Feelings of guilt fuelled by anxiety

MY HEALTH EXPERIENCE:Days and nights were a blur of feeding and crying

BACK IN 2000, Derek and I were living in London. We had relocated to pursue challenging, interesting careers and had just bought our first home there, a bright and spacious apartment in the picturesque commuter belt town of Richmond-Upon-Thames.

Life was good and about to get better. We had been married for seven years at that stage and, although we both wanted children, we were only in our early 30s and felt no pressure. I was thrilled when I discovered that I was pregnant. I remember breaking the news to Derek one lovely summery evening in early May.

I was bursting with excitement as I swapped my customary glass of wine for water and shed tears of delight.

My pregnancy was very straightforward. I never once felt sick, just a little tired at times. Alex was due shortly after Christmas and finally, on January 23rd, two full weeks after my due date, I was brought into hospital to be induced.

The birth was a traumatic one. Progress was painfully slow and Alex got into difficulties during the birthing process with the result that we were rushed into an operating theatre, signing waivers between contractions, to have an emergency Caesarean section. All went well and our baby boy was born perfect.

The period I spent in hospital is a sleepless blur. I think I slept for a total of 45 minutes in three days. I had opted to breastfeed, but my lack of mobility, soreness, tiredness and inexperience made this very difficult.

I was soon supplementing with bottles and allowing myself to feel ridiculously and needlessly guilty.

Once I was discharged, my isolation from family and friends and my inexperience made life with a newborn very challenging. Alex was a beautiful baby but a demanding one. He cried for prolonged periods and refused to feed. He was eventually diagnosed as having acid reflux, a common condition where the oesophagus is underdeveloped and stomach acid is regurgitated, causing a burning sensation similar to bad heartburn and making feeding a very difficult process.

I lost sight of my lovely healthy baby and focused on his failure to gain weight. Days and nights were a blur of feeding and crying, feeding and crying. Derek was a wonderful support, but his job was demanding and I was alone for days on end. I began to suffer from extreme anxiety, a condition I had experienced before in my teenage years. I had violent, debilitating panic attacks and was convinced that I would lose consciousness and be unable to care for Alex.

Our marriage is very solid, but I was becoming increasingly difficult to live with, shrewish and tearful all the time. I was afraid to give voice to the terrible, selfish thought that by having this lovely baby I had ruined our lives. Overwhelming feelings of guilt fuelled my anxiety.

At this stage, I was so fretful that I could hardly sleep and stopped eating almost entirely. I lost three stone in as many months, looked dreadful and felt increasingly out of my depth. Acquaintances who I scarcely knew, girls from my antenatal classes who are now firm friends, opened their homes to me and I cried into endless plates of sandwiches and cups of tea.

My health visitor, Joyce, suspected postnatal depression, but I managed to pull myself together for her visits, afraid that I’d be labelled a failure otherwise. By not facing up to the situation, I made life so much harder.

Some days were better than others and Alex was doing well, but something had to give. Finally, when Alex was six months old and running a slight fever I took him to my GP. While I was there the floodgates opened and I bawled and bawled.

She immediately diagnosed postnatal depression and wrote me a prescription for antidepressants, warning me that they would take a couple of weeks to take effect and that my symptoms might initially worsen.

I phoned Derek who immediately took time off work. My mum arrived within days and stayed for three weeks. I couldn’t bear to be alone. The pills, though they eventually proved very effective, were making me so anxious that I was throwing up frequently.

I was persuaded to return to Dublin until things improved, but Derek knew as he watched the taxi head for Heathrow that I’d never come back.

I moved home and finally started to sleep. Mum was fantastic and took care of Alex every morning just to let me rest. Derek commuted and, within weeks, we had decided to move back permanently. I loved London but simply couldn’t turn my back on the support that I needed so badly. We sold up and he found a new job.

The medication got me back on an even keel and gave me a chance to recover.

What helped most was joining a support group run at that time by psychologist Ursula Brennan in conjunction with the National Maternity Hospital. Each week six new mums shared experiences and benefited from Ursula’s professional insight.

Hearing others echo my story was incredibly cathartic. Soon I was having more good days than bad and I started to slowly reduce my medication. Within 18 months I had made a complete recovery.

Three years later I was pregnant again and, given my history, was referred to Dr Anthony McCarthy in the National Maternity Hospital.

He explained that, although I am predisposed to anxiety, the trigger was most likely isolation and inexperience, and that I was unlikely to relapse.

I don’t do birth the easy way, however, and lovely little Ewan arrived into the world after 14 hours of frustratingly slow labour and yet another emergency Caesarean section that also resulted in a significant loss of blood.

Three days after he was born, Dr McCarthy arrived at my bedside and assured me that I was exhibiting no symptoms of PND. Like every mum I have my off days, but the depression never returned.

PND: What is it?

Postnatal depression is, as the name suggests, a period of clinical depression experienced by about 10 per cent of new mothers in the months following childbirth.

Symptoms generally emerge within two to eight weeks, but late onset is possible. Despite extensive and ongoing research, the precise cause has not been identified. However, trigger factors include one or more of the following: a traumatic event such as bereavement during pregnancy; a difficult birth; a predisposition to feelings of anxiety and depression; a major change in lifestyle (such as giving up a career for motherhood); and high expectations of parenthood.

PND: What are the symptoms?

ANXIETY AND DESPONDENCY

This is often exhibited as a fear of spending time alone with your baby. Sometimes negative feelings can be particularly acute at a specific time of day or night. Also, not every day is the same. It is helpful to keep a diary recording your feelings.

IRRITABILITY

Particularly directed at a partner or children. A sufferer can often see no possibility for enjoyment in life.

FATIGUE

A feeling of utter physical exhaustion.

SLEEPLESSNESS

Despite an overwhelming tiredness, sleep is frustratingly elusive.

LOSS OF APPETITE

Accompanied often by dramatic and unhealthy weight loss.

AN INABILITY TO COPE

Everyday tasks seem overwhelming. Yet perversely, a sufferer is often reluctant to seek support and help as this feeds guilt and a sense of failure.

SUPPORT: 

If you need support, the first person you should turn to for advice and help is your GP or public health nurse. If further intervention is required they can provide information.

Aware volunteers are specifically trained to deal with this form of depression. www.aware.ie or tel: 01-6617211.

Post Natal Depression Ireland is a support group that holds monthly meetings in Cork Maternity Hospital. www.pnd.ie or tel: 021-4923162.

The Parentline helpline is a good source of support and advice. www.parentline.ie or tel: 1890-927277.

Ursula Brennan at the Fairview Therapy Centre. www.fairviewtherapycentre.ie or tel: 01-8561289.

Dr Anthony McCarthy provides an out-patient clinic service in the National Maternity Hospital and holds a private clinic accessible with a GP’s letter of referral. Tel: 01-6373128 for an appointment.