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The edge of reason: Motherhood after severe postnatal depression

By June 13, 2020No Comments

postnatal depression

After trying to take her own life, one new mother came back from the brink. Here, she tells Sophie White about the gift of second chances and self compassion…

**Content Warning: The following article contains references to suicide and self harm.**

Some months after her first baby was born, Sarah* stood in her kitchen in the early hours of one of those terminal nights that new mothers know well. The nights that seem to go on without let up. By this point for Sarah, the nights had seeped into her very being. She felt empty. Numb.

The week that Sarah’s first baby was born, her mother died. The birth, precipitated by a loss of such magnitude, was a painful, exhausting experience which culminated in an emergency c-section. Her little baby struggled initially and had to be transferred immediately to the neonatal unit. Sarah never got to hold him in the first moments and days of his life.

Empty arms in the aftermath of a birth are an anathema, an acutely painful absence. Sarah is quick to acknowledge now, in that way that we do, how there are scenarios infinitely harder. And there are. But still the chaos of grief, pain and fear in the first days of new motherhood was a gut punch. Destabilising.

“I know some people’s babies end up in the neonatal for weeks and months and may never get better and that is obviously so much worse but in terms of expectations – having just buried my mother and the labour not going well and being in hospital with the baby nowhere near me – I just felt like nothing was as advertised. And everything bad that happened, I did try to move on from it but it does all mount up, every little thing. It’s like a chain reaction if one link of the chain gets broken – it can be hard to pick yourself back up again,” explains Sarah.

Between then and the moment standing alone in her kitchen, the emptiness had become tumorous. Growing and unknown. “I was numb… convinced that my baby didn’t need me, that he’d be better off without me.”

She selected an instrument.

Even now, Sarah can’t really remember what took place next.

A blackout. Her husband found her. Panic. A new terror born. An urgent but efficient room of doctors sewing a seam through Sarah’s life. Sarah was saved. And though a certain ambivalence lingered about surviving, she worked to get well.
In the aftermath of her suicide attempt, Sarah had a blood transfusion and was then moved to an acute psychiatric ward, before eventually receiving home-based treatment. She struggled with enormous guilt around what had happened, though gradually with help she began to come back to herself.

Sarah and I first spoke when her first baby was nearly a year old and she was feeling tentatively recovered. We stayed in touch. Her honesty about what had happened to her had helped me to a degree that is impossible to quantify. I have made peace with many aspects of my mental illness (potted history: Drugs => nervous breakdown at 22 => meds+therapy+time = a 35-year-old mother of three who still, from time to time, has episodes of depression and delusional thoughts, who still relies on med+therapy+time to get her through).

Over the years, I’d let go of the various iterations of guilt and shame that plagued me around being mentally ill but the one bruise I still cannot go near is the postnatal depression I suffered in 2014.

I still fixate on it. Had it harmed my baby? Was it my fault? Even six years later and with such tangible and wonderful proof of it having no lasting effect in the form of my witty, warm, loving boy – if I try to talk about the postnatal
depression the words catch. The words worry at the dam I’ve packed tightly around the shame. The words threaten to disturb the dormant sickness.

Sarah symbolised hope for me. How could she not? If you have scoured the internet on a quest for comfort in the aftermath of search phrases like:

‘I don’t love my baby’
‘Baby four months old, I want to die’
‘Scared I’ll hurt my baby but don’t want to’

– all you’re looking for is confirmation that this thing (the interloper depression takes many forms: beast, demon, pain, terror, despair) is not you. And is something you can come back from.

Sarah came back. She returned from a precipice many don’t. “You really only ever hear of very bad postnatal depression that ends in tragedy. Like a mum killing herself or the baby but it’s really important that there are positive stories out there,” says Sarah. “It’s something I found really hard the first time round because you’re looking for stories of people who
recover [from something like this] and it’s very hard to find.

“At the time, I just felt my baby would be better off without me. There was no logic to it. When I can look back at what led up to my being not well, I can look at it now objectively, almost like looking at a good friend, and say ‘that was really, really
hard’ as opposed to how I was at the time, being like ‘God, could you not just get on with things?’

