Postnatal depression from a doctor’s perspective: remember you’re not alone



You’re not the first woman to sit across from me, sometimes with your partner and child in tow, sometimes alone. Your shoulders are shrugged, tears well and then you say “something just isn’t right” or “my partner and mum thought I should come see you” or “I know this should be the best time in my life but I don’t want this baby or this life.” The tears flow, my hand will often reach out and touch yours... “I promise you’re not alone in in feeling like this” is often one of the first things I utter...

Perhaps you know someone suffering from postnatal depression, maybe you have survived it yourself or possibly you are living with it, currently fighting your own battle with the illness. It’s as common as 1 in 7 Australian mothers being affected. So why is it that we still don’t speak about it openly? The stigma of mental illness continues strong today despite the fact that in a group of seven mothers there is almost certainly one that has battled (or is battling) the illness.

The truth? No mother is immune. After I experienced a traumatic labor which ended in an emergency C-section (but also the divine Miss S) I was at increased risk for the condition. I honestly waited with baited breath. I wondered not if, but when it would hit me. I knew what to look for as a GP – low mood, losing interest in my hobbies, feelings of guilt and worthlessness, sleep changes to name a few, but it can be hard to notice anything in the first months of a new baby. Between breastfeeding, adjusting to your new life and sleep deprivation, you barely know what day it is let alone if you’re mood is deteriorating. I am grateful that I never suffered from postnatal depression but being a GP, having knowledge about the condition, having a supportive partner and family didn’t make me immune. Sure it lowered my risk but even those with the “perfect” marriage/house/job and all the money in the world are not shielded; postnatal depression does not discriminate.

I often find that parents sit around sharing the very positive aspects of their parenting journey. You tend to get the social media version of their life – their child sleeps through the night, things are great at home, life is complete with their baby in it, they have a lollipop and glitter garden in the backyard. You start thinking that perhaps there’s something wrong with you. I know I did. I was enjoying my child but let me assure you, I grieved our old life sometimes (in a loud and teary manner) and I remember in a very sleep deprived moment asking myself, “what had we done?”. And I wasn’t depressed. I was simply “adjusting” to the completely new universe of parenthood. But often you can’t openly voice the fears and raw thoughts you have – you wouldn’t want to pollute the parenting love fest with your reality. So imagine how hard it must be for the mother out there battling depression – it’s already dark but comparing your struggles to the lollipop and glitter garden parents only makes it darker. I admit that I was very fortunate to have met like minds who shared their struggles with breastfeeding and the crazy thoughts they had after months of sleepless nights.

The dark cloud of postnatal depression can be large and obvious with a mother who voices thoughts of taking her child’s or her own life. Or it can be quiet, insidious and stealthy, slowly creeping up so that not even the mother has any idea what is going on until someone says, “are you OK? You seem off.” The penny drops – wait a minute, maybe I’m not. In lots of patients I’ve seen there is a strong sense of guilt – how could they feel so low and be so ungrateful despite having everything they’ve always wanted? But it’s not a choice to feel depressed – it’s due to complex chemical imbalances in the brain (we think!) and you can’t just snap out of it.

The women whose lives are at risk, or whose children are, are emergency cases. These are the women who should be admitted somewhere where they can get the support that they need 24 hours a day from a medical team. I’ve treated patients like this and the turn around can be phenomenal with the right care.

But there are also the quiet sufferers and they need just as much support from their GP, psychologist, friends and family. And whilst psychology input, counseling from the GP and lifestyle changes (like regular exercise) can be enough in some cases, in others we need to use medication. And before anyone protests medication isn’t a “cop out” – your words very often in the consultation, not mine – taking a tablet for depression is no different to taking a tablet for high blood pressure or a headache. We do what we need to get you back to the “old” you. I’ve seen many women recover – the old them starts shining through again, they start socialising, the feelings of guilt and worthlessness slowly go away. These mothers start seeing that they are a wonderful parent, friend, partner. However, the critical first step is talking to someone – anyone.

So if you’re a sufferer (wherever you are on the spectrum) there is light at the end of the tunnel I promise – use all the tools you have available – your family, friends, psychologist, medication (if needed), exercise. If you’re reading this and thinking you don’t know any mother who has been touched by postnatal depression then the truth is you have your blinkers on and asking “are you OK?” might just be the trigger for a friend or family member who is silently struggling. If you are one of the people reading this now thinking you’re stuck in the thick fog yourself then start by talking to someone –  there should be no judgement or shame for despite our lollipop and glitter gardens (and regardless of whether they are well tended to or unruly like mine) we are all vulnerable to mental illness.

If you or someone you know is struggling with mental illness then please contact your GP or lifeline on 13 11 14.

Words: Dr Preeya Alexander from The Wholesome Doctor


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