Have I Escaped Postnatal Depression Second Time Around? A ‘Fourth Trimester’ Update

Bea is nine weeks old tomorrow. It’s been a huge couple of months full of lots of highs and a few lows so I felt it was time to share my experience of the so-called “fourth trimester” as a mum who has previously suffered severe postnatal depression and anxiety.

Anyone unfamiliar with my story please feel free to take at look at the posts of this page, but to summarise Bea is my second baby; following the birth of my son in 2013 I suffered severe Postnatal Depression, Anxiety & OCD which took me a long time to recover from. Therefore the decision to have a second baby was not easy or something we took lightly.

Bea’s birth

Since my son’s birth played such a big part in my illness I was determined to have a different experience this time. Thankfully I did! And I’m so grateful as I believe it’s helped hugely with mine and Bea’s bond and my feelings about motherhood. Get the full story here. There will also be a future post all about birth & bonding.

postnatal depression - Laura & Bea after c-section

The worst moment so far

The most anxious I’ve felt since Bea was born is definitely the anxiety attack I had in hospital on the second night I was there. Triggered, as it so often is with me, by lack of sleep my feelings of overwhelm combined with the hormone crash from the previous day, plus extreme physical pain, led to a burst of anxiety symptoms that reminded me just how terrifying attacks can be.

I begged my husband to stay later at the hospital and told the midwives how I was feeling. Sadly, at that time of night on a weekend there wasn’t much they could offer me except to say they had called the on-call psychiatrist who gave me permission to up my medication dose. This wasn’t really an option as I’d only just upped my dose anyway, following the birth.

Essentially, I was on my own and at a bit of a mental crossroads. I had two options; give in to the anxiety that was suddenly coursing through me, engage with all the scary thoughts and potentially spiral into a very dark place. Or take the more difficult route, the route that required more hard work but would hopefully lead to a better outcome – i.e. pull out my survival kit, open my notebook and do some CBT; rationalise some of my thoughts.

After an hour of sweating, panic and a racing heartbeat I grabbed my notebook with shaking hands and turned to a fresh page. I did a fear vs fact sheet which instantly calmed me and then I worked hard over the next 24 hours to turn my thoughts around.

Thankfully, I managed to get a bit more sleep that night and everything felt a little brighter and calmer. I reminded myself that it was early days, I was still in a lot of physical pain, and I needed to take it one moment at a time.

Being in hospital was hard. I had to stay in for a three day minimum for Bea to be monitored due to my taking Citalopram during pregnancy (a precaution that every nurse and midwife I spoke to agreed was overly cautious). When I had visitors it was amazing but when it was just Bea and I alone I felt isolated and scared. But I also felt love and competence in a way I never did first time around which was a huge relief.

Physically, I appeared to be struggling much more than I remembered from my first section which had a big impact on my mood. I’ve since found out that second c-sections can be more painful during those early days because your previous scar tissue has less flexibility than normal skin and will pull more. It would have been nice if someone had told me this while I was still in hospital and wondering what was going on! The staff were definitely more stingy with pain meds this time too – and you don’t get diclofenac anymore which I found very disappointing!

Back home

On the third day I had a turning point in the pain becoming more manageable which made a big difference, and being told I could go home was amazing.

The first 24 hours at home I felt strangely high. I’d made it through the op, I had a wonderful birth experience, I was in love with my daughter and I’d talked myself down from an Anxiety attack. I was queen of the world!

But as time progressed and the dreaded hormones crashed I began to feel more edgy. Nothing as bad as that night in hospital but I spent a lot of time analysing my mood and looking over my shoulder for Anxiety. It was exhausting.  Hormones have a great deal to answer to. I was tearful and overwhelmed much of the time and in a happy bubble at others. Thankfully, this time, I knew what was going on.

During this period with Teddy I didn’t recognise my mood for the hormone drop it essentially is. I just assumed I hated motherhood and couldn’t cope. But I never mentioned this to anyone and, instead, allowed the obsessive thoughts to take over and become postnatal depression – way after the hormones had leveled out.

