On post-natal depression

When I read “We need to talk about Kevin,” I didn’t read it thinking that it was about a mother with PND. But the movie reviews are describing it as such. And I wonder, as someone who was diagnosed with PND in week 2 of her baby’s life, is that a fair assumption?

If you haven’t read “We need to talk about Kevin” by Lionel Shriver, and you have not been recently diagnosed with PND, then I would definitely recommend it. It is a truly remarkable book and stays with your for years. I read it, gosh, probably six years ago now, and still sometimes think about it and wonder about the questions the book poses. In brief (and I won’t do a spoiler so you can read on), it is about a woman who is married and gets pregnant with her first child. Throughout the pregnancy she is ambivalent about the baby, and once she has her baby boy, this doesn’t change. She never really likes the baby but does what mothers are “supposed” to do in terms of taking care of it. She is not like this with her second child – there she is like the books say mothers are supposed to react. Anyhow, the book looks at the role of the mother in her son’s subsequent actions. The old, familiar nightmare of how much can you blame the mother for?

Looking back, I can see why the lead character is described by the movie reviewers as a PND-sufferer. After all, she is not happy about having a child, the way you are “supposed” to be. And she doesn’t fall in love with the child after it is born, the way you are “supposed” to do. She is that Freudian archetype of the unloving mother, and surely she can therefore be held to account for her child’s personality flaws.

I would just want to question whether this is necessarily a portrait of someone with PND, or if it is someone who simply does not have to usual reactions to her child? And not being able to admit to that, things only get worse. Does a mother’s reaction to her child have to be medicalised, or can it simply be another state of being which that mother will need to work out as she is, ultimately, now responsible for another human?

I can speak from my own experience only. I have PND. I have a mood disorder which has required treatment in the wake of giving birth. The root causes of PND are largely believed to be sleep deprivation and reaction to the hormonal swings and roundabouts of motherhood. There are also risk factors, such as having a C-section – major surgery can trigger depression, as depression, in evolutionary terms is a state where the human is encouraged to lie low, the conditions outside the cave not being conducive to hunting, gathering or any other activity. Other risk factors include: social isolation; life stresses such as financial stress or moving house; a history of past episodes of depression or anxiety; a perfectionist personality; and a difficult relationship with one’s own mother, which comes up when becoming one. So: tick, tick, tick, tick and tick for me ;-).

I have received absolutely stellar support from my husband, Yen, and my friends, both near and far, and I want to thank them for that. I have also received the best treatment I have ever had for depression or anxiety from Marg Booker at the Tresillian Family Centre. I have been part of a PND therapy group, whose other members are naturally anonymous, but who have been an incredible support in normalising our current journey, and sharing it.

As Marg said, “You have PND. It’s like travelling in India – some parts of it are really, really yucky. But it’s part of the journey, and that’s not even a bad thing. It just is what it is.” And having spent three months in India, about 10 % of that with some form or other of gastro, I knew what she meant.

The rate of PND is high – something like 1 in 8 women will experience it, and 2 out of 5 of their partners. The rate is much higher if you narrow it down to the highly educated band of women.

There is no shame in being treated for PND. But similarly, there should have been no shame in the mother character’s response to her child in “We need to talk about Kevin.” Whether she had PND is moot. But if she did not, it was shame – shame of her lack of feeling towards her son – that stopped her from reaching out and working through it, and developing, by sheer intelligence and will if necessary, the ability to love and connect with her son. And if she did have PND, it was also shame that prevented her from seeking treatment. No mother should ever be ashamed of who they are.

If you are interested in finding out more about PND or want some help, you can visit PANDA or call 1300 726 306 as a starting point, or Beyond Blue. I went to my GP. Also, the early childhood centre midwife who visited my in the second week (first week home) referred me to the Tresillian, which is an incredible resource if you are in NSW. There is also the mental health hotline on 13 11 14, and if you are concerned for yours or your baby’s safety then go to the local hospital and get yourself admitted pronto. You can be helped – right now, you need to know, even if you can’t feel it right now, hope is possible.

