If you think you might have postnatal depression, please see your GP, midwife or health visitor. They can help make a diagnosis initially by asking you two questions:
- “During the past month, have you often been bothered by feeling
down, depressed or hopeless?”, and - “During the past month, have you often been bothered by taking
little or no pleasure in doing things that normally make you happy?”
If the answer to both of these questions is yes, then it is possible
you have PND. However, depression is not a clear cut disorder in the sense
of either having or not having it. There is a spectrum from almost normal
mood to total incapacity, with an arbitrary cut-off for “clinical” depression
somewhere along the line. The cut-off is basically about when treatment
becomes useful rather than the level of symptoms or impairment.
Your health professional should conduct a screening method for depression,
known as the Edinburgh Postnatal Depression Score (EPDS). This short survey
with ten simple questions is typically completed about 6-8 weeks after
your babies’ birth. It includes such items as: ‘I have blamed myself unnecessarily
when things went wrong’ and ‘the thought of harming myself has occurred
to me’. Mothers who score above 13 are likely to be suffering from a depressive
illness of varying severity, although this diagnosis should be confirmed
by personal interview and clinical assessment.
In some cases, your GP may do a blood test to rule out physical causes
of your symptoms which frequently occur after having a baby, for example
anaemia or an underactive thyroid gland.
Although most health professionals are well-trained and sympathetic towards
mothers experiencing PND, be prepared to be persistent if you think you
might have the symptoms. Some mothers of multiples encounter unhelpful
attitudes, for example health visitors being distracted or in awe of your
lovely babies and not focusing on you. Another problem is health professionals
may often be dismissive of your feelings, presuming you are struggling
to cope because of the exhaustion and stress of looking after more than
one baby, rather than diagnosing depression. A large proportion of the
mothers who were ‘not sure’ if they had suffered from PND in the Tamba
survey said they had told their GP they thought they were depressed, only
to be told they were not clinically depressed, just struggling to deal
with a situation with very little support. It is also not unusual to feel
rushed and unable to discuss complex emotions and mental health issues
while struggling with two or more babies in crowded baby clinics and during
appointments with GPs.
In the Tamba survey, several mothers experiencing postnatal depression
said they wanted to “pass the tick test” and were reluctant to give honest
answers. One mother described being “so determined to prove to people
that I could cope”. Other women said they hid the signs of depression
and tried to fool the questionnaire. This was partly because they were
worried that being diagnosed with PND would mean they were a bad mother,
but they were also worried that their babies might be taken into care.
It is highly unlikely that your babies will be taken away from you. The
aim of diagnosis and treatment is to help you care for and bond with your
babies. Even in the most exceptional and severe circumstances, where women
require treatment at a mental health clinic, specialist mother and baby
clinics are available.
Courtesy of Tamba - www.tamba.org.uk
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