Emma - Interview 41

Age at interview: 33
Age at diagnosis: 32
Brief Outline: Emma was diagnosed with postnatal depression following the birth of her second child. This came as a complete shock as was her first experience of mental health problems. Practical and emotional support from her mother and sister, talking therapy, and antidepressant medication helped Emma through this difficult period. After a year she felt she was back to her 'old self' and was able to cease her medication. She would like to see her counsellor again for some 'maintenance therapy'.
Background: Emma is an occupational therapist currently on maternity leave. She lives with her husband and two young children. Ethnic background' Anglo-Australian.

More about me...

Emma had a happy childhood growing up on a farm and then at boarding school in the city, where she formed a great group of friends. She completed her degree, then travelled and worked overseas with her boyfriend, now her husband. They returned to Australia and Emma had first child when she was 30. 
Two weeks before the birth of her second child two years later, Emma suddenly experienced a ‘debilitating sadness’, which manifested as ‘uncontrollable crying and feelings of nausea’. These feelings came as ‘shock’ and Emma would have dismissed it as a passing phase, but for the severe insomnia that followed. A few days before her second son was born, she went to the hospital and was prescribed sleeping pills by the resident psychiatrist to help her sleep. She remained in hospital but her distress continued, even with the sleeping pills. After the birth she thought she might be experiencing postnatal depression, because she felt 'so different' from her normal state of mind. At discharge, the psychiatrist advised her to see if things improved - an approach she did not find helpful. However her distress became worse and despite being cared for by her mother and sister, she felt fearful and alone at home. She experienced suicidal thoughts and did not find her husband supportive during this time. Six weeks after giving birth she again visited the psychiatrist who diagnosed her with postnatal depression.
Emma was overwhelmed and shaken by the way diagnosis was conveyed to her, but also relieved that she could name her problem. She was prescribed sertraline, commenced counselling with a psychologist, saw her family GP regularly, and accessed a helpline for women with postnatal depression. Her mother and sister provided much appreciated support. Eventually Emma stopped her antidepressant medication because it was causing migraines. She then experienced severe side effects associated with stoping taking antidepressants, but she worked through this. She felt she was regaining ‘clarity of thought’, a lessening of her anxiety, and feeling like her ‘old self’. She has since taken sleeping tablets occasionally, but has not returned to antidepressant medication. 
Since her experience Emma has discovered a family history of mental health problems and has spoken to an uncle who shared his experience of depression, which she found very healing. Emma’s mother and sister still provide her with emotional support. She advises mothers to take time to live in the moment and enjoy time with their children. Looking back on her experience, Emma acknowledged that her experience was life changing and she made a decision to simplify her life and enjoy spending time with her children, family and friends.

Emma talked about what she liked about counselling, including her counsellorÂ’s efforts to involve...

And, I'd never been to a counsellor ever before anyway and it's quite a luxury to sit in front of someone for an hour and not have the guilt feeling that you're like I am now - overtaking the conversation [laughs]. Where you're, you know, you're pumped - you do all the talking. It's, it's quite a therapeutic thing in itself, I think, to be able to discuss yourself for an hour. So I'd never tried counselling before so I, I guess that was also, a positive aspect of it. But, uh, what did she do? She, she sort of let you, I mean I guess counsellors do, they let you talk and they just guide you, guide you along the path that they see is to be the most relevant and most pressing issue you've got. 
And she also saw me with [husband] because I, I requested that [husband] comes along and she was very open to that. Because she said it's a whole family thing that needs to get through this and I thought that was helpful. Um…
He was fine. He's not a typical bloke in that sense, [husband]. He'll, he'll - maybe he's under the thumb but he'll go to these things if I want him to. But, I, I mean he's hurt me a few times with the postnatal depression. Because he made a joke when he first walked in there about something and I - because that's our relationship. We're quite, quite light hearted people normally and I, that just showed to me - and [counsellor] actually said it. She, she said it just shows you haven't actually come to terms with the seriousness of this, that you don't joke about this about to Emma at the moment. She's, she's living through it and it still, it still - you can see in my face it still hurts me today. 
So also, so, so I guess that's the other thing when I found [counsellor] and she was very warm and caring and you felt like she really cared. That, the other thing that [counsellor] kept saying and I, it was like a mantra in my head - you will get better. You will go, you will get through this. The thing about depression as opposed to postnatal depression is that you get through it. It, it's not with you forever. You may have relapses in depression or what have you but because it's postnatal depression you will get through this. And I can remember lying at night, I can remember running and that was my mantra on my foot hitting the, the pavement. I will get through this, I will get through this.

While Emma was experiencing perinatal depression, her husband was unable to talk with her about...

