Posts Tagged ‘fatherhood’

Meerkats and Perinatal Mental Health: What is the one thing I do when meeting some-one who is depressed or anxious?

November 9, 2016

It’s help them to calm their brain.

meerkat-alert

Picture a meerkat, up on the tips of his feet, eyes and ears peeled for danger. Red Alert. The meerkat is on patrol for the night. His brain and nervous system are hypervigilant, sensitive to all dangers, out to protect his clan.

Now picture the other miakats (that’s how I like to spell it!). They are asleep. They are warm and curled up, maybe cuddling up to a fellow miakat. They feel safe. They feel relaxed. They are resting and reenergising for the next round of activity.

They swap. Once the patrol miakat has done his patrol, he can rest, while some-one else takes over patrol duty.

The problem with anxiety and depression, is that the brain’s alert/danger system is stuck to “on”, leading to exhaustion. This alert/danger system shows itself in the inability to sleep well, the constant worrying about whether you are good enough, or whether your baby is healthy enough, or whether other people are talking about you, constant restlessness mixed with tiredness, irritability, and so on.

So, the first thing I do when I meet some-one who is depressed or anxious, is help their brain to switch from the alert/danger system, into the calm/relaxed system. I relax them in session, and then I give them a relaxation MP3 to listen to every evening as they go to bed. It’s like a sleeping tablet that has no side effects. It’s like a respite for the brain, from that constant struggle. It’s the start of things getting better for them.

meerkat-sleeping

Mia Scotland

Clinical Psychologist

http://www.yourbirthright.co.uk.

Have you written a postnatal care plan yet?

October 10, 2016

You wrote a birth plan, because birth is a big deal. But did you write a postnatal care plan? After your baby is born, your whole body and mind are in transition. Transition can be so tough, it’s even got a psychiatric label attached to it (Adjustment Disorder). Your body is physically transitioning in crazy, magical ways, and you are mentally transforming to get used to being instantly interrupt-able, having strange sleep patterns, putting yourself second, and grieving your lost carefree past. You are learning to know and love your baby. (Honeymoons were designed to help you love your new partner. Babymoons should also be designed to help you love your baby). Your brain is processing the birth. The list goes on and on and on and on. So, don’t just go home and hope for the best. Here is an example of what your postnatal care plan might look like:

“My Postnatal Care Plan

I have written a postnatal care plan because I very much want to enjoy my first few weeks getting to know my baby. I am aware that I have a tendency to do too much, and to feel guilty when I’m not getting stuff done. I want to ensure that this doesn’t happen following the birth of my baby, and so I am planning how to take care of myself in the first two precious weeks with my baby.

Generally, I wish to spend time skin to skin with my baby, I wish to establish breastfeeding, and I would like my husband to be an integral part of this with us.

Immediately upon coming home:

My husband would like to carry me and our baby over the threshold.

I would like a warm bath with rejuvenating bath salts, and then I would like to get into fresh (new) pyjamas and into our king size bed with new fresh sheets, and my baby.

I would like the lights kept low, my phone and my remote control next to me.

I would like to eat a huge, warm, filling meal of cottage pie and peas, washed down with camomile tea and a glass of champagne.

I would like my husband to join us as much as possible in bed.

For the first two weeks after coming home:

I would like visitors to stay away for at least 12 hours, apart from the midwife and my lactation consultant, who I have pre-arranged support with.

In the first three days, I would like very close members of my family only, to visit.

I do not want my baby to be held by anybody else in the first three days, other than her father.

We have arranged for a food delivery of fresh fruit, salads, sandwiches, chocolates and champagne. There are plenty of ready cooked meals in the freezer too.

I have arranged for a cleaner to come in every other day to tidy and clean the house, as per my husband’s requests (she will not clean our bedroom).

I have specific herbal/homeopathic remedies that I will be taking each day.

After the first three days, I have arranged for a postnatal doula to come in and provide emotional and practical support every three days.

My husband will help to ensure that I get plenty of rest, by regularly encouraging me to go to bed, and ensuring that the household and visitors are taken care of.

My husband will take a few hours out of the house each day, to do something to help him to feel refreshed also.

According to how I feel, I plan to spend most of the first two weeks in and out of bed. I might take a walk or potter around the house if I feel restless, but if not, I will stay in bed to recover and adjust, both physically and mentally, and to help me to fall in love with my baby and establish breastfeeding.”

What do you think? If you are thinking “that’s a bit overindulgent” then you are totally not getting how important this time is. If you are thinking “it’s only relevant to rich people” then drop the champagne and the au-pair, but stick with bed and help from family. If you’re thinking “what if I’m a single mum” then think even harder about your postnatal care plan, because support matters, whether its from a husband, a mother, the NHS, a best friend or social services.

It’s my prediction that postnatal care plans will become more and more common. If you’ve ever used one, I’d love to hear from you.

Mia Scotland

Perinatal Clinical Psychologist

http://www.yourbirthright.co.uk

Leave mum holding the baby at your peril: Postnatal depression and what we expect of women

December 31, 2014

trauma mum n babyI just left a woman in her house with her baby.  I was her doula, and I was visiting her after the birth, to congratulate her, and make sure she is okay.  My role wasn’t actually to check that she is okay.  Most people want a doula for the birth process itself, not for after the birth.  But as a doula who is also a psychologist, I know that the time of settling in after you’ve had a baby can be much more of a roller coaster ride than the birth itself.  And it lasts much longer.

