Treatment programs
disorders treated
Post Natal Depression
Quick facts
Expectations of motherhood are seeded from the moment the woman finds out about her pregnancy. These expectations flourish in the following months, being fed by the well meaning comments of friends and family and reinforced by the beautiful images of newborn babies. It is no surprise therefore, that it is easy for a new mum to fall flat as soon as the reality of a screaming dependent newborn emerges.
In the days and months following the arrival of a new baby, many adjustments and changes are juggled by the new mum. For about 20% of these women, this can be extremely difficult with the development of symptoms of clinical depression.
Signs and Symptoms
Since the days of the great Greek Physician Hippocrates, mental illness following childbirth has been recognised. The symptoms include:
- Spontaneous crying, lack of concentration, suicidal thoughts
- Disinterest in the new infant
- Guilt about the depressive feelings
- Reluctance to discuss negative feelings toward the child
There are many theories about the cause of PND. These include the role of hormones and personal/family history. The demands and changes of having a baby, stress on the marital relationship, few social supports and isolation may be other factors causing this depression. Other issues, which can contribute, include traumatic birth experiences and high anxiety levels.
Mother and baby interaction may be affected by PND. This includes a lessened sensitivity to the child's needs or even negative response to the infant's behaviour. The problem may be made worse with a crying, colicky, irritable or needy baby.
Low self-esteem, poor self-image, anxiety and guilt are characteristics of PND. Some mothers have unrealistic expectations of themselves and may see themselves as incapable. This may be worse if the mother views her relationship with the child as difficult.
The support and help women receive from their partners, families and friends is very important in the process of recovery. Other family members, particularly the father, may also be experiencing considerable stress and anxiety and may need extra family or professional support at this time.
Further reading
options for Treatment
The treatment of Post Natal Depression requires a comprehensive approach, which takes into account the many different factors of the condition. Medication is often used to treat the metabolic imbalances that occur in more severe cases. Psychotherapy in a supportive group setting or on an individual basis is most often useful.
The most effective therapy approach in the treatment of depression is Cognitive Behavioural Therapy. As this forms the basis of PND, it is deemed to be of central importance to any intervention. However, PND is made up of a number of issues which include insecurities regarding basic mothercraft skills, difficulties with adjusting to the changes a baby brings, including changes in the relationships with friends, family and partner. Such areas of difficulty may require reference to other specialist fields and other models of therapy such as family therapy or interpersonal therapy to maximise the effectiveness of the treatment.
The involvement of partners and families in the treatment process should be encouraged but the mother seems to benefit the most from keeping the baby with her as much as possible. A contraindication for this is if the patient is psychotic and clearly not able to respond to any of the child's needs.
The aim of therapy is to improve mood and coping skills and therefore increase self-confidence and confidence in caring for the baby. This involves identifying problem areas using cognitive behavioural techniques to identify negative, or unhelpful thoughts and expectations to do with motherhood. Specifically there is a focus on challenging unrealistic thoughts and expectations of the birth and baby.
Mother and Baby Program
The Mother Baby Program is designed to meet the specific needs of mothers experiencing Post Natal Depression. The program has an "informal" structure and focuses on the development of practical skill development and the support of mothers during this busy time. The aim is to nurture their confidence in their ability to care for their baby's needs and develop healthy routines.
What is the aim of therapy?
The aim of therapy is to improve mood and coping skills and therefore increase confidence in yourself and caring for the baby. This involves identifying problem areas and helping to see what changes have occurred in your life, then teaching ways of managing the changes. It includes looking at support systems, your life balance and needs. It also helps to look at changes in your relationships and roles.
The therapy uses cognitive behavioural techniques with an emphasis on thoughts and expectations to do with motherhood. Specifically there is a focus on challenging unrealistic thoughts and expectations of the birth and baby.
New coping skills including relaxation training, limit setting, stress management and mood management is taught. There are also parts of the programme, which are dedicated to education in mothering, health-care and community support services.
Generally the treatment encourages self-responsibility for change and the promotion of self-esteem and confidence.
Treatment Program
Groups run from 11.00am to 3.00pm daily. These sessions include discussions on the birthing experience, the losses and gains of motherhood, modifying unrealistic expectations of their new role, and learning useful strategies for the management of depression, anxiety and panic. Great attention has been paid to mobilising existing support networks and enlisting the support of community services if required.