There’s More to Postnatal Mental Illness than Tears
*Refers to mental health*
*Some reference to high risk pregnancy and poorly baby*
When I first scheduled to write this post, I had a good idea what I wanted to say. But as I got down to planning the details, I realised just how complicated mental health can be; Like a giant spider web, there seems to be bits that connect and branch off, and are all just a little bit tangled up. I would guess I am not the only one who has found this when I begin to dig a little deeper. So I will try to keep the discussion to postnatal mental illness, but I am slowly beginning to realise as I write this post that my mental struggles are in some way influenced by each other - postnatal mental illness, chronic low self-esteem, obsessive compulsive disorder, anxiety… everything links in one way or another and it is quite a challenge to isolate just one and speak exclusively about that.
MY PERCEPTION OF POSTNATAL MENTAL ILLNESS BEFORE BABIES
I remember as a child watching the soap opera story lines about PND. I’m sure some of you saw them too. Everything is exciting, the baby is on its way and then the newborn is passed up to its mother and *BAM*, it starts. The new mum feels nothing, their face is blank as they look at their baby, maybe even turning away as the little one is laid in the cot next to them. Alternatively, there were the strong, bubbly females who had a baby and suddenly became very tearful, lost and overwhelmed by motherhood and the loss of their old identity. It always seemed to be a shock. Completely out of the blue and out of character, and I’m sure for many ladies that is exactly how it felt. This was the image I feared during my first pregnancy and when my son, J, was handed to me, I sat staring as his cute, wrinkled, little face feeling a sense of relief that I did feel love for him. I think I almost convinced myself in that moment that I couldn’t have any issues with PND because I didn’t immediately feel low, and I don’t think I really accepted that postnatal mental illness was, and is, a struggle for me until two babies later.
STARTING WITH BABY NUMBER ONE
As I discussed last month, breastfeeding was a major factor for me in the beginning with J, so I won’t go into those details again, but in truth, I wonder now in reflection whether I was always going to struggle even if I had been able to breastfeed.
See, I’ve always been a little bit of a perfectionist, and I had learnt many coping methods from a young age that helped me to feel in control and safe. I learned to plan, organise, study and lead where possible in order to make sure things met the expectation and to receive positive feedback. I needed the A grades, the awards, the outstanding observations. Anything less meant there was an improvement that could be made, a disappointment, a failure somewhere. And I think I approached becoming a mummy in exactly the same way. I studied. I read all the leaflets, the baby books and the websites. I had fixed schedules in my mind, an idea of how to encourage a baby to nap, and ways to ensure you are teaching them to sleep through the night. There was already an expectation on what parenting should look like weeks before J was born. The reading also created quite a bit of anxiety about safety. I found myself reading about BPA in plastics and the need to sterilise perfectly, and subsequently, things that I had never even considered a risk to my baby, suddenly worried the life out of me. Moreover, it also sparked the thoughts that if these things were dangerous for my baby without me knowing, what else could be? This was all prior to my breastfeeding difficulties, and I guess when we examine it like that, it’s easy to see how my mental health would be impacted. To another mama, I know this would not have had the same effect, nowhere near. It probably wouldn’t have bothered them at all, but for me, the responsibility of looking after my baby felt so much bigger and overwhelming.
And then along came J, and suddenly I found myself in the thick of newborn motherhood with all the theory of how it should work, but in reality, it wasn’t going that way at all. I couldn’t understand what I was doing wrong. Of course, logically I know that babies are not robots, and just because the baby book says they should go to sleep when you sit gently tapping their hip in a heartbeat rhythm, doesn’t mean they all will. But anxiety doesn’t work on logic and rather than accepting that it wasn’t working for us, I took it personally. I was failing to live up to the expectation. I became rigid about feeding and sleeping schedules. And when he didn’t want to sleep, or woke up after half an hour, the frustration was overwhelming. ‘Why does he need rocking off when I followed the book’s routine exactly?’ In addition, the noise of the crying became too much in those moments. It seemed to grow louder and engulf me to the point where I couldn’t think straight, and I found myself feeling angry with both him and myself. Which as you can imagine, sparked a world of shame. I’ve since learnt that anger when a baby cries is not unusual for someone with a highly sensitive personality, but it doesn’t make it any easier to accept. I remember standing at the bottom of the stairs, screaming ‘Why can’t you just sleep? What am I doing wrong?’ I couldn’t understand where this anger had come from. I didn’t want to be an angry mum. It went against my values and yet in those moments, it was like an eruption of frustration and shame. There were also anxious predictions forming anytime we approached the time for sleep. I would start overthinking the idea that he wouldn’t sleep, and how I would feel when this happened, which of course meant by the time sleep time arrived, I was already feeling wound up and anxious.
There was also a sense that if my baby was crying for any reason, that meant he was unhappy and therefore I was a bad mum. I’d always imagined that a naturally good mum’s baby would rarely cry. That she would pick him up and he would instantly be soothed by his mother’s presence, and every time this didn’t happen, I was faced with a huge sense of failure once again. I couldn’t work out what I was missing. I was scared to cuddle him too much in case it was ‘making a rod for my own back’, and worried that if I kept picking him up, it would cause confusion for him. And the whole time, I bullied myself for not being able to soothe my baby the way a mum should be able to do instantly. And of course, as he got older, other behaviours would trigger the same emotions. The grabbing things he couldn’t have constantly, the need for consistent connection, the wrestling to get away during nappy changes… all of these moments created the same angry response… ‘What am I doing wrong? He needs to listen to me! What kind of mum can’t get her baby to lay still for a nappy change?’ These were all going through my head in those moments, and I often found it all overwhelming. I felt trapped and desperately wanted to escape. I wanted to just catch my breath and feel like myself again away from the responsibility and the sense of failure.
