For first time mom Kelly Smith* bringing her new bundle home from the hospital was a moment she had fantasised about for a very long time. She envisioned cotton soft baby skin and a fresh baby smell to fill her home with love and excitement.
Little did she know she’d be faced with quite the opposite: a paralysing sense of panic hit her hard.
Smith realised that prepared meals and supportive nursing staff were not part of at-home set-up and that keeping baby alive, while she herself was recovering from a C-section, was an overwhelmingly daunting task.
Her initial symptoms presented as worry – "a constant state of stress," she describes. First it was dust she was concerned with, then it was the temperature of the room and before she knew it, her worry was out in full swing…
"I’d literally stress about everything - from his breathing rhythm to the hygiene of the bottles. I’d doubt everything and question myself on repeat," says Smith.
In addition to the constant worry, she also experienced intrusive thoughts that made her extremely sensitive to knives. "I remember having to close my eyes or actually cover a knife with a cloth or a towel, each time I walked past one. I could literally feel it cut into my baby, and was scared that this somehow meant I’d harm him".
Despite all this, Smith says she didn’t notice anything to be amiss. It took a drastic encounter in which the sleep deprived mother responded to her baby aggressively.
"I remember wanting to throw him against the wall one night. It was around 3 am and when I heard him cry, and a beast came over me - I picked him up with the intention to throw him. Thank God I didn’t."
"My pent up panic and exhaustion could’ve had devastating consequences - I was lucky to gain control in that moment," says Smith.
Are you at risk?
Despite the fact that there still seems to be some stigma around post natal depression, it is a very common occurrence and "not the mother’s fault," says Dr Lavinia Lumu - a Joburg based psychiatrist with a special interest in Maternal Mental Health.
She explains that many mothers struggle to adjust to life after a baby and explains that while there are certain risk factors, one cannot peg the condition to one single cause.
"Genetic and biological factors related to the hormonal changes in pregnancy and psychosocial stressors could precipitate the onset of PPD, but it is never the mother's fault," Lumu stresses.
The South African Depression and Anxiety group lists the following risk factors for PPD:
• Depression during pregnancy
• Pregnancy at a younger age
• Ambivalence about the pregnancy
• Having more children
• A history of depression or premenstrual dysphoric disorder (PMDD)
• No social support
• Living alone
• Marital conflict
Symptoms may present differently for different mothers but it is important to seek professional help if you feel you aren’t coping, or if you experience symptoms of sadness for longer than two weeks.
There is no need to feel concerned or ashamed – getting help is as simple as visiting a GP or obstetrician, if you aren’t already a patient with a psychologist or psychiatrist. Your doctor will perform a screening assessment and decide on the best treatment for you, says Lumu.
Trusting yourself after PPD
It is normal for moms with PPD to take some time to regain their confidence. Lumu explains that depending on the severity of the condition, and the treatment approach, moms can generally expect to see improvement within two to four weeks.
This is usually the case for moms who suffer from mild depression and who are receiving medication, but the process may take longer if intervention is in the form of psychotherapy. It is important that the patient work closely with her doctor to monitor the condition as there is no on-size-fits-all recovery time frame, but PPD is a highly treatable condition.
For Kelly Smith, it was quite a process, "but working with a therapist was a great help. I didn’t want to be left alone with my baby, but slowly started trusting myself once I began to find my rhythm. Getting to know my baby’s needs and schedule was what I needed to feel more in control. Having support during my recovery really worked wonders for me, and after 6 weeks of treatment I began to feel more like myself.”
Dr Lumu emphasizes that if the mother does not feel safe with her baby, she must be completely honest with her healthcare practitioner.
"There are cases where the mother may feel suicidal or like she may harm her baby. In these instances it is imperative that the mom not be left alone and be supported by her family until she feels well".
*Kelly Smith is a pseudonym for a South African mom who suffered from PPD.
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