The agony of PRE-NATAL depression: It strikes one in eight pregnant women, but many of us don’t even know it exists
22:09 GMT, 3 October 2012
23:16 GMT, 3 October 2012
When Emma Gallagher first felt her baby kick inside her, it should have been a joyful moment, but it left her angry, tearful and dreading the prospect of becoming a mother.
‘I was delighted when I got pregnant for the third time,’ says Emma, a 25-year-old full-time mother who lives near Peterborough with her husband Sean, 25, an engineer.
‘But as the pregnancy progressed I began to feel overwhelming anxiety about having another baby.
Emotional rollercoaster: Hollie Byrne pictured with her son Connor
‘I thought I’d never be able to love her. I had dreams in which I imagined I’d be able to give her away, then would wake with a horrible sinking feeling that I couldn’t.
‘We’d planned a third child, and I should have been happy. What kind of mother feels that way about her unborn baby What was wrong with me
‘I mentioned to Sean that I was nervous and not sure I wanted the baby, but I couldn’t tell him the full extent of my feelings. I felt isolated. I just cried with fear and frustration, and Sean bore the brunt of it without understanding why.’
When Emma eventually described her feelings to her GP, he diagnosed antenatal depression — a little-known and rarely talked about condition that affects an astonishing ten to 15 per cent of mothers-to-be.
Post-natal depression, often referred to as the baby blues, is, by contrast, openly discussed and new mothers have access to all sorts of advice and medical expertise on how to treat it.
Despite the conspiracy of silence, studies show that a woman is much more likely to be depressed during her pregnancy than she is eight weeks after her baby is born.
Without treatment, antenatal depression can pose a serious threat to a mother-to-be, who may stop taking care of herself or, in extreme cases, become suicidal.
Half of women who suffer from ante-natal depression will go on to be diagnosed with post-natal depression
‘I was shocked when I was diagnosed with it at 32 weeks pregnant,’ says Emma. ‘I had no idea such a medical condition existed.’
A meeting was set up for Emma and Sean with the charity Home-Start, a voluntary organisation offering friendship and practical help to families with at least one child, and a volunteer began to give Emma support at home.
She remembers still not wanting her baby as she went into labour in December last year. But as soon as she had given birth, everything changed.
‘I was overwhelmed with love for Faye. It was almost as if my subconscious threw all this love at her to compensate for the terrible things I’d thought while I was carrying her.’
Emma now feels her family is complete, but wishes she had confided in someone sooner so she would not have had to endure such agonies.
Alley Einstein was 24 weeks into her third pregnancy when a simple question from a stranger sent her into a full-blown panic attack.
'I felt I didn't deserve to have a child': Hollie couldn¿t bear to leave her bedroom during her pregnancy, let alone the house. She was too frightened to seek professional help
‘When’s the baby due’ asked the well-meaning shop assistant. Alley recalls: ‘My heart was racing and I was sobbing uncontrollably but I’d no idea why.’
Now 38, Alley, from West London, had spent years travelling the world as a writer and broadcaster, before hoping to start a family in her mid-30s.
She became pregnant in 2008 by her then husband Michael, an auditor, but miscarried at 12 weeks.
After a second early miscarriage, she got pregnant for the third time in June 2009. ‘I believe the fear of losing my baby — and a family history of stillbirth — triggered the depression that dogged my pregnancy,’ she says.
Alley’s depression worsened and she refused to acknowledge publicly that she was expecting a baby.
‘I’m 6ft tall, so I was able to hide my pregnancy well, but I fell apart,’ she says. ‘I became terrified by thoughts of the future. I’d go to bed with my heart pounding, worrying about being a good wife, a good mother, a breadwinner.
‘It wasn’t about the baby — it was about how I would manage to do everything and be everything to everyone.’
Six weeks before her due date, Alley finally consulted a private psychiatrist, who diagnosed severe antenatal depression.
The psychiatrist prescribed antidepressants, which Alley took for ten weeks leading up to and after the birth. They did improve things a little, but didn’t solve the problem.
It’s only recently that antenatal
depression has come to the wider attention of GPs, midwives and health
visitors who are now taught that a woman who suffers from it has a
higher risk of developing post-natal depression
Alley was also advised to see a therapist, but she refused, despite encouragement from her husband. ‘I was scared of what people would think,’ Alley says. ‘I was terrified it would go on my medical record that I was an unfit mother.
‘I had nightmares about social services being in the delivery suite waiting to take my baby away.
‘That’s the most crippling thing of all — the fear that if you admit to antenatal depression, you might lose your baby,’ she says.
Sadly, her depression was so deep-seated that it didn’t abate after the birth of her daughter, Stellar-Blue, in January 2010.
‘I knew I was so lucky to have my daughter,’ recalls Alley. ‘My husband was a brilliant hands-on dad and we had a 9am-to-5pm childminder at home, so Stellar-Blue was well looked after, but by then the darkness had taken hold.’
Not being able to breastfeed made Alley feel even more of a failure. She stopped talking to her husband, and stopped seeing her friends.
Five months after Stellar-Blue’s birth, Alley consulted a private therapist, but she went to see him only twice. ‘I was sure I could cure myself if I fought the depression hard enough,’ she says.
