Today the Daily Mail ran an article about pre-natal depression.1 According to the article’s author, Rachel Ragg, pre-natal (antenal) depression affects between 10% and 15% of mothers-to-be, but in spite of this, little is known about it and it is rarely discussed. In fact, Ragg goes on to write about a ‘conspiracy of silence’ that surrounds this condition.
One of the mothers interviewed, Emma, described how, when she had become pregnant with her third child, she had initially felt delighted, but then began to feel ‘overwhelming anxiety’ about having another baby:
I thought I’d never be able to love her. I had dreams in which I imagined I’d be able to give her away, then would wake with a horrible sinking feeling that I couldn’t.
We’d planned a third child, and I should have been happy. What kind of mother feels that way about her unborn baby? What was wrong with me?
It was not until Emma visited her GP that she diagnosed with antenatal depression. Even when she went into labour she still felt she didn’t want her baby. In fact, it was only after she had given birth to Faye that her attitude completely changed:
I was overwhelmed with love for Faye. It was almost as if my subconscious threw all this love at her to compensate for the terrible things I’d thought while I was carrying her.
Another mother, Alley, described how, following two miscarriages, she became pregnant for a third time, and then fell into a deepening depression. As her depression worsened she refused to publicly acknowledge that she was having a baby:
I’m 6ft tall, so I was able to hide my pregnancy well, but I fell apart. I became terrified by thoughts of the future. I’d go to bed with my heart pounding, worrying about being a good wife, a good mother, a breadwinner.
It wasn’t about the baby — it was about how I would manage to do everything and be everything to everyone.
In the end she also sought professional help, from a psychiatrist, who prescribed anti-depressants. She was also advised to see a therapist but initially refused because she was afraid of what people might think, that she would be seen as an ‘unfit mother’, and that social services would take away her baby.
What strikes me about these stories, which judging by the comments at the end of the article are not that uncommon, is the sense in these expectant mothers that they should not be feeling this way. That they ‘ought’ to be pleased they were expecting a baby; that somehow it was (morally?) wrong to feel depressed, and not to want to be pregnant.
From a psychotherapeutic point of view there are many unanswered (and perhaps, for some people, unanswerable) questions here. For example what does motherhood mean to particular individuals, especially when there may be a history of difficulties in this area, e.g. a history of miscarriages, or difficulties in becoming pregnant in the first place? Did that particular individual even want children, or was it pressure from her partner, her family, her friends and peers that drove her to become pregnant? What does it mean for someone to admit that they don’t want children at all, or any more children? What role does motherhood play in sustaining a person’s sense of identity and worth in the world. What might they be having to give up by becoming a mother? What role do children play in holding a particular person’s marriage or relationship together? What’s wrong with being depressed and admitting it? What’s wrong with being depressed and seeking professional help?
These are just some of the questions that a psychotherapist might encourage their clients to explore, but hopefully it’s becoming clear that being depressed because you are expecting a baby is neither something to be ashamed of, or something that can necessarily be medicated away. Depression is always a symptom of something else; and that something else is often a complex mixture of psychology, personal history, interpersonal relationships – and, yes indeed, biology. The main thing for the individual who suffers from antenatal depression (or any other form of depression for that matter) is to have the opportunity, the time and space, to be able to explore and articulate why they feel the way they do, and not to have to be in a position where they feel guilty or ashamed about it.