Knowing how hard it is to adjust to a new baby, I found it difficult to walk away.  She is doing really well.  I have no concerns about her or the baby at all.  She expressed the usual bewilderment, lack of confidence, tiredness, tearful days, that all new mothers experience.  Her tiredness and anxiety are “normal”.

But I came away questioning this once again.  How can it be that we accept it as “normal” to feel overwhelmed, anxious, tearful  and tired, after having a baby? Neuropsychology actually suggests that parents and babies are primed for joy, love and connection, not misery.  In fact, every time there is a joyful and loving interaction, the baby’s neural connections become stronger.  The baby’s brain literally grows in response to joy and oxytocin.  Evolution has encouraged this, and we can see it every time some-one comes in to look more closely at the baby (which, as it happens, is the prefect distance for the baby to be able to focus on you) and then smiles and coos at the baby.  And we simply can’t help ourselves when babies smile back at us.  We immediately laugh, smile, and coo even more (or is that just me?).  We all do it, adults and children alike.  In other words, the need for joy and connection is not just met by the mother, it is met by all of the baby’s social circle.

However, in our society, we seem to think it is normal to feel exhausted, overwhelmed and wretched in the first 6 weeks of babyhood. And if we “expect” mum to be struggling, then how do we spot when “normal” becomes “depression”?   Women I speak to whose diagnosis was missed,  say that they did tell their midwives and health visitors that something wasn’t right, and that they didn’t feel normal.  But they were told that that was normal.   We are also missing the signs in fathers too.  Postnatal depression amongst fathers is on the increase. This, I am sure, is related to the enormous pressure they are under to be a hands-on dad, to be at the birth, to look after mum, and to continue to work full time, with barely any paternal leave or additional support.

How did we get to a place where it is considered normal to feel rubbish after you’ve had a baby? Is it really normal to feel miserable and trapped and overwhelmed and exhausted?  While I was vaguely musing about this in the back of my head, I left my doula client on her own in her house.   As I left, I said “it doesn’t feel right leaving you alone”.  And it really didn’t feel alright.  Not because there’s anything wrong with her, or her ability to cope, or her mental health, or her bonding with her baby.  But because I was leaving a woman on her own in a house with a four week old baby.   If that seems okay to you, then that is because that is what our society does.  It’s normal in our eyes.  We have stopped being able to see just how wrong that is.  But it is wrong.

Looking after a baby is a full time job. Well, no, it isn’t actually.  With a full time job, we get to go home, sleep, eat, shower, tidy up, switch off mentally, and choose what to do in between the job.  A baby does not give you predictable time to do any of the above.  You might get to take the lunch out of the fridge and microwave it, but you might not get time to eat it.  You can never switch off, and you have to be always instantly interruptible.  Just having one other person in the house makes such an enormous difference to all of these things.  You can shower.  You can prepare lunch.  You can leave the house for hours!  You can sleep for hours.  You can turn to some-one and say “oh my goodness, this is ridiculous” and have a bit of a laugh together.  Just having one other person in the house makes such a difference.  And yet, we leave women on their own in the house all day every day, and think nothing of it.  Single women also have that burden all night too (I can’t even imagine how our society can fail to grant them utmost respect .  They certainly have mine.).  Not only are new mothers left with the constant rolling demands of looking after a baby, but they are left in a house which needs attention.  If it isn’t given attention, she will be living in her own mess and dirt.  No-one wants to do that, and yet, we happily say to new mothers “leave the housework, it will wait”. I disagree.  It won’t wait, unless you actually want to live in your own dirt.

Contrast this with other cultures.  Imagine , for a moment, that you have just had a baby.  You are tucked up in your bed, with your baby beside you (yes, you are allowed to sleep alongside your baby, just like every other mammal on the planet does).  Your room is clean and tidy, because some-one else is looking after that for you.  Every four hours, some-one comes in with delicious home cooked food for you to eat.  Every morning, some-one is there so that you can get out of bed and shower and freshen up.  Once a day, you are given a hot stone all-over body massage.  Yes, this really does happen in a number of cultures!  The daily food and massage are considered to be an essential part of your recovery, both physical and mental.  You and your baby are together. Your job is to get to know your baby, and enjoy being with your baby.  You feed and change your baby.  You get to know your baby. You sleep and recover.  After a number of weeks of this, you are considered transformed enough to emerge into the real world as a fully-fledged mother.  Like a butterfly emerging from its chrysalis, the transition to motherhood is viewed as a psychological and physical process, not as a on- off biological “event”.

Our culture doesn’t do that.  And we pay the toll.  Perinatal mental illness is a rising problem generally, and the government are trying to put in place strategies for identifying and treating people who are suffering. While identification and treatment is important, it does place the emphasis on the individual woman, with the risk of blaming her as some-one who “couldn’t cope”.  Also, thinking that all we need to do is “treat” her with tablets and therapy also risks us reducing postnatal problems to discreet illnesses that just need “medication”.  Postnatal depression is not the women’s fault, and it is not a discrete illness like diabetes.  It needs attention from our culture too.  We need to treat women better when they come home with their new babies.  We need to realise that what we are asking of them is too much.  Being on your own regularly in your house with a baby or toddler is asking too much.  We need to start honouring, and caring for, mothers and fathers, because that is how we built parents strong enough to really care for our future generation.    power of compassion