I think [husband] was in denial about the whole experience and even now he still, we still, ah that's what - it's something we do argue about. Is that I don't think he supported me in that but I, uh, I think it's just scared him beyond wits' belief because, oh, I guess I don't know, I was the strong one in our little duo. And, I wasn't myself, wasn’t at all the character that he knew. but it still hurts to think that he didn't take a day off work or can, you know, he'd ask how you were, how I was. 
But, uh, when I was upset and, at night and what have you, he'd sometimes get angry if I'd woke him up. And I know that's something we've got to resolve, that's a whole total different issue. But, yes, that's something that needs closure on it I think. Because it, we do want three children and I'm absolutely terrified that this is going to come back again. It may not, it may they say.
And even, I can't, I know we need to talk to a counsellor because he still doesn't, he's still almost in denial. He doesn't understand how bad it was and when I talk about, even the fact that I wanted to run in front of a bus, no you didn't. Sort of brushes it off and it causes me just to not even bother talking about it because it, I get too frustrated by it. So we, I mean she does relationship counselling too as a counsellor so, and because she knows us maybe it's a good idea to go back to her again for that. Now that I can go with sort of a different agenda or a different set of issues. Because having a child's hard enough on a relationship, let alone one being depressed. It would break up a lot of people I think, could easily do it.
Because I think I was scared enough of it myself and he was running away from it by going to work every day. You know, I can remember crying and crying, trying to do [younger son’s] nappy and poo's everywhere and I'm crying. I couldn't see because I'm crying and he just kissed me on the forehead and kissed the kids on the forehead and walked off and went to work.
It broke my heart and it still does make me feel that. You just, you - I don't have the word - you just feel, yeah, unsupported and I don't know. He definitely prioritised work over any thing I had on. I can remember waking up and saying [husband], do you remember last night? I was this close to walking in front of a bus. It no actually I don't know if I was attention seeking as well. I don't know if I had those suicidal thoughts because I wasn’t getting support from the one person I needed - my husband. And so was I attention seeking? Looking for his acknowledgement of how serious this was by, by sort of making it a bit more, intense? Or a bit more dramatic or?

Emma was shocked by a psychiatristÂ’s insensitivity in diagnosing her perinatal depression.

I didn't, I think you just gel with some people too. Like in, to be honest the psychiatrist I never really got a connection with her. I felt like I was a number and she did keep telling me she's a resident here and she's on a contract and I, I was, as I said to you before, I wasn't in any state to listen and take on someone else's problems. But she did tell me sort of things about, I guess it was just light hearted conversation, you know, you make a nice small chat. But I, I wasn’t in any state to hear about how she's not happy that her job isn't permanent and all that sort of thing. I didn't think it was appropriate by any stretch. 
And when I just cried, when I cried in her office she just sort of looked at me as if I was a freak. And when I cried when she said post, when she said you've got postnatal depression and I absolutely burst into these tears she sort of. I think she actually said something which I took to heart - and you do when you're in that state of mind. Said something like, well what did you think I was going to say? And I thought that wasn't particularly supportive, so it would have made it so. 
Yep. Second sentence when I walked into the, door…
Absolutely, it was like being knocked in the face from Mohammed Ali. It was, I can remember just taking, stepping back and being short of breath. Even like I said, you know, classic sort of, oh panic. Yes, yeah. I'm almost, I'm not that kind of person but I almost wanted to write in to the [name] Hospital and complain about her. Just to have a bit of justice or just, it was actually more so she didn't do it to somebody else. So she didn't - you've got to, I think you've got to let people down kind of a bit more gently. Even if you've seen six people during the day and you've told them that they've got depression. Everyone's an individual and it can still shock them.

Emma talked about the reasons she found her counsellor especially helpful.

The other treatment I had was counselling. I saw this divine lady who, specialises in postpartum relationships and, I can't remember. That, that's her speciality and she's written various books on it 
I thought I could, I mean she actually, she's open about having PND herself. She's got four children, she had it with her third, which is random and I've heard various stories like that. But she, so between her, so sorry she was fabulous support. I found her amazing, even if I was just calling up for a, to book an appointment. She actually took the time to ask how you are. It wasn't just like you were making, a money maker for her or, she even - even her little answering machine messages on the phone. Isn't it funny how you really latch onto things but just to hear her voice on the phone really calmed me down because I knew that, alright in two days I'll be able to see [counsellor]. And I'll, I'll discuss this with her or I'll just sit in her office and cry and she'll get it, she understands it. So she was like a rock for me, her and my GP and my mum and my sister were my support crew.
I just always felt like she was there. She was very flexible with her times and she'd always make a time for you during the day or - she worked up until six o'clock and I remember one time I was really bad and she said, oh just come now. I've closed but just come now. So she, she sort of, I felt like she understood that, when you're in a really bad state. I don't know, it's probably not nice for her from a completely work/rest, uh, relationship for me but, she understood that you needed, you need, when you need the support you kind of need it. And so that was quite selfless of her and also she, I felt that she'd, she'd been there herself, I could just, talk to her quite openly and even, uh, openly about how bad I was feeling. 

