the mother would be happy and find it hard to understand why she can’t just snap out of it.
If the PND continues untreated these impacts can worsen over time and the toll it takes on family members increases. Stress and depression may be an outcome of these ongoing impacts and it may be important for the family members to seek support and treatment for themselves as well.
This leads me to the Importance of Parenthood Antenatal Education
Education during pregnancy provides a really valuable opportunity to raise expectant couples’ awareness of mood changes related to childbirth and to help them to manage their expectations.
Education about PND for expectant couples would significantly reduce the trauma this illness causes. Studies show that expectant couples are more receptive to parenting and PND education if information is presented in the early stages of pregnancy rather than towards the end.
Women ( and their partners ) who have learnt about PND in antenatal classes, and then go on to develop symptoms, may be less likely to panic and will remember learning about PND and know where to go for help.
I think information about PND during the antenatal period would:
- help to dispel the myths and misconceptions about it, helping to de-stigmatise it.
- give new mothers permission to ask for help, if they don’t feel the way they expect to feel after having a baby, encouraging women to take control over their own mental health; and
- inform expectant couples that the symptoms of PND are recognisable and that help is available, which aids in earlier recognition and interventions.
I don’t have the stats on how many antenatal educators introduce women in their classes to the possibility that they might develop PND but it is likely that one woman from every antenatal class will develop it.
Probably every woman attending antenatal classes, whether she is aware of it or not, knows someone – a relative, a friend or a neighbour – who has been affected by PND.
Many women I work with who have gone through PND question why their antenatal classes didn’t prepare them for the possibility of it. Many complain that their classes emphasised preparation for delivery rather than preparation for parenthood. They feel that if they had been taught to recognise the early signs they would have sought help earlier and so minimised the distress that their families experienced.
I do know that some antenatal education programmes now include an interview with the expectant couple that provides an opportunity for routine antenatal screening, for some recognised contributing factors, such as pre-existing trauma, child abuse, previous childbirth trauma, history of illness or previous hospitalisation.
But the problem here in the UK in my experience is that people tell me all their problems but don’t like the idea of counselling – seeing it as weakness.
We need to blow up that myth and way of thinking.
Asking for help in my opinion is a sign of strength.
I think we need to prepare expectant parents about the possibility of PND, talking more openly about it, and talking about ways to receive support that destigmatise it.
So, if I bump into Adele in a Green Room or on Loose Women I’ll get her to educate, not run away from her own experiences, so she can help, empower and support other Mums suffering from PND.