Advice for partners and friends of those with PND

I know that my other half felt so bad that he hadn't realised that I had Postnatal Depression, as did several of my best friends. But I don't blame them for not noticing, I did a great job of hiding my feelings. I feared people thinking I was "not coping" with motherhood and I didn't want people to see me as the failure that I felt. So 'How are you?' questions were always responded to with 'I'm fine thanks'. Personally I had days when I wanted to just cry in response to that question, but I didn't want to show "weakness", plus no one wants to deal with that, no one expects a negative response to that question.
So my first bit of advice is really be observant, ask a couple more questions, show that you really do care about how they are feeling and they might be more open about it.

What you need to know

• PND is a form of depression, it is not a "lesser form"of depression, it can be as severe as any other form of depression.
• Postnatal Depression is not uncommon,  roughly 1 in 10 woman have PND.
• It can occur at any point within 1 year of the birth
• Men can get PND too, 1 in 25 of fathers in fact, so you also need to look after yourselves and speak to someone if you feel you need to.
• The hardest step is recognising it and acknowledging the thoughts and feelings and asking for help.
• You may be the one to recognise that low mood/tearfulness, although common in the first few weeks due to hormone changes and exhaustion, should not continue. Speak to her and find out how she is feeling, encourage her to speak to a professional, such as her health visitor or GP if it is not improving.
• Remember that with the right help, this can be resolved.

Factors that can predispose PND

• A previous history of depression or anxiety or bipolar disorder.
• A family history of depression 
• A traumatic birth
• Chronic sleep deprivation 
• Illness/health issues in the baby
• Breastfeeding difficulties
• Relationship difficulties
• Lack of support
• A dramatic drop in hormone levels post birth
• A particularly emotional pregnancy related experience- miscarriage, unexpected pregnancy,  IVF, multiples...
• Personality- low self esteem, perfectionist, OCD...
• 
  

Symptoms to look out for (not all these symptoms will be present, it differs from person to person which will be experienced)

• The "baby blues" lasting longer than 2 weeks
• A persistent feeling of sadness or tearfulness 
• Lack of energy, exhaustion
• Reduced enjoyment of things you enjoyed before
• Slow, hesitant speech.
• Trouble getting to sleep, or staying asleep but being tired.
• Withdrawing, isolating themselves from social situations
• Difficulties concentrating
• Trouble bonding with the baby
• Thoughts about harming themselves or their baby
• Nightmares 
• Panic attacks
• Feelings of failure, guilt, self blame, 
• Feeling unable to look after the baby or voicing concerns to that affect.
• Irritability
• Lethargy/ lack of motivation
• Changes in appetite  (reduced or increased)
• Frequently crying for no reason 
• Speaking negatively
• Self neglect
• Excessive worry
• Lack of their usual humour.
• Obsessing over their health or their babies
• Avoiding seeing friends and family
• Physical symptoms such as rapid heartbeat, sweating, sickness or fainting, headaches, blurred vision
• Low sex drive

How you can help

• Have a responsive conversation about how you are both feeling. Listen
• Encourage her to get professional help
• Remind her that she is a brilliant mum and doing a fab job.
• Tell them you love them
• Bring positivity into the house
• Be aware that she may take small comments or jokes to heart,be aware that venting may be taken personally too.
• Try to let any irritable comments she makes, pass without affecting your mood.
• Give your other half a lie in and take the baby for a walk so she cannot hear them and is able to rest.
• Tidy up after yourself and do some household chores without having to be asked.
• Comfort when she needs a good cry. 
• Keep her company, so she doesn't feel alone but also allow her, her own space at times.
• Take over to allow her time to have a bath/shower and give her that break, don't interrupt that time with non urgent questions.
• If possible then help with the evening/ night feeds to allow her to gave a chunk of unbroken sleep.
• If that's not an option, be the one to put the baby down to bed as you're likely to have much more success than mum who smells of yummy milk.
• Discuss with her the best practical ways in which you can help
• Appreciate that there will be good and bad days
• Don't laugh at the little things that you don't realise will upset her. My other half laughed when I accidentally touched a hot pan in a moment of exhausted stupidness and it led to a melt down on my part. 
• Take her out, if she is ready, don't force her out of her comfort zone.
• But also look after yourself, allow yourself some time too. Living with someone with PND is emotionally exhausting. Ask family members to help out.

Things are sent to try us

This week my 14 month old son had his 5th trip to A&E and his first ever hospital admission. Alike last time, it was due to a virally induced wheeze. My little boy is a constant worry to me. I am aware that all mums will forever worry about their children, but part of my post natal depression and anxiety involved catastrophising and in particular fearing losing my son. The fact that he has been so poorly since last summer, has really not helped that aspect of my PND. I have asthma so the chances are that my little man will develop asthma too, especially with his respiratory history do far, but this cannot be diagnosed at his age or without an even more extensive history than his.

It really upsets me to see him working so hard to breathe, needing nebulisers and inhalers very frequently, having the nurses taking his observations regularly with concerned looks on their faces. We had another positive experience with our GP who referred us straight to paediatric A&E and with the nursing and medical staff at the hospital were fantastic too. But that doesn't fully reduce the anxiety I felt over my poorly monkey.

We spent 1 night and 2 days on the paediatric ward after a couple of hours in the Paediatric Decisions Unit. That ward was hot, noisy and busy. We shared a bay with 4 other children and parents.  Only one parent is allowed to stay but my other half remained with us until late. My son struggled to sleep whilst we were there and did eventually but not in his cot, he spent some of the night asleep in my arms in my bed. He was very clingy and I very protective. After a few nights co-sleeping with him I had to reluctantly get him back in his cot. It was a balance between him being well enough to be without me monitoring him by his side and not wanting to ruin his sleeping routine.

Additionally I caught his virus so I was looking after him whilst feeling poorly myself. All of this would have massively taken its toll on my mood previously but I'm proud of how well I have coped. Being unwell, exhausted and concerned but staying calm (most of the time) and just managing everything the best I could. I am winning.