With Depression Awareness Week underway, respected Natal Psychotherapist and founder of the Fertility and Birth (FAB) Network, Lori Fitzgerald, believes that not enough is being done to help women with postnatal depression.
She also argues that postnatal depression is an often misunderstood illness where a woman is led to believe that the cause of the depression is uncontrollable or haywire hormones, and therefore can be left to feel as though recovery is out of her control despite there being no strong evidence to support the hormonal causation theory.
Also, as the latest evidenced studies points to anti-depressants being no more effective than the placebo effect as oppose to being the hormone balancing wonder pills they are marketed to the NHS as, psychotherapists like Lori are seriously querying if antidepressants really contribute positively to a woman’s recovery from PND or if in actual fact they hinder?
Lori Fitzgerald asks why so many women who struggle with postnatal depression are left with the choice of a prescription for antidepressants or computerised counselling when what they would potentially ultimately benefit from is appropriate loving support, nurturing care, physical security and rest prior to and post birth.
Lori said: “I see so many patients who have been prescribed with anti-depressants when the consensus amongst my clients is that healthcare professionals could better support them with an open mind, broad shoulders, a nurturing nature or by asking a few well chosen questions and then listening to the patient’s response. One of my clients visited her GP and as soon as she told him she felt she may be postnatally depressed he immediately wrote out a prescription and didn’t question her emotions or lifestyle further. Furthermore the medication prescribed couldn’t be taken when breastfeeding which left her seriously considering giving up the one aspect of being a mother she had focus on and enjoyed.
Another client said that since taking the medication, which she had been prescribed for her feelings of postnatal fatigue which is incredibly common, she could barely remember her child’s name. When she spoke to her health visitor she was told that she only needed to continue with her medication for another year but was given no clear reasoning or evidence behind this statement”
“It’s important women take proactive control of their mental health and understand that anti-depressants will not cure an absent partner, money worries, anxiety, sleep deprivation, feeding issues, low self esteem, lack of confidence, a house or job move, demanding children or birth trauma. They will not balance a thyroid or adrenal gland, a prolapse, hair loss nor mend a broken heart. They may successfully mask these complaints. And they may also leave a woman feeling too flat to deal with the real issues herself (or with appropriate support) in good time to enjoy her children and family life without fear, worry or anxiety.”
Postnatal depression is a form of depression that occurs following the birth of a child. Symptoms of PND are often categorised as; low mood, feelings of unhappiness, tearful, irritable, tiredness, insomnia, appetite changes, lethargy, unable to enjoy anything, loss of interest in sex, negative or guilty thoughts and anxiety.
With PND the trigger is the birth but the depression itself can be caused by any number of things. It is often viewed as a special category within the depression spectrum but Lori argues that, despite the unique trigger of birth itself, becoming depressed postnatally is still depression and should be supported as such.
“Male GPs and mental health workers have spoken to me about their fear of working with women who are depressed postnatally as they feel it’s an area of mental health they can’t empathise with, but I argue that they shouldn’t be scared and instead support women to recover as they would do anyone who approached them with depression”.
Lori argues that healthcare professionals and therapists supporting women with PND should look to work within evidence based practice rather than be under the thrall of drug companies who offer sponsorship.
Current statistics suggest that up to 15 per cent of women develop a form of depression after giving birth and 12 per cent of women will have situational PND which, with the right therapeutic support, can be addressed relatively easily. Situational PND is a form of depression that is caused by the added pressure put upon a person postnatally when their existing situation isn’t supportive or conducive to coping with the pressure of birth or parenting.
Lori explained: “Postnatal depression lasts on average 3 to 6 months, with good therapeutic support it’s less, yet I am seeing women who have been on antidepressants for up to 10 years and are still being ‘written off’ as being postnatally depressed. I find this deeply shocking. The clients I work with are often able to recover from postnatal depression quicker without antidepressants than with a prescription due to recognizing key lifestyle needs or gaps and being supported to make appropriate lifestyle changes. Often women require a greater level of physical and emotional support when becoming mothers than they have might have allowed for. Each birth and baby is a new learning curve for mothers”.
“It’s imperative that new mums allow themselves to rest and to access what is known as the ‘Babymoon’. The time taken to bond with their baby should be as regular as possible and they must be supported to have almost continuous skin to skin in the first 12 weeks following the birth. This increases all the feel good hormones that we need to bond with our baby, increase breast milk flow and feel happier. I feel new mums shouldn’t be cooking meals, cleaning or entertaining a procession of guests. They should be supported to take a very long and very relaxing break. But often if there are other children in the household or a less than supportive partner this can be hard for mum and I feel this can be where PND can start. If women are supported to recognise where there need gaps fall and address them I believe a great deal of PND cases wouldn’t manifest”.
“It’s also important to realise that the ‘Baby Blues’ is a different situation and isn’t, and shouldn’t be, categorised as PND. This is when a woman becomes emotional and tearful a few days post birth as her pregnancy and birthing hormones finally leave her body and make way for the new breastfeeding and uterine contraction hormones. These feelings should pass within a few days but if they don’t women should seek empathic support.”
Lori currently takes referrals from the NHS as well as works with clients in private practice.
“Anecdotally I’ve noticed that the clients I see who are drug free are able to recover and move on in a shorter space of time. And whilst I will always work with and support women who are on medication with the same unconditional positive regard to their feelings as those who are medication-free I am aware that these women may be requiring a longer term of support within therapeutic practice. I feel angry at the injustice of this on behalf of the women who haven’t been supported to understand PND and have been potentially falsely informed that it’s their hormones and therefore they have no control over how they feel,” Lori said,
Lori established the Fertility & Birth (FAB) Network in 2012 as she wanted to promote heightened choice, confidence and control for women in the areas of fertility, pregnancy, birth & beyond. “I feel very strongly about women being able to make informed choices when it comes to their physical, emotional and spiritual wellbeing. But we can only make informed choices when we are actually given the information and the vast majority of women are left in the dark about decisions that can affect their health or that of their families. Being told that PND is caused by hormone imbalances that they can’t control and will require amazing wonder pills is potentially one prime example”.
Lori, from Leeds, is a mother of two and a Natal (Antenatal, Birth and Postnatal) Psychotherapist who specialises in supporting women with anxiety, depression and Post Traumatic Stress following birth (also known as Birth Trauma).
Lori is one of a limited number of specialist private counsellors in the UK who support women with natal emotional health. Lori is an Associate Member of the BACP (British Association for Counselling & Psychotherapy), Member of the UK Psychological Trauma Society and Founder of The Fertility & Birth Network (FAB).
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