Maternal wellness and late onset PND
I have covered the topic of postnatal depression many times and I have mentioned the concept of late onset PND a few times too. However, after a few queries regarding the Postnatal Wellness Programme which I offer, I felt it is necessary to normalise the concept of late onset postnatal depression.
What is late onset postnatal depression?
To begin, let’s remind ourselves what postnatal depression is and how it is different from the baby blues. It is entirely normal for mothers to have low moods, anxiety and hormone-related moodiness in the days following the birth and these feelings usually last for six weeks. However, for a number of women, the feelings are exaggerated, more prominent and they interfere with her normal functioning. This may then be considered postnatal anxiety or depression and help should be sought from a healthcare professional.
Late onset postnatal depression is diagnosed when these aggravated feelings of despondency manifest much later; eighteen months later and sometimes more! If this is the case, it is quite difficult to diagnose since there are usually many other underlying issues which may lead to the problem.
What causes late onset postnatal depression?
There are many factors that contribute towards late onset PND.
- The six-week appointment is a ‘checking-in’ time when patient and doctor are able to discuss any issues related to physical and mental health. After the ‘six-week appointment’ with one’s healthcare professional, many mothers receive very little support and medical attention. (Personal anecdote: After the birth of my second son, I received a call to confirm my six-week appointment. I didn’t realise it at the time, but the call came on one of my ‘bad’ days. I cancelled the appointment simply by saying I wouldn’t be able to make it. And that was that. In hindsight, I realise my error and loss. I also wonder if the doctor’s office could have called again to check on me, and if home visits should not be made a regular thing. It is not that I didn’t have family support. It’s that my immediate support structure was not equipped to deal with what I didn’t even know I was going through at the time.)
- Another cause of late onset PND may be that once the baby has grown a bit, partners and family members go back to work and to their regular lives while the mother is left to tend to baby’s needs with less support than before. Being alone, feeling solely responsible and tending to baby’s needs, especially if baby is teething or ill, can be quite overwhelming.
- Some women were working before baby arrived and now find themselves ‘stuck’ at home. The feelings of irritation, worthlessness, hopelessness, lack of interest in being at home, wanting to get back to their old work routine, etc. can overwhelm even the strongest heart.
Maternal mental health
Pregnancy, delivery and the first few months following a child’s birth are times of considerable change for a woman and her family. It is a period in which significant physical and emotional changes take place and it may become challenging for some women to prioritise their own wellness. Moodiness and detachment are not usually planned for when planning a family, and factors such as multiple birth, infertility or loss of a child can make the process more difficult. The changes that a woman and her family go through immediately after birth, although amidst excitement, may make adjustment to the new normal difficult.
When two become three
Feelings of stress, anxiety, depression or irritable mood are common symptoms of the baby blues and usually occur within six weeks of the birth, however, often more symptoms arise or the existing symptoms worsen. Postnatal depression is common in a large number of women and is nothing to be ashamed of. Maternal wellness is imperative to ensure the well being of the child as well as the family unit. Counseling during the difficult time is encouraged to help improve family dynamics.
Late / Delayed Onset PND
Postnatal depression may manifest up to eighteen months post birth, and at times even later. It is often difficult to diagnose due to the time lapse after the birth, however, help is still at hand. So, if you find yourself or a loved one with feelings of despondency or disillusion, in low moods much of the time, you should seek help right away.
PND is never a fun space to be in, but with patience, support and some treatment, you can overcome it.
Stay well, inside and out
Waheeda, a.k.a Waydi
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