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HEALTH / Jul ‘2016

Tears and fears

Mother Suffering From Post Natal Depression
HEALTH / JUL ‘2016

Tears and fears

Expert in the field, Professor Marie-Paule Austin discusses why post natal depression is such a debilitating illness which affects a large number of new mothers.

Words PROFESSOR MARIE-PAULE AUSTIN

Most new mothers sing the same song. You know the words. It goes, “I had no idea how hard it would be. I’m too tired to even make a cup of tea.” Repeat.
Everyone struggles to keep their head above water. But what do you do if you feel like you’re sinking? Professor Marie-Paule Austin is working as a lifesaver for women who are in danger of going under. She’s the Chair of Perinatal Mental Health at the University of New South Wales and runs the Mother and Baby Unit at St John of God Health Care in Burwood — and she is there for you.
In 2012, a Victorian woman suffering from postnatal depression killed one of her infant twin daughters and left the other brain-damaged. It is Marie-Paule’s mission to support women through their darkest hours so that they never feel pushed to such desperate, tragic acts.
Depressed women have a real handicap in the daily business of being a mum.
“Depression affects our motivation, our ability to think clearly, to make decisions, and to organise ourselves,” says Marie-Paule. “It reduces energy levels, can impact on sleep and appetite, and is often associated with increased anxiety. It can include low self esteem, a sense of hopelessness, and thoughts that life’s not worth living. All of those symptoms put together mean that if somebody suffers with a significant depressive episode, their ability to function day-to-day will be significantly impacted.”

Professor Marie-Paule Austin

“If the mother is isolated and there's no one else to take over for a while, then that child is more at risk of what we call insecure attachment patterns.”

Caring for baby
“Depressed women have difficulty maintaining a routine with the baby. We’ve seen mums who just can’t remember when they last fed the baby or if they put enough spoonfuls in the formula. So in that sense the mother is not able to tend as well in a practical way to the baby.”

Bonding with baby
“What we find in most cases is that, even if a mother is able to provide the practical, day-to-day stuff — like feeding at regular intervals, settling the baby and so forth — she’ll more likely be affected in her ability to emotionally care for the baby.
“If she’s totally preoccupied with very negative thought patterns, she can’t be in the moment, picking up Baby’s cues. Babies are very communicative, right from the start. They don’t have verbal skills, but they’re doing all sorts of things to catch Mum’s attention and begin that lovely emotional bonding relationship that they need to develop with their primary carer.
“If Mum’s not able to attend to the much more subtle stuff, then the baby will, over time, learn not to expect that from Mum and will start to look for that from other key caregivers. That’s if the mother’s lucky enough to have one of her parents or in-laws or a partner who can give Baby that emotional input. But these days it’s very often the mother at home on her own with the baby. It’s very isolating. And that will impact on the gradual process of bonding and attachment that develops in the first year or two of the child’s life.”

Mother Suffering From Post Natal Depression

“If she's totally preoccupied with very negative thought patterns, she can't be in the moment, picking up Baby's cues.”

Baby’s future mental health
“If the mother is isolated and there’s no one else to take over for a while, then that child is more at risk of what we call insecure attachment patterns. In the more vulnerable, less resilient offspring, that may translate into an increased risk for their own mental health in future, and their own capacity to engage in meaningful, committed relationships. So depression can definitely have a trans-generational impact.”

Do you need help or a good zzzz?
Most of us will cheerfully admit that our beloved babies drive us crazy from time to time. So how do we differentiate between serious depression and just feeling overtired and stressed out?
Marie-Paule says, “Even clinicians don’t always know the first time, because sleep deprivation can send some people literally crazy. If you sleep-deprive someone and isolate them, in some cases they can become psychotic.
“Sleep-deprivation is inevitable with a newborn, even in the best circumstances. So we admit the mother and the baby to a Mother–Baby Unit, such as the one we have here in Sydney. We give Mum a period of time where she can catch up on sleep. Sometimes that’s all she needs.
“If we’re concerned about depression, what you’re looking for are some key features, like a sense of not being able to enjoy anything. So, even if someone got a good enough sleep and you’d think they’d have a bit more energy to enjoy things, they don’t. They can’t see any point; they can’t see any future. If there’s no sense of hope, no capacity to enjoy any aspect of their life, then we’re much more likely to think that this could be an episode of depression rather than sleep deprivation or anxiety with a new or unsettled baby.

“If she's totally preoccupied with very negative thought patterns, she can't be in the moment, picking up Baby's cues.”

“At the Mother–Baby Unit, about 30 to 40 percent of the babies we see are actually quite unsettled. So we help with the routine, those mother-craft skills that many first-time mums lack — settling and feeding, things that create high levels of anxiety.
“We take pregnant and postnatal mums, with their babies up to one year of age, from across the whole Eastern States. Anyone who thinks that they or a relative might need help can ring St John of God Burwood Hospital on 02 9715 9200 for advice.”

Chair of Perinatal Mental Health at the University of New South Wales and runs the Mother and Baby Unit at St John of God Health Care in Burwood.

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