On boobs

Maternity bras are the pits. You suddenly have these ridiculously large boobs, and have to ensconce them in flimsy things that couldn’t hold a pair of empty seashells in place. Some are better than others, and various people have recommended websites to me selling “pretty” ones. But try going for a strenuous walk (ie above 2 km an hour) in one of those and tell me how your back feels thereafter.

It’s truly weird, having such big boobs all of a sudden. You get used to your own profile over the course of a couple of adult decades. As you start to shed some of the baby weight, you think, hey, I might be able to fit one of my old tops. And so you try it on. And it no longer reaches your waist, and you have to look away from the mirror because all you can see there is someone else’s chest wearing your once petite clothing. And you didn’t even know it was petite at the time. Ah, all those years when you could have thought of yourself as waif-like, wasted on thinking that you need to lose a pound or two. If only you had known then what you know now, staring at your reflection only out of the corner of your eye in the hope that that will somehow minimise what you see there.

Not that there is anything wrong with big boobs. Lots of people actually undertake surgery to attain what breastfeeding women curse and cajole into button-down shirts or specially designed t-shirts with discreet flappage every day. It’s just that, when you are not used to them, and then suddenly THERE THEY ARE, it’s hard to know what, exactly, to do with them. How do you dress them appropriately? How do you take them out for daytime walks? How do you get them to sleep comfortably at night? It’s like suddenly being lumped (no pun intended) with two household pets, but with no friendly RSPCA to donate them to if things don’t work out.

The other thing about breastfeeding boobs is that they change size during the day and night. No one really tells you that. So your bra straps are constantly getting looser or tighter, doing that annoying sliding down your arm thingie which just gives you shoulder strain from sub-consciously trying to keep the strap up. Now there’s one they don’t talk about in post-natal Pilates.

I was never into showing cleavage in the past, mostly because I never really had any to speak of. Now, I show cleavage without effort or intention, and I am not sure I like it. At least it distracts from the baby weight I am still carrying everywhere else – everything is in Reubenesque proportion except for my height. I am like a short, K-Mart-dressed Eurasian version of those erstwhile lovelies.

For now, I have to resign myself to my “voluptuousness” (I do love a good euphemism). On the plus side (again, no pun intended), I can blame any splotches on my tops on the baby rather than my own, uncoordinated eating efforts. And I can train myself to look in the mirror for short bursts. It’s not as if a person stays the same forever anyway. Who knows. When my boobs return to their former size, I might even miss their company. Although seeing my feet again will probably make up for it.

Shoulding on yourself

I once heard a Vietnamese Buddhist monk say, “Always saying ‘I should, I should’ – that’s just shoulding on yourself! Hahahahahahahahah!”

I love how those Buddhist monks laugh.

I have been worrying about how my baby sleeps, especially during the day, but also how long it takes her to settle at night. (I am always worrying – apparently I have stress levels set at a fairly high threshold, so worry is what I do – what a great look-out I would have been for my tribe, 100,000 years ago!) Anyway, something occurred to me last night. The days when I don’t stress about it too much – when I don’t beat myself up for picking her up and cuddling her for one (or more) of her naps – are the days I feel less exhausted, no matter whether I got more than four hours sleep the night before. Stress and worry are tiring.

The other thing I realised was that, like most things I do, I am probably doing this pretty well. By “this,” I mean the whole, mothering, taking care of the baby thing. I tend to stress and worry about work or other activities, only to find later (sometimes years later) that I actually did better than I thought. It has taken me some time to realise that I am actually quite conscientious, even when I am slacking off. So then naturally, I worry that if I stop worrying, I will no longer do things so well :-).

I don’t want to “should” on my baby. Probably more important to model non-shoulding behaviour than to worry about perfecting feeds, sleeps and whatever else. It’s all going to change anyway (another Buddhist-ism. Hahahahahahahahahah!)

To cry or not to cry

That is the question that all mothers ask themselves probably 82 times a day. Do you leave your baby to cry at some point, or don’t you?

