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Post-partum depression is more common than you think

As many as a quarter of mothers suffer post-partum depression. Photo/Getty Images

Sleep disturbance and lack of energy can be signs of depression in new parents.

If the age of 25 is taken as the point at which our capacity for adult decision-making is fully developed, then I wasn’t a complete adult by the time I became a father at 22 – to twin girls, no less.

After their birth, my university grades improved dramatically, because I didn’t have time to muck about any more, but I also can’t remember the first two months. However, I do recall averaging two hours’ sleep a night and asking neighbours if we could use their washing line to dry some of our vast number of nappies.

In retrospect, I wasn’t old enough to miss adulthood, because I didn’t really know what it should be like, but it’s part of popular wisdom that your life changes dramatically and forever after you become a parent. Men (and maybe some women) find this particularly difficult – an existential crisis of what could have been.

Our cultures tell us that women are expected to look forward to motherhood. And it’s not Dad’s tummy that strangers want to pat. Childbirth is focused on the needs of the mothers-to-be for the very good reason that they’re the ones who physically give birth. Having fathers at the birth is a relatively recent development.

Perhaps this is why we know a bit more about what it’s like for women to become mothers. For example, maybe a quarter of them experience post-partum depression. This wasn’t officially recognised until 1994, when the specifier “with post-partum onset” was added to the diagnosis of major depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Or rather, mothers who became depressed after having a baby were “just” depressed. In the diagnostic context, “post-partum” means within four weeks of giving birth.

In the DSM-5, released in 2013, this specifier had been subtly changed to “with peripartum onset”, to recognise that the depression can start before birth. And there’s still debate about whether the plus- or minus-four-week window is big enough, because not all women who get depressed after childbirth do so within that bracket.

Major depression obviously means depressed mood for most of the time for several weeks at least. But it can also mean anhedonia, loss of enjoyment of things you normally enjoy. These primary symptoms also come with a package of sleep or appetite disturbance, lethargy or sometimes agitation, impaired concentration and feelings of worthlessness.

International reviews suggest maybe as many as a quarter of mothers suffer post-partum depression. Which isn’t to say all women who experience it are diagnosed or get treatment.

Many women attribute what they’re experiencing to having a new and vocal member of the family. Look at those symptoms: sleep disturbance, difficulty concentrating and lack of energy. You’re a parent, so of course you feel that way.

Well, no, maybe not, if that’s how it’s been for weeks. Our public health system has specialist maternal mental-health services around the country, with staff whose job is supporting mothers experiencing mental-health problems that started sometime up to about nine months after birth. If these symptoms sound familiar to you, or to someone you love, ask your GP about getting help.

And it’s not just Mum. Men get depressed, too, and maybe one in 10 new dads. Of course, blokes are worse at paying attention to what’s going on with them, and rubbish at talking about it or asking for help.

Many men also misattribute what they’re feeling to the life change or sleep deprivation. Maybe they think there’s something wrong with them because they can’t hack it? Maybe they don’t want to burden their equally knackered partner about it? Come on, lads, ask for help.

This article was first published in the November 25, 2017 issue of the New Zealand Listener.