Sunday 20 August 2017

'I sat on the bed with tears streaming down my face' - Mum opens up about battle with depression during pregnancy

Although her pregnancy was very much desired, BethAnne Linstra Klein struggled with depression throughout, until one doctor finally listened

'Functioning' again: BethAnne is happy now but during her first pregnancy she couldn't speak to doctors or midwives. Photo: Damien Eagers
'Functioning' again: BethAnne is happy now but during her first pregnancy she couldn't speak to doctors or midwives. Photo: Damien Eagers

BethAnne Linstra Klein

I was 32 when I became pregnant for the first time. I was with my partner, now husband, for four years, living together for two. It was a happy, steady relationship and the pregnancy was very much planned and desired.

In the first trimester, the tradition of not telling people felt weird; like it was a secret to be ashamed of.

I went for the "booking-in" appointment, and was surprised that we barely even spoke to the GP. I mentioned that I was feeling a little low, and they dismissed it. So, I did too.

Yes, I was scared, yes, I was hormonal, but this was more than that. I was ashamed that I felt so sad and anxious. I felt inadequate for not being happy about my impending baby.

As the baby grew so did this other thing inside me: an emotion so strong it was a solid thing, like bile in my heart threatening to drown me.

Through the second trimester, when I went to the GP or to the hospital check-ups, I tried to tell someone.

"I don't feel great. I feel… sad," being the closest I could get to explaining the black, bilious thing which threatened to kill me.

"Oh, I wouldn't worry too much about that. It's perfectly normal to feel a bit sad in pregnancy. There are so many changes. It's such an exciting time."

And I would nod, with tears streaming down my face, as they presented some platitude: "I'm sure you'll feel better soon."

Before I left the examination room, I dried my face and wiped my eyes.

God forbid all the happy pregnant women in the waiting room should see me crying. They would never understand. They would never sympathise.

As the weeks passed, we began to tell more people, my body was changing and I began to hide inside my clothes.

When people found out I was expecting, they would say, "Oh, congratulations on your pregnancy! Is this your first? You must be so excited."

I must be so excited.

And I am the worst person in the world because I am not excited.

The thought that I shouldn't be feeling this way made me feel worse, made me feel… defective.

I felt like a fraud as I struggled to act like I cared around my friends. When people asked how I was feeling, I answered with a vague "oh, I'm fine". It was the happiest reply I could manage, and since it didn't convey any actual unhappiness, people seemed to just let it slide and didn't press me any further.

I couldn't tell people because I knew they wouldn't understand, they would think me a bad mother before I had even had a chance to be a mother.

There is a stigma around depression which seems to focus on the person's inability to heal themselves. We wouldn't expect someone with a physical illness to cure themselves with just the power of their mind.

Yet, when the disease is within the mind, it's seen as a sign of weakness if you cannot 'snap yourself out of it'.

Depression resulting from a tragedy is just about acceptable. Depression arising from a very happy event is incomprehensible.

Pushing into the third trimester, things only got worse. I stopped saying anything to the doctors and midwives.

I just sat on the bed with tears streaming down my face as the doctors looked at my chart and never looked at me. They would examine me but see only the baby.

I was stuck in a loop: first I was sad, and then I felt guilty for being sad. If I had a good day, if I was happy at all, then when depression came back again, it created another layer in the complex guilt.

I loathed myself for not being happy and excited and normal. I felt guilty for not being able to sustain my own happiness.

And then finally, sometime near the 30th week, someone listened. My partner took off work to go to the appointment with me, as I had reached the stage that I couldn't speak for myself.

His purpose was to speak for me but happily, he didn't have to.

This time, the doctor listened. Dr Kent. I don't remember her first name but she saved my life. I cried and I told her how deeply broken I was, and she listened.

She got me a referral to the consultant psychiatrist in Holles Street. There, Dr McCarthy fixed me, or at least made me as whole again as I am today. I still have days that I fight depression.

I still struggle, as my self-esteem has never fully recovered. I find it hard to look people in the eyes when I talk to them. But I am a functioning human being again: I am happy. I laugh and I cry when it is appropriate to do so.

That was 2011, and since then I have had another baby in 2014. The difference was, that in the second pregnancy I was under Dr McCarthy's care, and my mental health was monitored throughout the pregnancy.

I was a different person. I enjoyed wearing maternity clothes, showing off my bump and not hiding it behind thick woolly jumpers.

To the people who care for women during pregnancy, I would ask that you listen to your patients. Remember they are humans and not just statistics on a chart. Depression doesn't always mean being in bed and unable to get up. Shouldn't we acknowledge that people have a voice and that they know themselves best?

Suicide does not always mean you are actively trying to kill yourself. It can be a wish to be dead or a level of risk-taking that's unhealthy.

To the pregnant women feeling the same way I did, please know you are not alone. You are not a freak, not a fraud, not a failure. You are ill. If the people you are asking for help aren't listening, keep asking new people. I am sorry to have to give this advice, but you must keep asking. It is my hope and my desire that the results of the recent Trinity College, Dublin Well Before Birth study (see panel) will challenge the stigma and expectations in perinatal mental health. I hope that you don't have to ask as long as I did.

BethAnne is one of the women taking part in the National Women's Council of Ireland's film Out of the Silence: Women's Mental Health in Ireland, which will be launched at the World Congress on Women's Mental Health today. For more information, visit nwci.ie

One in six pregnant women - or 16pc of pregnant women - attending maternity services across Ireland are at probable risk of depression during their pregnancy, according to the recent Well Before Birth study by Trinity College, Dublin and the Irish Obstetric Services. Ireland has the second highest birth rate in Europe, with an average of just under 68,000 births a year (2014).

This means that in one year, over 11,000 women could be experiencing or at risk of depression during pregnancy.

There is increasing evidence that depression during pregnancy can have an influence on obstetric health and may compromise the physical and mental health of the infant. However, screening for antenatal depression is not routine in Irish maternity hospitals and perinatal mental health services are under-resourced in comparison to other EU countries.

One in six are at risk, research shows

One in six pregnant women — or 16pc of pregnant women — attending maternity services across Ireland are at probable risk of depression during their pregnancy, according to the recent Well Before Birth study by Trinity College, Dublin and the Irish Obstetric Services. Ireland has the second highest birth rate in Europe, with an average of just under 68,000 births a year (2014).

This means that in one year, over 11,000 women could be experiencing or at risk of depression during pregnancy.

 There is increasing evidence that depression during pregnancy can have an influence on obstetric health and may compromise the physical and mental health of the infant. However, screening for antenatal depression is not routine in Irish maternity hospitals and perinatal mental health services are under-resourced in comparison to other EU countries.

Irish Independent

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