Posts Tagged ‘postnatal depression’

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.


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.


Mia Scotland

Clinical Psychologist

Happy mummy, happy baby

September 1, 2015

So, I’m eating a slice of toast while reading a blog from my facebook page this morning.  I can do that now, because my children are older.  I can even finish my cup of tea, and make sure that I am wearing appropriate clothes to walk the dog in. I no longer find myself rushing around to make sure my children have their hats and scarves on, and then to go out realising I am wearing no jacket.  Putting others first seems to be what mothers do, to the detriment of their own mental health. This is partly related to guilt.  Guilt is a big deal in new mothers.

So, as I read this blog about babies’ mental health, I am struck by how easy it would be for this blog to make mothers feel even more guilty.  It is littered with phrases such as “what parents do profoundly shapes who we will become” and “early experiences matter – a lot”. It tells us how our handling of our babies shapes their personality, their future mental health, their critical thinking skills and so on.

Then it goes on to say that the good news is that “nurturing strong mental health in young children is not a specific undertaking in which parents need to engage – as if it were a “job” or task.  It is how parents are with their babies that matters….delighting in the joy of young children’s daily discoveries”.  Well, frankly, that this is good news is debatable.  If it were “a task” it would be easier to complete.  You could have a checklist in the morning, and make sure you have done your jobs.

  1. Dress baby
  2. Feed baby
  3. Smile at baby and make eye contact

But no.  Now, we have to “delight in the joy of young children’s daily discoveries”.  Actually, if you have ever tried to get a toddler out of the house on your own, with a baby still in their jumpsuit, having to get to pre-school on time, not having eaten yourself, or finished your cup of tea, with baby sick still on your shirt, and your toddler says “look, a leaf on the ground”, you do not delight in this.  You do not feel like cooing, smiling and delighting in your toddler’s very slow progress along the pavement.  You grit your teeth and say “come on” in a voice that is far too squeaky, desperately wanting your toddler to move it, so that you won’t be late again.

The blog is correct. It is the delight and joy that people share with their babies, that helps the baby develop.  Mother and baby create a “dance” of interaction.  With each positive interaction, the baby’s brain fires more neurons, lays down the foundations for feeling loved, trusting and explorative.  Nature designed mothers to look into their baby’s eyes and feel joy, for this very reason.  But nature did not design us to be able to do this on our own in a rather large, otherwise empty, house.  It is not fair to tell a mother who is doing this job on her own, that she “just” needs to be joyful, if you expect her to do a job that is stressful, lonely, unsupported and practically impossible, and then ask them to be joyful while they are doing it.  Not only do we as a society do just that, but we then actually have the gall to suggest that if they aren’t joyful they are damaging their baby’s mental health!  You cannot feel guilty and joyful at the same time.   This is because stress hormones (associated with feelings of guilt, shame, depression, anxiety, worry) and very different to calm and joy hormones (associated with relaxation, mindfulness, connection, warmth, compassion, mutual joy and sharing).  Stress cuts across joyful feelings immediately because nature designed us to prioritise being alive over being happy.  So if a mother is stressed, she will find it harder to “delight in the joy of young children’s daily discoveries”.  When a mother has her baby, she is recovering from a birth physically and psychologically, she is learning to adapt to being a mother (being responsible for a little being, no longer able to put her needs first, no sleep and so on), she is  grieving her old life and adapting to her very different new life, she is having to manage the housework, cleaning, ironing, cooking, school runs, worrying about her weight, worrying that her husband still feels included and loved, and so on.  This is too much for a new mother.  She needs to rest.  She needs to be looked after.  She needs people around her.  She needs her privacy.  I have to say, a little part of me envies Mormon mothers (yes, I actually wrote that!). While some people think it dreadful that they should share a husband, I see it slightly differently, because in Mormon households, the mother is not alone. Imagine if you always had other “wives” around you in the house, to help with housework. Imagine if you only had to be responsible for feeding your children one or two days per week, because some-one else is cooking the other five days.  Imagine if, when you need a wee, but your child needs to put their shoes on because you are late, imagine some-one saying “I’ll do it, you pop to the loo”.  Imagine, when your child has had a dreadful tantrum, and you feel like you’ve been dragged through a hedge backwards, some-one says “you poor thing.  I’m going to make you a cup of tea, and settle your toddler down with a drawing for you”.  Imagine, when you are about to shout at your toddler because you are tired and wired, you can turn to some-one and say “I feel like screaming” and she can laugh and say “I know that feeling.  Off you go, I’ll spend 5 minutes with her”.  Imagine on a day when you have a cold and you feel wretched, a woman says firmly to you “go to bed and stay there.  I’ll do this”.

The point isn’t that we should become polygamous, the point is that society needs to look after mothers if we want mothers to look after babies.  The research shows us that mothers who feel the “joy” of parenting do a great job raising kids.  However, one cannot force “joyful” parenting on some-one, especially not by increasing guilt.  You create the conditions for joy.  In response to the research, society has to do a great job taking care of mothers. The flipside of joyful parenting is sad, scared parenting.  Perinatal mental health problems are on the rise, and we know that this is not good for babies.  The government is addressing this by increasing “identification” and “treatment”.  This is important, but we are putting sticking plasters on a bigger problem.  Isolating and burdening women is the problem.  And it’s affecting fathers too now, as they are increasingly expected to juggle full time work, house, children and looking after mum.  They are getting sick too.

Stop the guilt. Stop the scare mongering.  Prioritise taking care of our families, so they can thrive in joyful, relaxed interactions.  Simples.

Mia Scotland, Clinical Psychologist and Author of “Why Perinatal Depression Matters“.


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