This time I knew so much more. I recognised the emotional state for what it was and that it could be largely temporary. And I had support already in place.  I told my midwife and health visitor how I was feeling and they referred me to the specialist mental health Health Visitor (who I actually already knew through my advocacy work). Just having that initial chat with my healthcare providers and putting a short term plan in place (a call from my community midwife to check in the following day and a visit from the MH health visitor the following week) made the world of difference to my mental state and my mood began to lift almost straight away.

The second week at home felt a little easier. I was still distracted by hyper-vigilance but it had lessened. We’d found our feet a little with Bea and realised she would settle herself at night (whoop!) and I could distract myself with visiting relatives.

postnatal depression - newborn baby, green flowery onsie

A new routine

The most nerve wracking prospect that second week was knowing that my husband had to return to work the following week (typical anxiety-sufferer – worrying about something that hasn’t yet happened!). I’d gotten used to sharing the load with him, of him doing the school runs and 50% of the baby care – not to mention him making me sandwiches and drinks and saving my healing stomach muscles from having to heave me off the couch.

To try to counter my anxiety about the following week I began to put a little routine together. Routine is so important to our wellbeing, particularly for new mums, as once the baby arrives days begin to blur into each other and we can feel pretty lost and chaotic.

My new routine was to consist of various baby groups, coffee with a friend, visits from the health visitor and a day a week with my mum. The most amazing baby group I’ve joined is the Mindful Mums course. This is a six week course designed and delivered by the specialist mental health Health Visitors in the Southend area and it’s been so wonderful. Not only is the content incredibly useful (I personally got a lot of value from the recap on CBT techniques) but it’s been brilliant for peer support too as I’ve been able to connect with other mums who may also find early parenting a little challenging.

Just like with the healthcare support, the mere act of putting a routine in place helped me to feel calmer. The first week flying solo came and went and I survived, maybe even thrived a little.

So have I escaped Postnatal Depression? 

During those first four weeks I found it tricky to know how I was doing. Even the health visitor mentioned that they find it difficult during the early weeks to tell which ladies are developing difficulties and which are just experiencing the normal hormone fluctuations and motherhood adjustment period.

As I’ve settled into Bea’s second month with us my confidence has grown. Not just in my abilities to be a good mum but also in my ability to manage any Anxiety that arises. Confidence is a huge part of getting and staying well; believing that you can cope with any mental difficulties or symptoms you encounter.

postnatal depression - newborn baby, white lace dress
Photo courtesy of www.willowandrosephotography.co.uk

During the last two months I’ve had moments of sheer bliss; of a new baby happiness I never believed I was capable of. I feel hugely grateful that so far my experience has been much easier than last time.

This doesn’t mean I’m not struggling. I still look over my shoulder for Anxiety but it’s lessening and I’m finding it easier to ignore. I still have bad days (like the day I’m writing this!) where parenting a young baby feels so bloody relentless. It’s the only word for it. Every day can feel like Groundhog Day and it’s exhausting and frustrating.

What’s been most interesting for me though is experiencing new motherhood in a more balanced, ordinary way. Even on my best days, when Anxiety is nowhere to be found, it’s still not a Pampers advert. It’s still tricky, tiring and unpredictable. But it’s also fun, funny and magical. And this time I have space in my brain to appreciate the latter and not just become consumed by the former.

The future

I intend to keep my appointments with the specialist health visitor, and I will still prioritise self-care and routine. I will keep my anxiety management techniques close. But I will also try to balance my fear of anxiety’s return with my enjoyment of the now.  Does it matter if I’ve escaped postnatal depression?  I guess not.  Maybe there is no black and white of diagnosis, maybe we’re all just on a sliding scale.  I’m going to try to stop focusing on the question and enjoy my baby in a way I never thought I’d be able to.

Related posts:

The Big Decision – Another Baby After PND

5 Tips For Preparing For A Baby After PND & Anxiety

PND Relapse – 6 Ways To Prepare Your Older Child