Perinatal mood disorders (antenatal and postnatal depression and/or anxiety) are common conditions. One in seven mums and one in ten dads experience depression in the first two years after having a baby. One in 10 women experience depression during pregnancy. [In this article I have written describing the experiences of mothers but the content applies equally to fathers as well.]
What does postnatal depression look like? If you do a google image search for “depressed mum” the images you get are of forlorn looking women in fluffy robes with loose ponytails. They hold their babies and their foreheads and stare into the distance. Passive, pensive, quiet, a tear gently rolling down her face. THIS is what a depressed mum looks like.
But for the women I see in front of me, postnatal depression can sometimes be a different beast. I use the word beast on purpose, because for many mums that is how they feel: like a wild animal.
One common but not often talked about symptom of perinatal mood disorders is rage. An intense feeling of anger that feels like a volcano – one that erupts frequently and erratically. Women describe their experience of rage to me as: all consuming, instant, explosive rage, terrifying, usually out of the blue and extremely hard to handle. It can tend to come up when they feel they have nowhere to turn, and is often fuelled by exhaustion, feeling out of control, and an inability to soothe a screaming small person. Inadequacy is also a factor here – why can’t I give my baby what s/he needs? Why can’t I stop the crying? Why can’t I cope with the crying?
Admitting to these feelings and experiences can be very difficult to do. Especially when we are surrounded by images of what mums, dads and families “should be”. We live in a society where it is okay to be sad. But not angry. Not out of control. Not like this. Women experience feelings of shame and guilt for the anger and rage. Enter guilt. Massive, all consuming guilt. Their thinking becomes completely black and white, they can’t see a way out. Words like ‘always’ and ‘never’ feature a lot eg I’m always like this, things are never going to get any better.
Often times it isn’t the baby who bears the brunt of the mother’s rage. It might be that she has no patience for her toddler and is finding herself snapping and yelling or otherwise not parenting the way she wants to be. Or perhaps her great relationship with her partner feels like it is crumbling as small incidents escalate and she finds herself lashing out in a way that was previously unimaginable. This can be exacerbated by a partner who is struggling to understand the extent of the anger, where it is coming from, and how to deal with it. Some women also admit to finding the rage so overwhelming that they may resort to self-harming as a way of releasing these big feelings.
Where does this anger come from?
Many of us have heard people talk about “flight or fight” response. We have a part of our brain, our sympathetic nervous system, which is hard-wired to keep us safe. This part kicks into gear when there is a real or perceived threat. It ramps up our heart rate, breathing rate and tenses muscles to get us ready to jump — called our “fight-or-flight” response. The focus suddenly switches from thinking calmly (being rational) to a purely physical reaction. This part of your mind is basically shouting, “DEFEND yourself!” The rage is the “fight” part of this system.
The challenges of caring for a new baby can mean that for some new parents, this part of the brain – our alarm system – gets dialled up and our “flight or fight” reaction becomes hypersensitive. When added to hormonal changes, broken sleep or an unsettled baby, it can create the perfect storm.
But there are strategies that can help. A part of the rage cycle is that it feeds on guilt and shame, so finding someone who you feel safe to explore these feelings with is central to getting help. A psychologist can also help you to develop strategies to help turn down that dial on your sympathetic nervous system. Below is one example of an exercise that can be used to help when you are feeling overwhelmed by your emotions.
Recognise & Allow Emotion:
Aha! I’m feeling…[angry/sad/scared]. It is OK, I can allow myself to have this feeling…I can make space for it.
I don’t have to be afraid of this feeling or try to get rid of it.
I can just watch this feeling and see what it does, I don’t have to get caught up in it.
Let’s see, where do I notice the emotion in my body?
This is just an emotion, a feeling to be felt, nothing more and nothing less.
I am not my emotions, I am the watcher of my emotions.
Use imagery to gain distance from the emotion [This feeling is just like an ocean wave… I don’t need to fight the wave frantically…I can just go with the wave, letting it bob me up and down, or riding it into shore.]
I will turn my attention back to the task I am doing now …noticing what I can feel…hear… see… smell… taste…
I will turn my attention towards my breath…the breath being my anchor to the present moment…noticing each breath in and each breath out
Deal with Emotional Comebacks:
I feel the emotion returning…that’s OK, that’s what emotions do, they like to rear their head again. I will just go back to watching it again…it is just another [ocean wave]…
The transition to parenthood is a time of great change. It’s normal to feel emotional or overwhelmed from time to time, but some people develop a more pronounced anxiety or lower mood (depression) which affects their daily functioning. There are treatments, supports and services available to help you through this experience. If symptoms last for more than two weeks, it’s time to seek support.
The signs and symptoms of antenatal anxiety and depression can vary and may include:
- Panic attacks (a racing heart, palpitations, shortness of breath, shaking or feeling physically ‘detached’ from your surroundings)
- Persistent, generalised worry, often focused on fears for the health
- The development of obsessive or compulsive behaviours
- Abrupt mood swings
- Feeling constantly sad, low, or crying for no obvious reason
- Being nervous, ‘on edge’, or panicky
- Feeling constantly tired and lacking energy
- Having little or no interest in all the normal things that bring joy (like time with friends, exercise, eating, or sharing partner time)
- Sleeping too much or not sleeping very well at all
- Sleep problems unrelated to the baby’s needs
- Losing interest in sex or intimacy
- Withdrawing from friends and family
- Being easily annoyed or irritate
- Extreme lethargy: a feeling of being physically or emotionally overwhelmed and unable to cope with the demands of chores and looking after baby
- Fear of being alone with baby
- Intrusive thoughts of harm to yourself or baby
- Finding it difficult to focus, concentrate or remember (people with depression often describe this as a ‘brain fog’)
- Engaging in more risk taking behaviour (e.g., alcohol or drug use)
- Having thoughts of death or suicide
If this sounds like you, I would encourage you to make an appointment with your health care provider and reach out for some support. I see women (and their families) in private practice in Brisbane, and you can find out how to make an appointment via my “contact” page.