Sadly, though, she couldn’t. The pressure proved too much for Michael and the couple separated earlier this year.
Alley says: ‘It’s a tragedy. Michael was the love of my life and the best possible father. I only wish I’d taken his advice to seek help.’
Alley, who still works as a writer, finally consulted her GP when Stellar-Blue was a year old. He prescribed a further course of mild antidepressants and referred her to an NHS therapist.
Alley saw the therapist for 12 weeks before she felt her symptoms had abated in spring of this year.
‘I deeply regret that my baby’s dad and I are no longer together,’ she says. ‘But, thankfully, my daughter has a great relationship with both of us.’
It’s only recently that antenatal depression has come to the wider attention of GPs, midwives and health visitors who are now taught that a woman who suffers from it has a higher risk of developing post-natal depression.
Studies have also shown that babies born to these women may be premature or have a low birth weight and be less active and attentive than normal.
At its most severe, antenatal depression can even result in women having a termination, then bitterly regretting it when their symptoms abate. These can include chronic anxiety, feeling isolated, irritability and sadness, agoraphobia and suicidal thoughts.
Psychologist Alison Knights says that these feelings are surprisingly common among expectant women.
‘All pregnant women undergo massive hormonal changes. Some might be unusually sensitive to this, but the risk factors vary from woman to woman.’
These might involve a past history of abuse or neglect, a previous history of depression and anxiety, severe morning sickness, financial problems, work or relationship problems, and unplanned pregnancy.
Hollie Byrne, 30, from the West Midlands, is a former retail manager who was stunned when she fell victim to the illness.
After trying for 18 months to conceive, she and her husband David, 31, also a retail manager, underwent two rounds of IVF before Hollie became pregnant with twins in August 2010.
‘I was ecstatic,’ she says. ‘I did six pregnancy tests just to be sure I was having a baby, and the idea of having a ready-made family in nine months’ time was a dream come true.’
But just three weeks into her pregnancy, Hollie started to suffer from chronic sickness. ‘I couldn’t keep anything down. One minute I was on top of the world, the next I felt scared and alone. I thought maybe the IVF medication was still in my system and making me feel so up and down.’
‘I was so sick that I was signed off work for four months. I felt my body was letting me down, and that turned into feelings of inadequacy and complete emptiness.’
In fact, Hollie was experiencing the onset of antenatal depression and couldn’t bear to leave her bedroom, let alone the house.
‘It was my life’s goal to become a mum, but now I was terrified that fate was telling me I wasn’t cut out for it,’ she says.
Her fears seemed to have been confirmed by a scan at 18 weeks which revealed that she had lost one of the twins.
‘I felt I didn’t deserve to have a child,’ Hollie says. ‘I didn’t want to become too attached to my remaining baby in case we lost him, too.
‘I felt sick, I couldn’t sleep because I was so worried about not being good enough. I was tired, and I felt like crying whenever anyone asked me anything about the baby.’
She was too frightened to seek professional help, though she did confide in her husband. ‘I felt David was the only person who wouldn’t judge me, and he was always there when I needed him.’
Then, when Hollie was 33 weeks pregnant, her midwife sensed there was a problem. ‘She thought I seemed anxious, so I finally told her how I’d been feeling. Even then, though, I played it down, because I was still terrified my baby would be taken away from me.’
Despite counselling in the three weeks before the baby was due, recovery was to be a slow process.
‘Immediately after the birth, I felt an overwhelming love and protectiveness towards Connor, but I still felt inadequate, out of my depth and scared,’ says Hollie.
When Connor was six weeks old, Hollie went back for further counselling. After two months, she was assessed by a psychiatric nurse, who referred her for Cognitive Behavioural Therapy (CBT) last February. She eventually stopped having therapy in June when she felt her depression and anxiety had lifted.
Hollie and David are now hoping to add to their family, and she says: ‘I wouldn’t be so hard on myself second time around. I wish I’d been honest with my midwife and sought counselling earlier.’
Alison Knights says the fear of a baby being taken away is one of the worst aspects of antenatal depression.
‘Depression is an illness like any other, and some of the very best mothers have suffered from it during or after pregnancy,’ she says.
‘Many women can find comfort simply by talking to other sufferers. Discussion boards on pregnancy websites and support groups can be a help. Sometimes you just need to know that you’re not alone.
‘It’s absolutely crucial for pregnant women to seek professional help through their GP, midwife or health visitor if anxiety and depression are interfering with their lives.’
This is particularly important if the conditions develop in the final three months of pregnancy.
‘Low mood is relatively common in early pregnancy, when women often feel sick and tired,’ Alison says. ‘Depression developing in late pregnancy is more of a concern, not least because women who suffer antenatal depression can frequently go on to suffer post-natal depression.
‘Identifying and counselling these women during pregnancy can reduce the risk of them suffering further problems.’
Emma Gallagher and her daughter Faye provide happy proof that, with the right help and support, there can be light at the end of what, for some, looks like a very long, dark tunnel.
Pandas Foundation (Pre and Post Natal Depression Advice and Support) offers phone and email support and an online community at pandasfoundation.org.uk