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Postnatal Depression: Facing the Paradox of Loss, Happiness and Motherhood (Family Matters) [Paperback]

Dorothy Rowe , Paula Nicolson
3.6 out of 5 stars  See all reviews (5 customer reviews)

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Review

"..It performs, in a womanlike fashion, the important job of depathologising postnatal sadness...this is the ideal.." (The Times, 3 December 2001)

"..this book should be a ′must read′ for dads, grandparents, anyone in the caring profession and any women who is about to tackle the monumental task of becoming a mother." (www.familyonwards.com 14 February 2002)

"It recognises how things are today with families living far apart, and the ever increasing load a mother has to carry." (Young Minds Magazine, May/June 2002)

"...In the patients′ library this book could be extremely useful..." (Family Practice, Vol.19, No. 4, 2002)

"…I would recommend this book to any pregnant woman,…Well done to the author!!…" (Forparentsbyparents.com, 28 March 2003)

"…I would like to end by recommending pages 170–172 to psycho–therapists dealing with depression across the board…and also to those dealing with other mental disorder." (Journal of Child Psychology and Psychiatry, Vol.44, No. 6, 2003) 

"…a clear and practical book…" (The Sun, 16 September 2003)

"…definitely a book I would recommend for all." (Primary Health Care, September 2003)

“…gets to the heart of the matter…expecting and new mothers are shown how to take a more realistic approach…” (Stress News, April 2004)
 

"..It performs, in a womanlike fashion, the important job of depathologising postnatal sadness...this is the ideal.."
(The Times, 3 December 2001)

"..this book should be a ′must read′ for dads, grandparents, anyone in the caring profession and any women who is about to tackle the monumental task of becoming a mother." (www.familyonwards.com 14 February 2002)

"It recognises how things are today with families living far apart, and the ever increasing load a mother has to carry."
(Young Minds Magazine, May/June 2002)

“…gets to the heart of the matter…expecting and new mothers are shown how to take a more realistic approach…” (Stress News, April 2004)

"...In the patients′ library this book could be extremely useful..." (Family Practice, Vol.19, No. 4, 2002) 

"…I would recommend this book to any pregnant woman,…Well done to the author!!…" (Forparentsbyparents.com, 28 March 2003)

"…I would like to end by recommending pages 170–172 to psycho–therapists dealing with depression across the board…and also to those dealing with other mental disorder." (Journal of Child Psychology and Psychiatry, Vol.44, No. 6, 2003)

"…a clear and practical book…" (The Sun, 16 September 2003)

"…definitely a book I would recommend for all." (Primary Health Care, September 2003)

From the Publisher

The birth of their child is one of the happiest times for mothers. However, ninety percent of new mothers find themselves in tears and feeling down soon after giving birth and one in ten become depressed in their baby's first year. In the traditional medical view Postnatal Depression (PND) has been considered to be the consequence of hormonal changes but this alone is not enough to explain PND completely and health care professionals and researchers are still struggling to identify who will suffer from it and who will not.

In this down-to-earth, practical guide, Paula Nicolson, not only explains PND and outlines the theories of its causes, but also confronts the fundamental questions that most women want to know: "will it affect me?" and "what should I do if it does?".

Using the stories of 24 women trying to adapt to being mothers, Paula Nicolson deals with the issues at the heart of this problem. By having a better understanding of the realities of motherhood, including the psychological and biological aspects, new mothers are able to develop a better self-awareness, which in turn allows them to deal with the emotional and practical challenges that lay ahead.

Aimed directly at expecting and new mothers, this clear and accessible read is also an aid for health professionals and researchers of PND who struggle with the apparent lack of logic surrounding it.

From the Back Cover

Why do I feel so sad when I am so happy? I must be a bad mother.

Having a baby is usually a reason for happiness and celebration. Depression after childbirth causes emotional pain and suffering that lives side by side with the joy. That is the underlying paradox and it is that paradox that frequently leads to a sense of bewilderment and guilt.

Through the stories of 24 women trying to negotiate their lives as mothers, Paula Nicolson helps women understand more about the realities of motherhood. Ninety per cent of new mothers find themselves in tears and feeling ′down′ soon after giving birth and one in ten will become depressed during the first year. Postnatal Depression: Facing the Paradox of Loss, Happiness and Motherhood shows how better self–knowledge and a greater understanding of PND can help lift the burden and restore self–esteem and harmony to mothers and their families.

"Paula Nicolson develops her now classic study of maternal depression to help women who are unhappy after childbirth understand, accept and survive the onslaught of conflicting emotions they experience" – Sheila Kitzinger

Excerpt. © Reprinted by permission. All rights reserved.

