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Guess it's very subjective. I know when I first started feeling bad, lots of people dismissed it as usual baby blues/new mum tiredness, and even now I get frustrated when people try to say 'yes but isn't it like that for everyone'. I think if you've have depression before it'll be familiar. if not - well, different for everyone, but for me, I saw little point in going on, cried more than I didn't, thought the world would be better without me, felt panicky and sick whenver i was left on my own with the baby, thought going to the park with the baby was the equivalent of going to the moon, thought I'd made a terrible mistake...Would lie on bed crying, unable to pick up the baby when he needed me. I think the biggest thing that marked it out from other people's experiences of baby blues/tiredness was not that i was suicidal, but that I didn't see the point in life any more.


Edited to add: on a more prosaic note, there is a questionnaire (think called the Edinburgh Scale) which GP can do (or poss midwife/health visitor I don't know) and it will ask certain questions about your state of mind - whether you look forward to things anymore etc - not sure how useful such a tool is, I didn't really need it but it certainly gave the GP confirmation that I needed help.

My PND kicked in at about 8 weeks; I had terrible insomina due to paniky thoughts about EVERYTHING baby related. It was truely awful. The point where I realised it was more than just exhaustion and the baby blues was when I had a night of very dark thoughts (ending my life). I was staying with my Mum and Dad at the time (due to army husband away overseas - on operational tour for 6 months, which was a huge contributing factor I think) and when I told my Mum the next day (probably the lowest and saddest point in my life) we both realised it was time to seek help. I saw my wonderful old family doctor who was amazing, prescribed me very low dose anti-depressants (10mg) and I never looked back! I finished my course of anti-d's last week and am now the happy mum of a delightful 5 and a half month old little girl. It was the worst time of my life but we've come out the other side smiling!

I think the problem with PND diagnosis is that you will often find some/most of those who work in health care very reluctant to diagnose it in the first 6 weeks after birth. I had very obvious signs of PND about 4 days after birth (spent hours reliving birth, unable/unwilling to sleep despite total exhaustion, spent most of time crying) and a MW sent for my GP at the time in order to get a referral for counselling asap. The GP refused saying that if he made a mental health referral he would be "laughed at" (he used those words exactly!) because my symptoms were typical of alot of women post-natally. So I think PND can be really difficult to diagnose in the first few months after birth, and perhaps alot easier to diagnose if you still feel that way say 6 months after birth. Needless to say the disparity between what the GPs believe and the MWs, and to witness that type of conflict, is not very conducive to recovery from PND! As KateW mentioned, having a doctor or HV who knows you or who you trust, can make such a difference. I was very isolated when I had my son, many miles away from any family, and that made a difference.


I did finally get diagnosed with PND 6 weeks after birth after I had the Edinburgh Scale used on me twice. The first time I lied through my teeth (a total stranger HV who wasn't very sensitive and I honestly thought why on earth would I want to speak to you about such horrible feelings about giving birth), the next day I literally caved in realising that I had lied in the test. In my very fragile state we then came to live with family around here from our then home out of London, and an outstanding Dulwich HV came to see me and went through the Edinburgh scale CORRECTLY i.e. no paper in sight, asked me how I was feeling etc, and I finally got treated for the PND which had remained undiagnosed for 6 weeks and as a consequence of being undiagnosed made me feel worse really than I needed to feel.


I think when you ask how you know what it feels like to 'cross the line', its that feeling that you can't even be bothered to put a brave face on it anymore. When the baby blues kicked in it felt like someone had spiked my drink with a depressant, and that feeling never went away. I had never had depression before and so felt very confused by it, and through lack of sleep/opinion of GPs and family, felt it was a 'normal' part of motherhood to feel so down after giving birth. Perhaps it is from time to time, but I think when that feeling takes up every waking minute of your day and night, that is when its not ok and it is more than just feeling a bit down in the dumps...it is like you are carrying around a weight on your shoulders all the time. Its probaby normal to be weepy e.g. cry at the andrex puppy advert after you give birth, but its not really normal to feel an acute sense of anxiety or total despair.


However, like all types of depression I would imagine there are different shades, and yes it is subjective. One woman's mild PND maybe another woman's extended baby blues...

I see it as a certain darkness of thought. Not just being exhausted and very emotional, it feels more sinister than that. I had an overwhelming sense of doom after number 1. My brother had died of cot death before the back to sleep campaign in the 1970s and i was absolutely convinced my son would too. I obsessed about it and would refuse to put my son down for sleeps as I couldn't bear the responsibility of it. I would also read story after story on the internet about families who had a similar loss. I lied when I took the edinburgh test, I couldn't bear to say it out loud. I really regret that as I went on feeling that way for well over a year and it's a time I will never get back. Now that I'm out of it and my mind is clear, I see that refusing to acknowledge it was the worst thing I could have done. My poor husband had to do so much at that time for me and our son, he was wonderful. When I had my little girl I promised that at the first sign of things I would seek help. Fortunately there was no need to as I felt very happy and confident, and I also managed to do a lot of bonding with my son during my second mat leave which has relieved much of the guilt.


Moral of the story is that it is a much braver and stronger person that acknowledges their PND and seeks help. Better for everyone too, Mum, Dad and baby.

Lochie Wrote:

-------------------------------------------------------

> Its probaby

> normal to be weepy e.g. cry at the andrex puppy

> advert after you give birth, but its not really

> normal to feel an acute sense of anxiety or total

> despair.

>

However it is normal to feel this if you have PTSD, which is something a large number of women experience after giving birth. Particularly if you felt any part of the labour was frightening, out of your control, or you are unsupported by friends and family. It's much more common than is recognised and consequently many women suffering from PTSD are misdiagnosed as having PND - particularly when the diagnoses is an early one, e.g. before 8-12 weeks. It's worth doing a little research on the symptoms, and the differences between PTSD & PND, particularly if you are pregnant and/or think you may have it, or be prone to PND (i.e have a history of mental health issues).


Personally I don't have much faith in the 'Edinburgh PND scale'. Its usefulness is severely limited - research suggests that it fails to pick up many women who suffer badly - and its effectiveness is largely dependent on the skill of the person using it.

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