Psychotherapy Counselling for Perinatal & Post Natal Depression
Perinatal & Postnatal Depression: Psychotherapy Counselling & Therapy in Central London
Please note the following terminology for Perinatal, Antenatal, Antepartum, Prenatal, Postnatal & Postpartum: A doctor, midwife or health worker might use any of these terms, as appropriate.
- “Perinatal” means the period immediately before & after child birth, though the perinatal period is defined variously but within the boundaries of starting in the 20th to 28th week of gestation and ending one to four weeks after birth. The broad medical view is that this term can be from about three months before to one month after birth
- “Antenatal”, “Antepartum” & “Prenatal” all refer to the period before birth.
- “Postnatal” or “Postpartum” is the period just after giving birth, after the delivery. Strictly in medical terminology “postpartum” refers to the mother, and “postnatal” refers to the baby – included in terms like “postnatal development”.
- “Postnatal depression” in commonplace terminology however, refers to the mother.
Baby Blues & Perinatal Depression
Pregnancy & childbirth can evoke difficult feelings for some mothers. It’s both a significant and happy event but the thrill and reward can also sit next to difficulties & stress. There are physical & emotional changes during pregnancy and after childbirth. Women can feel sad, tired (often from frequent night-time visits to the toilet) and fatigue, hunger or loss of appetite, anxious and can also have poor attachment to their baby.
In the initial stages of the antenatal period after the child birth, people often describe this as the “baby blues” – and it can affect up to 80% of new mothers. The symptoms (anxiety, feelings of being overwhelmed, frustration, mood changes, weeping, exhaustion & problematic sleeping) quite often resolve themselves and do not need treatment*. Doctors, midwives and health visitors are trained to understand if the feelings persist or become more severe (see below) and they should be able to spot when help may be needed. Actual “depression” may continue in between 10 & 20% of all new mothers. Postnatal depression can develop up to two years after the birth.
Sometimes symptoms persist or worsen – and these include the above as well as an increased number of other possible symptoms. These may include sadness or joylessness, emptiness, frequent crying, anxiety or concern about their mothering skills, feelings of guilt or inadequacy, inability to be comforted, reluctance to take care of oneself, irritability, lack of concentration and worries about both the new baby and what kind of mother they themselves will be. Sometimes fearfulness of the possible harm to the baby compounds these feelings. This is beyond the baby-blues and becomes postnatal depression. Having postnatal depression is a matter of concern for mother and baby’s wellbeing but it is a medical condition of which no-one should be ashamed.
It may be that if new mothers had experienced a difficult relationship with their own mother then anxiety around pregnancy can be quite acute. It may be that if they are someone who has experienced depression at other times in their life, pregnancy could trigger a further depressive spell. Postnatal depression, like any depressive episode can leave the suffering mother with feelings of despair and worthlessness. There are other social, relationship and psychological factors which impact on antenatal depression. Of course, new parenting stresses can contribute.
Levels of prenatal depression do correlate with postnatal depression. There are some studies which show the incidence of perinatal depression is mildy affected by race and social class but this is no consolation in any case, to the depressed parent.
Psychotherapy for Perinatal Depression
Engaging in therapy with a trained psychotherapist at this time can help mothers explore their feelings and develop a stronger sense of self and ensure a more fulfilling life as a new mother – in a confidential, safe and non-judgemental environment. Often discussing one’s feelings with a one of our three female therapist counsellors will offer insight and clarity and will help develop new strengths to cope.
Initially, women may feel reserved about talking about her symptoms with her health professional – they may be inhibited by denial, a sense of shame, fear – or it may be a lack of energy – but mothers should be encouraged to talk about their feelings and to seek help. Treatment may be psychotherapy or medication and this depends on the severity of the depression. In either case the earlier the treatment, the better the outcome is likely to be. Psychotherapy is widely believed to be more successful than medication though each woman may express her preferences.
In addition to psychotherapeutic help, additional support from other partner & community sources may well give a complementary benefit and vice versa. Good nutrition is also widely believed to complement any other treatment.
Perinatal depression can happen to anyone and no-one is a bad mother if they seek help**. In fact, it’s a sign of strength to seek help. Mother, baby and the wider family will benefit if mummy is feeling better.
Many of the above discussed symptoms occur before the birth, during pregnancy and any form of prenatal stress can have negative effects on mother and on foetal development. Depression is often caused by the stress and anxiety that pregnancy can so obviously bring – but other factors can increase the likelihood of antenatal depression such as an unplanned pregnancy, conception difficulties, any history of abuse, and social, employment, economic or family situations or responsibilities.
Medical and psychotherapy counselling is recommended for women suffering from antenatal depression.
Perinatal Depression in Men
Incidence of depression sometimes occurs with fathers too and has been measured between 1 & 18% of new fathers. The fact that fathers suffer puts into question that the depression is caused by hormones in either the mother or the father.
* There are a few tips to help the “baby-blues” including getting rest, eating well, getting help & support from friends, family &others, time for oneself, support groups & being realistic about how much one can sensibly do.
** Further Facts & Myths about perinatal depression – courtesy of Beyond the Blues website.
- Fact: Perinatal depression is a medical disorder. It doesn’t mean a woman wasn’t meant to be a mother or that she doesn’t want her baby
- Fact: Perinatal depression often goes undiagnosed because many women do not seek help as they may feel embarrassed or guilty about feeling sad at a time when they are supposed to feel happy
- Fact: Perinatal depression can happen to any woman
- Fact: Perinatal depression can be treated successfully
- Fact: Sometimes the reality of motherhood doesn’t match images portrayed in the media
- Fact: For many women, the early weeks and months of motherhood are very difficult
- Myth: Untreated perinatal depression will go away quickly and doesn’t affect a child’s development
- Myth: Pregnancy reduces the risk of depression in women
- Myth: Pregnancy is always “the most wonderful time in your life”
- Myth: Getting help for depression will result in your children being taken away from you.
- Myth: Giving birth, bonding and being a parent all come naturally
- Myth: Having perinatal depression means that a woman is weak or a bad mother
Miscarriage and abortion can lead to similar symptoms.
Please also see Depression Counselling & Psychotherapy