CHAPTER 1: BEING DEPRESSED

WHAT IS DEPRESSION?

.. depression affects not only how we feel, but how we think about things, our energy levels, our concentration, our sleep, even our interest in sex. So depression has an effect on many aspects of our lives.

... you think you'll never pick up and you feel so very ill all the time and you get no relief from it whatsoever. ... nothing is worth doing you get no pleasure from anything at all.

Depression is a paradox. It is the essence of hopelessness and despair. It has the potential to ruin your life and destroy relationships at home and at work. But it may also be the turning point - the opportunity for re-birth and personal development if you manage to weather the storm and rediscover your strength. Depression is the typical response to a loss and bereavement. It is also common for depression to accompany dramatic life changes that on the surface represent the opposite of a loss - lottery wins, pregnancy, promotion at work, marriage or having a new baby.

Experts have different explanations about the causes and effects of depression. The most frequently rehearsed perspective on depression is the emphasis upon depression as an illness. Such a model is popular because it removes the stigma that sometimes accompanies psychological problems by showing that depression is not the fault of the individual who is suffering. They have something physically wrong with them. They are not to blame as they have an illness that can be 'cured'.

This view, known as the medical model, suggests that depression is caused by an abnormality of brain behaviour. The brain either fails to produce or produces too much of the chemicals that control emotion and mood. Once the brain has lowered a person's mood the body will follow.

Psychological models of depression are more complicated. Many contemporary psychologists advocate a bio-psychosocial model of depression. That means that depression occurs as a result of previous mental distress, combined with specific 'risk factors' related to current circumstances such as social isolation and a particular ‘trigger', or event such as a death in the family. Psychologists generally agree that the symptoms and experiences of depression have common features. However they also acknowledge a complicated inter-connection between biological patterns (brain behaviour or even some genetic predisposition), psychological issues (these can vary to the characteristics of the unconscious mind, to styles of thinking or personality or a history of emotional distress of psychiatric disorder) and the impact of the social context (for example stress at work, domestic abuse or a bereavement).

Some writers see transparent and fundamental links between intimate relationships (or 'attachments'), loss of those attachments and psychological and emotional change. For instance a child who loses a parent to death or divorce will suffer an extreme form of loss. An adult losing a partner, friend or even a much-regarded job may find it difficult to face the changes which are demanded of them as the inevitable consequences of the loss. Such experiences may be the triggers for psychological decline, which lead to clinical or even psychotic depression. Alternatively, the changes following such a loss may demonstrate personal growth and the development of new-found confidence and strength.

Through our experience of early attachments (usually to the parent or significant adult in charge of infant care), we see the relationship of our self to others in the world. We also begin to make sense of our inner, emotional lives in this way. Thus a child whose parent is mostly available, caring, kind and supportive will not only want to maintain a wider world experience in which people behave in this way. The child will also see itself as being worthy, valuable and essentially 'good enough'. They deserve their place in the world. So, if a person from a stable and supportive background suffers a deep and unexpected loss of a loved one, they will go through a grief reaction but at the same time they will also be working consciously and unconsciously to achieve a resolution - to get beyond the grief and put it behind them. However because they have lost a good and close relationship they know they will not be the same and that the experience will change them. However they wil! l gain more self-knowledge and their demonstrated ability to get beyond their trauma will ensure them of the confidence that the pain will pass.

This explanation of the experience of depression describes a psychological process in which we think about the world and give it meaning. It is also about the way the unconscious mind operates to colour perceptions and experiences of the world. These issues will be explored in the context of the lives of the women who talked to me about their depression.

For many people, depression and deep unhappiness have their roots in emotional experiences that need exploration and psychological 'work' in order to overcome them. Drugs without self-understanding are not helpful in the long-term, although for some women they may seem to be the only answer at the time.

SYMPTOMS OF DEPRESSION

Clinicians frequently use the criteria laid down in the Diagnostic and Statistical Manual of Mental Disorders produced by the American Psychiatric Association when diagnosing clinical depression in a patient. This manual provides a list of symptoms of which five or more need to be noted on most days and which represent a change from the way the person normally feels and/or behaves.

These include:

- Depressed mood (feeling sad or empty)
- Diminished interest in pleasure
- Significant weight loss or gain, insomnia or hypersomnia (too much sleep)
- Agitation or the opposite – being slowed down
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate
- Indecisiveness and recurrent thoughts of death
- Thoughts of suicide or attempt at suicide.

The diagnosis of clinical depression is only valid if there is no other explanation of…

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