Ways to help depression: The medical side
So, it looks like you have postnatal depression (PND), the next step is asking for help. Your GP or midwife will assess you on the Edinburgh postnatal depression scale to see how much support you may need. This is anything from talking to a psychologist, to taking antidepressants, or even a mental health plan. Depending on where you are located depends on what type of support is available.
I personally started with a plan called ‘early intervention’. I regularly met with a psychologist who helped me with techniques for dealing with my thoughts and emotions. Generally talking to someone helps so much. Once the post-natal depression got worse, I met with my GP and was put on an antidepressant. A good GP does wonders. Mine is so supportive and non-judgemental, I travel half an hour just to see her. She has been with me since I found out I was pregnant. When I told her why I was there, she said she kind of figured Because of my history of depression and anxiety, it was inevitable. We discussed my moods, and she did an Edinburgh postnatal depression scale, where I scored pretty well if I do say so myself. We then discussed different medications. I was anxious because I had a bad experience previously with antidepressants, but she reassured me, and we had a plan to meet up again in a month to see how it was going. I have now been on them for two months and my mood is so much better. I have now been discharged from early intervention and am doing well.
If you are still having contact with your midwife, they are a great support and resource for ways to access support. They have a lot of experience with postnatal depression and know the services available to you. Having seen it a million times and have no judgement towards this, they know how hard it can be. This was how I was referred to the early intervention programme. When I first met my community midwife after having Quen, we discussed my history, she asked if I would like to talk to someone for support. Of course, I agreed.
If you don’t feel you can talk to your GP or just want to talk to someone for support, there are many different phone line and support groups that are always there to help.
Help lines: Here in Australia, there are three main groups focused on postnatal depression PANDA, Beyond Blue and pregnancy, birth and baby. They all have a lot of information on their pages and a help line. PANDA is focuses on anxiety and depression for pregnancy and the first year of motherhood. Beyond blue has a much wider range of services for different mental health conditions and pregnancy, birth, and baby is a lesser-known site, a government site that has so much information online and again a help line.
Medications: The most common antidepressant given for PND is selective serotonin reuptake inhibitors (SSRI), these include paroxetine, fluoxetine and sertraline. They work by increasing the amount of serotonin (a chemical that helps your emotions and sleep) in the brain by reducing its reuptake. SSRI side effects include headaches, dizziness, nausea, bowel issues, sleep problems and dry mouth. Another antidepressant is serotonin-norepinephrine reuptake inhibitor (SNRIs), a common example is venlafaxine. This works by blocking the intake of serotonin as well as norepinephrine and has side effects similar to SSRIs but can affect your blood pressure. I have been taking Sertraline. The main side effects for me have been nausea if I don’t take them with food, and jaw pain which is pretty unusual.
For those effected more severely, may need more help, which can start with a mental health plan. This will be commenced with your GP where you can discuss all about how you feel, and a treatment plan is created with you. This will have more support available such as psychologist, social worker, occupation therapists and regular reviews. In Australia it also gives Medicare rebates for different appointments relating to your mental health.
Therapy: Psychology can include cognitive behaviour therapy (CBT), self-guided help, interpersonal therapy, problem solving therapy and acceptance and commitment therapy (ACT). I personally like ACT as it allows you to feel and think what is going through your mind, acknowledge it, and then move on. Being involved in the present and not fighting but also not dwelling on thoughts. This is discussed further in Therapies and Techniques.
Other more uncommon or extreme care includes electroconvulsive treatment (ECT), where electro-currents in the brain are activated. This is proven to be very effective for even the most severe depressions. No, it is not like the movie, the patient is put under anaesthetic and don’t feel anything. Or there can even be hospital based treatment where you can be under their care or even admitted for a period.
There is such a wide variety of options for care as mental health is not a one shoe fits all. There is also a large number of holistic style options to use either on its own or together with medical treatment to help with improving mental health. See The Holistic Way for more.
Most importantly: Never be ashamed to ask for help.