Diana Barnes “Maternal Depression and Disrupted Attachment” – My Notes
This is in no way an overview of the CAPPA 2014 session by Diana, but instead my notes of what impacted me from the session.
Have you thought of the birth of a child as a developmental crisis? It is! Well Diana shared a few things that can cause this crisis. She seems to think there are four myths of motherhood:
- Mothering is instinctive
- There is a notion of the perfect mother
- Madonna images
She said often moms feel like these myths are true. They often are trying to obtain that perfect mother spot. But we know birth experiences can cause her to not feel perfect before the baby is even put in her arms. She feels awful if she does not have the perfect bonding time. And she is trying to figure out what a “good” mother is. But feelings like wishing her baby was a different gender can cause her to feel awful about her baby. And these are things she is often afraid to share with others.
She said dads often have issues with gender roles. And they have difficulty with occupational roles vs. family roles. Diana said she hated it when dad’s would say they were babysitting their own children!
She suggested that moms who are struggling with this change to motherhood to figure out what they loved to do before. She suggested integrating pieces of the things they loved back into their lives. She shared about how stress crosses the placenta. Often the seeds of postpartum depression are planted during the pregnancy. Depression in pregnancy can often be seen in the child four years later showing up in conduct disorders. Excessive depression symptoms in pregnancy show more propensity toward depression afterwards. So it is important to get help if you are feeling anxiety and depression during your pregnancy.
The baby blues often have the same symptoms of premenstrual type emotions. You can be tearful, irritability, sadness, sleeplessness, anxiety and exhaustion. Postpartum depression occurs in 15-30% of the folks who have the blues. And although folks feel it happens early in the newborn period, it can happen anytime in the first year. It often happens in the first 3 months but can be as late as 6-9 months before it shows up. Moms often have more confusion when depression hits due to exhaustion and sleep deprivation, not eating and often lots of weight loss.
Obsessive compulsive disorder occurs for many moms during this time. There is confusion between reality and truth. This is where thoughts of hurting the baby can enter into the equation.
Panic disorders can also arise during this time. Shortness of breath, trembling, agitation and restlessness and excessive sudden anxiety arise. This happens to 10% of women. Often their symptoms make them feel like they are having a heart attack. There is often a family history of this. And this can be triggered by having had a traumatic event in their past or a traumatic birth experience. This can lead to PTSD symptoms. Reliving past experiences, feeling a sense of doom accompanied by nightmares and flashbacks occur.
PPDS- the next level of concern has women saying they feel something is wrong, they feel like they are just going through the motions, they try to find comfort and support and yet are guarded in their recovery. They often feel they are struggling to just survive. They feel they have died to self
Postpartum Psychosis is life threatening and the mom needs hospitalization. This is an emergency. She may be delusional and have hallucinations. She may be manic as well- happy one moment and then deeply sad.
There are psychosocial issues that cause depression after the birth of a baby. Having a sick baby, a lack of support, complicated birth, multiples, and a stressed life prior to the birth can add to this situation. There can be biological issues such as a thyroid deficiency, previous depression, a family history of depression, premenstrual dysphoric disorder, fertility issues and pregnancies that are close together. There are also psychological issues such as an unsupportive spouse, poor relationships with family members- especially her mom, trauma, issues that are unresolved and ambivalence toward becoming a mom.
Attachment to our infant is based on the things we feel are significant. So our infant learns attachment during this time based on how the mother is responding to him or her. The baby is figuring out if this is a safe place or not. The first six months for the infant is essential for them to feel this proper attachment. This lack of attachment affects the next generation.
Diana shared about a video on the still face experiment. This social interaction with the newborn is essential for their development. So helping this mom will be helping her baby and the whole next generation. We need to have a network of help for new mothers. This decreased responsiveness can be helped when the mom is helped. These moms often are either very unkempt looking or overly made up. But either way they are both disconnected to their babies. Babies will have cognitive delays if they are not properly attached to their caregiver. But long term the results can be devastating.
My thoughts are that women need to be listened to in their early pregnancy. We need to help her in her prenatal preparation so that her network for success is established prior to the birth. Doulas can assist with helping moms feel listened to in their labors and have more gentle births. We need to have a network of support after the birth for new families. Postpartum doulas are an essential for those first few weeks. And women who still have issues need to be diagnosed early and treated quickly.
I do feel that if a woman is nurtured properly during her exposure to motherhood in her earlier years, mothering can be instinctive. But I feel motherhood has been do disrespected over the years that women have not been nurtured to listen to their instinctive voices, thus making that instinctive mothering diminished.