Depression During and After Pregnancy (Things We Don’t Know about Pregnancy Series #18)

Postnatal depression is thought to occur in ~1 in 10 mothers, making it a common form of mental illness. The onset and peak of the illness may be weeks or even months after the birth of a baby, and the condition lasts for weeks, months, or longer.

Symptoms

The condition is characterised by persistent negative feelings – towards yourself, your baby, and things you previously had an interest in. Most parents find their inability to bond to their baby most upsetting, and many feel guilty, hopeless, and even suicidal. Physical symptoms include disturbed sleep, tiredness, increased or decreased appetite, and difficulty decision-making.

We don’t know what causes postnatal depression

We don’t know what causes postnatal depression, although it’s associated with hormonal changes, such as a drop in one hormone called allopregnanolone. But these alone can’t explain everything. Women go through huge and varied hormonal changes during pregnancy and early motherhood, and postnatal depression doesn’t effect everyone. In fact, for a long time, people believed that pregnancy hormones were protective against depression, and it was simply something new mothers couldn’t get – leading to many undiagnosed sufferers^[1].

Worried Woman Image credit: RyanMcGuire (CC0 Public Domain via Pixabay)

The Call of the Void

Apparently, I experience ‘High Place Phenomenon’.

As a climbing instructor, I’m used to people saying “I can’t go any further – I’m afraid of heights.”

And I always say, “So am I.”

Of course I am. Everyone is. We just develop strategies for managing that fear, and some manage it better than others. The first time I climb somewhere new, I can feel the fear eating away at me, like a voice in my head saying “Oh god, oh god, oh god.” My strategy is just to get to the top and get it finished – and once I’ve done that, going up again has lost its dauntingness.

It can even feel exciting. I’ve oftentimes sat on the edge of a ledge preparing to belay and realised how easily I could unclip and jump to my death. The thought of the rush of the world shooting past, the feeling of somehow having triumphed over my survival instincts and beaten nature, the sense of freedom, power, and the excitement tremble through me. I’m drugged up on adrenalin. My fingers move instinctively with the rope – and it’s a good job they do, because my mind is addled.
 

Looking down from above. Image © Thing We Don’t Know.

Does this sound familiar? 30% of people experience it at least once. The French call it l’appel du vide – the call of the void – and that is exactly what it feels like to me. A beckoning. As though someone were on my left shoulder... whispering, “Do it!”