Ellie is now 12 weeks old, and we are starting to wonder if now she might be ready for a bit of tough love. According to “Sleepy Sense,” we should be training her to send herself to sleep, and anything else is a disservice to our baby. This is not to say, dump her in her room and let her “cry it out;” but it may entail some crying, and what I want to know is, how much, and how old do you start?

In “Baby on Board,” a big point is made of the role of carers in the babies’ brain development. The author, a neonatologist, explains that current research shows that a person’s self-esteem and ability to form loving relationships basically comes down to how you treat them in the first 18 months of their life. No pressure, so. That said, the author does say you should get your baby into good sleeping habits before they are 5-6 months old, when they can start learning how to “manipulate” you to get what they want.

So what to DO? Is 12 weeks too young to start sleep training, by which I mean, trying to settle and re-settle in the cot, and leaving to cry for say, 10 minutes before responding – and still trying to leave in the cot when responding? Or is this going to damage my baby irrevocably so she becomes one of the toddlers in the child attachment experiments who seems to not care at all when muma leaves the room, or who clings to muma desperately, not believing that she will come back once gone. Or am I going to instead train her to not be able to sleep without my assistance if I continue as I am doing, thereby doing some other sort of damage?

(I should point out at this stage that it’s naps that I am finding it hard to settle Ellie for, during the day. She normally naps pretty well in the mornings, but in the afternoons she may sleep for a cycle or worse, the dreaded half cycle, and generally refuse to sleep for another one….sometimes I end up rocking her and holding her for her nap, just to avoid her getting too overtired….And at night she is still “colicky,” by which I mean she needs to be rocked or held for anywhere up to 8 hours before she will finally crash out. But once she does crash out, she has just started to sleep for at least 5 hours – once, she slept for 8! she had a cold – but still! – which is pretty acceptable to me as a human in need of sleep). When do we stop giving her the benefit of the colicky doubt and start to treat these afternoon/evenings as periods for determined sleep training on our part?

And what constitutes crying exactly, anyway? For example, do you start counting ten minutes from when she starts grizzling, even if there are pauses between grizzles? Or do you say you have left her to cry for ten minutes only when she really starts screaming consistently, as in, no-holds-barred, see how long I can sustain this note opera training? And if grizzling counts and I have left her for twenty minutes and then she starts to properly cry, does that mean that all this time, I have already been doing irreparable damage to my baby’s brain and she is going to be a crank who spits bile at waitresses about her babycino?

Ah sigh. Yen and I have agreed to err on the side of caution and still pick her up and respond if she starts to seriously cry. We want her self-esteem in tact and her cortisol levels regulated, more than we want her in good sleep habits. That said, I think she is generally doing pretty well – just making my days rather stressful, but hey, my cortisol responses are already set in stone. And in the evenings I do gratefully lie down, letting Yen do the hard yards of rocking and comforting until I think it must be time to feed her again – as one wise woman said, let the baby wear out one parent at a time. And with some trepidation but also, I think, remarkable foresight for someone with perennial exhaustion, I have booked us into baby boot camp for when she is four months and one week old. Because I may be a soft touch, but those midwives sure aren’t.

On chocolate

Can I just say that I love chocolate? It can be your best friend and your worst enemy – too little and you just want more, too much and you turn into a madly typing demon woman, but just the right amount and you are sanguine, busy, with energy but still able to concentrate, awake enough to take care of your baby but not so awake that you won’t sleep when you finally get the opportunity.

At the moment I am off dairy, as we suspect bubba had a reaction to it in my breastmilk, so I am getting all my chocolatey requirements from gluten and dairy free Macro biscuits, which are essentially the GF equivalent of Tim Tams. Mmm, I hear you say ;-). But really, they are quite good, and on a suddenly rainy Sunday afternoon, the sky darkening, the baby napping, the husband reading and the Gilmore Girls providing a happy patter in the background, sitting with two chocolate biscuits, a reliable baby monitor and a mug of decaffeinated tea, I am a happy little dairy-and-gluten-free vegemite (well, vege-spread, but let’s not get too technical about it).