Emma talked about significant negative effects of the antidepressant she was taking, once she...

When going off, going off the Sertraline was horrendous. You get, I got brain zaps - I don't know if you've read about these brain zaps? They're horrible. They're sort of like a, it feels like you've touched an electric fence and you get a flash of light in front of your eyes. And it's, and you get a, one big enormous electric shock or shake out, as, out of your whole body. Quite a few of those. Got quite a lot of dizziness. This probably went on for two to three weeks while you're tapering down. Well you taper down for quite a few months but I had quite a bad period for two to three weeks there. And you get dry mouth. 
Your thoughts again are a bit all over the shop. You, yer, I don't know how to describe it but I've always called it brain chatter and I was quite tangential in my thoughts. I'd, scattery, all over the shop when I was coming off the Sertraline, so, it was bizarre. But it, from my experience I wouldn't, I'd probably, wouldn't not have wanted to go on them. 
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Emma says that attending a postnatal depression support group did not help, but telephone counselling through a non-government perinatal depression support group was invaluable.

I did join a postnatal depression support group but I found it freaked me out more than it benefited me. Because I thought, this sounds terrible doesn't it, but I thought those poor girls were even worse than I was. , so it sort of almost felt like I was being dragged back down again.
How did you find this group? 
A volunteer I think at [name of postnatal depression support group] when I called up - no, oh dear I can't remember. I just remember I con, I actually had to call [name of postnatal depression support group] on the phone a few time, just to talk to someone who understood. So I'd probably call them once a week.
I remembered when I had [younger son] I still had the fridge magnet up. And it was the kind of thing where I thought, oh well I could throw that fridge magnet away but it's useful to stick things up on. I won't need it one day and of course I did need it one day. And [name of postnatal depression support group] were beautiful. The, the girls at the other end of the phone - generally they were - no there were a few men. 
[name of postnatal depression support group] they, whenever I call them they were divine. They - sometimes I just called them and just cried for 20 minutes into the phone and you could just get a sense that they understood where you were coming from. 

Emma found receiving a diagnosis beneficial and talked openly about her perinatal depression.

Oh yeah, about my PND - I don't know if everyone experiences it differently but I, from the day of diagnosis I've been extremely open to tell absolutely anyone. And I remember getting my legs waxed and I was, the lady said how are you? And I said, not so good, I've got postnatal depression. And I thought, I'm one of those nutters who tells way too much about their life and I know I was only doing it for myself because, you know, the trouble shared is trouble halved and I felt much better about it. 
But I also thought at that time I felt like a real, I needed to get out and tell people that this happens to normal people who are generally very happy. Because I felt, gosh if it can happen to me it can happen to anybody out there. Because I'd never, ever - I hardly ever, ever cried, do you know? It was a total change of life for me. So I remember telling all the playgroup girls and, and since then in actually discussing it with a few people, quite a few people have gone forward and said, you know, I think I've actually had, I had postnatal depression when I had my children. And I found, and I also want to cry for them because they've suffered for, I know a friend she suffered for 13 months and she's sure it sounds exactly the same postnatal depression and that was her third child. And I just don't know how she went through it. 
I, once I had the label and I got over the shock of it, it was a stepping stone to, to recovery. But I guess for some people to be told they've got it makes more reality for them and that can be quite scary, I guess. Because then you have to admit it. You can no longer deny that you've got it. And the stigma associated with mental health issues as well, eh, you feel like a basket case.

Emma described discovering pleasure in enjoying simple things with her children.

But maybe I also say recovery because I, I want to believe it. Do you know what I mean? I don't, I want to feel like I'm through the other side and so by saying it, it will mean that I am. But I actually feel I am. I feel much better. I feel I can deal with a lot more things. 
And I have talked to my GP about a third child and my anxiety about getting it again. But she's very pragmatic and very, you may not get it, you may. Let's deal with it when it comes. 
It's made me reflect a lot more on life and its stresses and the pressure we put on ourselves as parents and mothers and - I mean I wonder if I would have done that anyway. But because I do, I now do this meditation quite a lot it's made me sort of see, it's slightly go off, off on a tangent of trying to simplify life and live in the moment. And not be influenced by, trying not to be influenced by how nut society tries to entangle our lives.
Yes the simple kind of life, have a lot more home days. And try and live in the moment where sometimes if, I try not to be on the phone when the kids are awake, you know. You've got a lot of admin anyway but certainly the internet can drain time so I try not to be on the internet. I try to sit down, I mean it's so basic - sit down and read with the kids and count their toes a couple of times a day, do you know what I mean? Just enjoy them and just sit out, it doesn't have to do anything, just sit out there and catch grasshoppers and just enjoy. 
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