“I have a lot more compassion for myself now. My standards are a lot more realistic. When my first was only months old I used to go to the library and get out books because I felt I should be reading to him in Irish – and if that’s the standard you have, you’re only going to fail!” she laughs.

Despite the trauma at the centre of our conversation, Sarah laughs a lot. “That’s just a tiny example of something totally ridiculous that you can beat yourself up about and take the joy out of life.”

“I remember thinking ‘will I ever get my life back’. But you do. My relationship is normal again – you know it’s normal again once you’re back arguing about little things and he’s not tiptoeing around thinking “I’d better not upset her or
she’ll try to kill herself again’. I tried to give up, I couldn’t cope with the idea of being a burden on anyone. And when I survived, I worried it would follow me around for the rest of my life.”

It’s a worry so many who experience the emotional whiplash of postnatal depression experience. Gradually, Sarah began to feel more stable and even began to discuss the possibility of having another baby. In these conversations, she and her
husband unpacked what they had come through, fully acknowledging the impact of Sarah’s mother’s death.

“The fact that I knew that my mother simply couldn’t die again was actually very reassuring,” she says. Sarah and her husband welcomed their second child nine months ago. “To be honest, I feel I don’t have that much interesting stuff to say: It’s been boringly good this time!” she laughs and it is lovely to hear how mercifully uneventful the first year of her second child’s life has been.

“Because of everything that happened before, I was so well looked after in the hospital. A psychiatric nurse saw me every day I was in the hospital and then came to my house once a week for the first six weeks. The support network was amazing. And luckily I didn’t need it, but it was very reassuring.”

The decision to have another baby didn’t come lightly for the couple and they took steps to minimise the inevitable strain that can come with a new baby. “I’d had a full year of feeling fine and my first baby was two by the time I was pregnant again,” says Sarah. “My husband and I discussed it together and decided instead of me going on maternity leave and doing everything, we would keep my childcare in place. We also got a cleaner. It sounds so precious but I knew it would take the pressure off. My mum is gone but my childminder is the next best thing. She’s wonderful. I knew she would step up if I needed her. I also discussed the decision with my older sister and she was so supportive.”

Sarah also sought the advice of her care team with whom she is still connected. “I still see my psychiatrist very occasionally. And I did say it to them before becoming pregnant and they were like ‘yep, it’s not totally out of the question.’
No one came up and said it was a terrible idea which I was amazed by because my logical side thought it was a terrible idea for a long time. That support network was very important and having a cleaner lined up to clean the house. It sounds so basic but just having that box ticked really helped.”

“I think I realised from talking to friends who had mums or sisters nearby, that that’s the kind of thing they do to help out – housekeeping and childcare – and if you don’t have the family close by, you need to get someone and pay them!
Even if it means you’re totally broke.”

Sarah also arranged to stay with her in-laws in the early weeks as a plan B if things became overwhelming at any point.
“These are things you don’t think of with a first baby because you don’t know. Even with the breastfeeding things were different. On my first baby, I had a lot of feelings of failure around stopping feeding but the second time, I just knew
that I would surrender to sitting down feeding every day for the first few months and that it would gradually become less intense and I was very accepting of that, whereas the first time around I just couldn’t accept it. That acceptance is the key to realising that this won’t be forever.

“The bad period feels so far away now. During my second pregnancy I was very careful to take it one day at a time. I think during my first, I’d gotten very bogged down in worrying about the future.”

Even during a scare in the pregnancy, a period in which Sarah cried and worried a lot, she knew it wasn’t anything like the dread and despair that had engulfed her during her previous bout of depression. That “empty feeling about nothing in particular and everything at the same time”, as she put it, never came.

“I wouldn’t have believed in the height of the depression that I would ever be well again let alone have another baby, let alone have another baby and be well and be back at work. Even the idea of surviving the lockdown days – all day long in the house with a toddler and a baby while my husband is out at work – the idea of getting through that would’ve been incomprehensible.”

If you are affected by any of the issues covered in this piece please seek help. Here are some free resources:

www.pieta.ie or text HELP to 51444 or call, for free, 1800 247 247
www.aware.ie or call, for free, 1800 80 48 48

Photo by Matt Hoffman on Unsplash

*Name has been changed