As I am writing this, it is quite clear that I was struggling with postnatal anxiety, but at the time I had no idea that postnatal anxiety involved the obsessions with routine or the rage. I just kept telling myself all of those feelings were because I was getting it wrong and I was just no good at being a mother. For that reason, I also didn’t want to reach out for support because I was ashamed of the mum I was. In hindsight, these feelings of failure were not new. I had built coping methods to avoid those feelings for years, but this was different. There’s no grades or feedback in parenting, and I had convinced myself that I was failing miserably, a feeling that has never really left me if I’m brutally honest.
BABY NUMBER TWO
My second baby was a completely different experience. C was born very poorly and spent a number of weeks in the neonatal. At this time, I was balancing the hospital with my sixteen-month old at home and recovering from a c-section. Interestingly though, at home, I found myself feeling more level this time and balanced. I understood that my son was upset with me for disappearing into the hospital suddenly and I found comments from some members of staff about my parenting boosted my confidence. But there were also signs of what was to come. I felt scared to care for my baby, worried that I would mess it up in some way and make the situation worse. I remember a nurse commenting that I was supposed to be calmer with my second, but I didn’t feel that way at all. If anything I felt much worse. Suddenly I had a baby that needed medication and I was fully responsible for her health. There were infections to look out for, hospital visits to prepare for and all of this in addition to the usual newborn challenges, alongside a toddler. And in the weeks after C came home, the anxiety increased and the rage began to rise again. I found myself gritting my teeth in those moments of frustration and yelling much more that I would have ever imagined with such young children. For me, the negative feelings were not towards my baby but towards the older sibling. It's horrible to think about it now because he was so little, but at the time, I expected so much more from him than was fair because I felt so overwhelmed. ‘Why has he thrown his food on the floor? Why can’t he just eat his food? Why is he crying again? What does he want now?’ Logically I know this behaviour is to be expected when a younger sibling is born, but it all felt like yet more evidence that I wasn’t doing enough, I wasn’t good enough as a mum and I was failing. And again the strict feeding and sleep schedules became a method to control the days, leading to frustration, anxiety and rage when things didn’t go to plan.
This time, I did receive some support because of my journey with C. I attended a PNI support group that was run by a charity and I also had a small number of CBT sessions where I was introduced to mindfulness and writing journals. Gradually, the rage reduced, although never really disappeared. I put all of those feelings down to my experience with C, alongside an unmet need for my own space and my inability to cope with all the challenges that motherhood brought with it. My OCD began to get worse around things that could make my children ill, from constantly washing my hands to worrying my cooking would give them food poisoning or obsessing that I would use cleaning fluids incorrectly. This caused me to begin avoiding everyday activities out of fear and by the time I fell pregnant with my third baby, I had referred myself for more CBT.
THE PENNY DROPPED WITH BABY THREE
With T, I thought I was doing really well. I felt more confident in those early days. The crying didn't seem to affect me in the same way, and I could manage my children’s needs and knew I was doing my best. Other aspects however, were clearly worse. I stopped sterilising the baby bottles all together out of fear that I would do it wrong and make her poorly. In fact, just removing them from the steriliser would create an overwhelming sense of panic that my hands were not perfectly clean and something bad would happen in the beginning. Powdered formula also felt too much of a challenge, too many things I could get wrong and until T was eight months old, we used the ready-made formula.
When T was around six months old, I noticed one day that I was clenching my teeth shut whilst trying to communicate with C, and it occurred to me that I had stopped doing that before T was born. This was the moment I realised that, whilst mental illness was not completely new for me, I was actually struggling much more postnatally.
And this time has been much worse. There have been days when I have felt unable to continue, unable to face another nappy or bath time debate, completely numb, whilst other days the rage is overwhelming. I don’t even recognise myself in those moments. There’s so much anger, it feels like an eruption and sometimes it can be over the smallest thing. Sometimes it's screaming, sometimes it's speaking in a way that I hate myself for yelling in front of my children. It goes against all of my values and everything I want to be as a mummy, and yet I feel unable to stop it. It’s like a build up of pressure and once it goes, the words just flow out. I can hear myself and I’m screaming at myself to stop, which of course only makes it worse. Then the tears arrive. Sometimes it's the pendulum swing between rage and tears, all of which are filled with the shame of allowing my children to witness it. Like a caged animal, I spend some days longing for a way to escape. And the shame of all of those feelings fuels the cycle day after day.
I am honest with my children about it all. I tell them that Mummy is just a little bit unwell and that it is not their choices that make Mummy shout or cry, it is the way that Mummy is feeling herself. I pray that they believe that until I can find a way to get better. Therapy is on the horizon again, and I need to hope that within time, it will get better and I will be ok with who I am enough that those little mummy fails don’t upset me so much.
MY UNDERSTANDING OF POSTNATAL MENTAL ILLNESS NOW
I can only speak about my experience but I understand now that postnatal mental illness doesn’t necessarily begin straight away and it doesn’t always mean you feel nothing for your baby. I have felt love for my babies from that very first moment each time and still I have struggled. In fact, I have noticed that my negative feelings tend to be towards the older children rather than my baby, which is just as upsetting when they need reassurance and love in those moments too. I have struggled within a few days and I have begun struggling months later. And for me, they are not new thoughts and feelings, but they are pre-existing thought patterns that are exaggerated massively postnatally, making it much harder to manage.
It does pass slowly. One day I will realise I am no longer gritting my teeth, or the rage is a little easier to control, but I also know that sometimes it doesn’t disappear completely.
And finally, I have accepted that asking for help does not make me a failing mum, just a struggling one.