On time out

I think I need time out tomorrow morning. It’s a terrible thing, because I feel intensely guilty for not wanting to spend every moment with my baby (I could write a book about mother’s guilt and I have only three months to draw from. Imagine the series in twenty years time! I could beat Robert Jordan). But I do think she gets tired of me too – by the end of the day she welcomes her father home with the glee only reserved for the exceptional.

A friend once described it like this: “I am my baby’s water – constantly flowing and always there. But his father is my baby’s sunshine, and just lights up his day.”

So I have asked for an hour of time out for myself tomorrow morning and my husband has readily agreed, even though he has a nasty head cold at the moment. A happy mother means a happy family, so the saying goes, and probably for a reason.

I have been a bit worried (cos that’s what I do), that I have been getting tired of my baby more and more often. Last night, I had to lie down for half an hour even though she wasn’t really settled, because I was just, so, tired. My husband offered to take over and I only resisted for a minute. She had worn me down.

A few nights previously (I think – my sense of time is shot through with diamonds of moments, like a bridal hairnet – dazzling but barely there) I had had to give her to Yen as well.

“Thank you,” I said as I passed her over. “I was contemplating defenestration.”

“You were going to take away all of Ellie’s assets?” Yen asked.

“No. I was going to throw her out the window.”

“Oh,” he said. ” I always get that word confused.”

Not that I would actually throw my baby out of the window (you can put away the DOCS hotline number). But sometimes, you just need a break.

I think I am going to schedule a regular weekend time out session. If it is in the schedule, I might feel less guilty about taking it and about wanting it. And I can look at it as important bonding time for Yen and Ellie, which it no doubt is. Then, when I come back to my husband and baby, refreshed by an hour free of my responsibilities, I will look at them both with the gratitude they deserve, rather than the weariness that I feel.

On child care

I am filling out an application form to be placed on a waiting list for child care. My baby is now 11 weeks and 2 days old, and it is hard to imagine leaving her anywhere away from me. But the reality is, if you don’t get your baby on a waiting list, you might miss out.

This did not occur to me before. But at mothers group, one mother detailed her tale of registering her baby at child care centres. She is going back to work in August 2012, and already the waiting lists have literally more than 300 names on them. 300! And that is a common story.

I squirmed about it for about a week and a half after hearing that. My logical brain knew that eventually I too would be going back to work, possibly as soon as April or June next year. But my arms, holding my baby, and my cheek, absorbing warmth from her recently sleeping skin, and my eyes, taking in the profile of her eyelashes and her big brown eyes – my most common view of my baby as I hold her over my shoulder, safe, while she takes in the world – all rebelled at the idea of it.

But alas, reality has prevailed. I am filling out the first of what will probably be more than several applications, in the hope that someone will look after my baby heartfully, mindfully, playfully, carefully – while I enjoy the freedom of returning to work and the eternal wrench in the gut that all mothers must know.

On mothers group

I went to my mothers group yesterday. It was our first solo flight – after the first five meetings at the early childhood centre, it is up to the group to sort itself out.

We met at a really big club, the type where members sign everyone else in. I normally avoid places like it on the grounds that I assume the type of people who go to clubs aren’t going to like the type of people who are like me. Of course when I think this, I am thinking of myself still as a teenager with braces I was paying for myself, purposely emphasising how unmainstream I was before the cool girls could do it for me.

I didn’t want to go to mothers group for similar reasons. They were all prettier than me, looking like they had lost all their pregnancy weight within minutes of looking at their newborn babies. Some looked better 10 weeks after giving birth than I did on my wedding day, with that knack for make up and hair which I have never mastered, partly through lack of practice and partly through defiance to mask my lack of practice.

But I had been told by a wise woman to treat the mothers group as your ” tribe.” “You don’t have to become best friends with the other women, judt think of it as meeting the other women at the well, exchanging information.”. So along I went, baby in tow, my ticket to belonging.

And it was….OK. We sat and chatted. Turns out that those other mums have no idea what they are doing either. One woman laughed, “Do you put your dishes back like this?” Pretending to put the plate away as quietly as possible. And we do that too! The woman was tall and pretty and wearing a size shorts I fit when I was 12. But it turned out we had more in common than I thought.