Motherhood, mental illness and beyond

I read about a study this week that claims women who suffer from depression in pregnancy may pass the illness on to their children. The article in question on the mental health website Black Dog Tribe explains:

Researchers at the National University of Singapore asked 157 pregnant women to answer a questionnaire to ascertain their mental health during the 26th week of pregnancy. Within two weeks of birth their babies were given MRI scans to look at the structure of their brains – in particular the amygdala.
 
It was found that the mother’s level of depression had no effect on its volume. However, researchers found reduced ‘structural connectivity’, or abnormal wiring, in the right amygdala of infants of more depressed mothers. The finding suggests that abnormal amygdala function can be transmitted from mothers to babies before birth.
 
Researchers believe that a history of maternal depression might contribute to a tendency to the life-long increase in the vulnerability to mental illness in children.

Great. Wonderful. Women are already expected to exist in some weird sort of protective bubble while pregnant, constantly threatened with potentially disastrous outcomes for the unborn child if we even think about breaking the rules on eating, drinking, smoking, taking medication, exercising – the list seems endless. But now women must also worry that the state of their mental health may affect that of their child for life.

Don’t get me wrong, the research is interesting (although I would like to see a much larger and more thorough study examine the same question). If these conclusions are upheld then it becomes all the more important that mental health during pregnancy is monitored and the woman supported. But I worry about the impact that the publicity surrounding this study may have on women who are already struggling.

Post-natal depression (PND) is becoming much more prominent in the awareness of both the public and healthcare professionals. Although the media tend to sensationalise any news story where a mother is believed to have PND, it is becoming less stigmatised and pregnant women are usually given literature or at least a chat explaining the warning signs. Far less publicised though is its counterpart, ante-natal depression (AND).

I have suffered from both – PND twice and AND once. They were equally awful and traumatic but at least when I had PND I sort of knew what was going on. It was a “thing”, something I’d been warned about and that my husband had been on the lookout for given my history of depression. But I’d never heard of AND. When I plucked up the courage to tell my midwife how I was feeling it was dismissed as being down to my circumstances (an unexpected and difficult pregnancy, having a toddler, having to move twice in 4 months then claim benefits etc etc). A few weeks later a remarkably unsympathetic GP told me the same.

But I know now that it was AND. The sinking feeling every morning when I woke up still pregnant; the dread that I might miscarry warring with the dread that I might not; the certainty that I was ruining my daughter’s life. Instead of joy I felt disgust whenever the baby moved inside my expanding belly. I felt as though I was infested, occupied by an alien being, but I was rational enough to feel searing guilt as well. What kind of mother was I, to loathe my unborn child? True, the pregnancy was unexpected but we’d always planned to have another child at some point. I couldn’t understand why I felt the way I did but I knew it was wrong. At times I even felt suicidal but I didn’t act on those feelings because, ironically, I didn’t want harm to come to the baby.

Had I been told, back then, that I might be condemning my child to an increased risk of mental illness – well, it may well have tipped me over the edge. Studies like the one described above are necessary but when there is little or no support available for women who may have AND then they could be dangerous. I was so utterly ashamed of how I felt during that pregnancy that I barely spoke of it to anyone, especially after having my concerns summarily dismissed.

Why is PND becoming such a well-known illness but not AND? They’re two sides of the same coin, in my experience. The feelings of worthlessness, despair, shame, guilt and unrelenting misery are the same whichever side of the birth you are. Women and healthcare professionals need to be educated; they need to be taught that like PND, AND is a treatable illness and not a character flaw.

To any woman who’s reading this and is concerned that she may be suffering from ante-natal depression I say: you are not alone. You are not a bad person, nor are you or will you be a bad mother. Talk to someone about how you feel. Don’t be ashamed and certainly don’t worry about what one small study suggests. Far more research needs to be done in this area before the suggestion of a causal link even becomes a real possibility.

As for me, my son is now nearly 2 and is a happy, sunny little fellow. I try not to worry about what the future holds, mental health wise, for either him or his elder sister.

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Comments on: "Musings on depression and pregnancy" (1)

  1. I *wish* your blog article had been written (and I had read it) when I was pregnant.
    I had AND and PND and now have Depression.

    My pregnancy was planned, uncomplicated, ran exactly to the book (morning sickness from day one, first kick bang in 18 weeks and measured right every time). Amazingly, I remained a size 12 even at term and was only 1 week overdue when I went into a short, natural Labour. Had a natural birth and home the same day.

    But I didn’t have the confidence to speak up. I was ashamed I wanted to terminate my baby. I had no interest in baby things (shopping, appointments etc) Inside I was screaming that I was trapped. I loathed my bf, now husband, for inflicting the suffering on me. I cried the day I finished work to go on maternity leave and counted the minutes every day until he came home from work.

    Ruby will be 2 in a few weeks. Having been (privately) treated by a psych and therapist I’m still struggling, but getting there. Some days with my little girl are great, or at least fine. Others are still very hard.

    AND and PND should be explained in antenatal groups. They are as important to recognise and understand as breastfeeding and Labour, in my opinion.

    gxx

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