Mental health: could you be struggling but be unaware of it?

It feels like mental health has become a ‘hot topic’ in the last few years. Thankfully, more and more people are now talking openly and honestly about their own struggles. And quite rightly so, because it’s really the only way we can help ourselves and each other through it.

Yet, despite all the talk, I’ve been asking myself this – is it possible to be unaware that we may be struggling?  Whilst we tend to know when our bodies are out of balance, and we feel ill, run down, or quite simply achy and exhausted, are we as aware when we might be struggling mentally? Are the signs and symptoms so subtle that we can miss them, even when we’re perhaps watching out for them?

Let’s talk about post-natal depression (PND)

A couple of weeks ago, I caught up with Emily Tredget, founder of MummyLinks, an app that helps local mums build friendship and support networks through playdates. This works on the basis that loneliness and the lack of a local network of friends we feel we can talk to are some of the biggest contributors to PND. Emily suffered severe post-natal depression and anxiety after the birth of her son, who’s now (at the time of writing this) two and a half years old. Emily and I had a wonderful chat, and I loved connecting with someone so passionate about building a community of supportive mums committed and ready to help each other.

Signs and symptoms

We talked about signs and symptoms of PND first. Taken straight from the NHS website, here are some of the symptoms of PND:

• A persistent feeling of sadness and low mood;
• Loss of interest in the world around you and no longer enjoying things that used to give you pleasure;
• Lack of energy and feeling tired all the time;
• Trouble sleeping at night and feeling sleepy during the day;
• Feeling that you’re unable to look after your baby;
• Problems concentrating and making decisions;
• Loss of appetite or an increased appetite (comfort eating);
• Feeling agitated, irritable or very apathetic (you “can’t be bothered”);
• Feelings of guilt, hopelessness and self-blame;
• Difficulty bonding with your baby with a feeling of indifference and no sense of enjoyment in his or her company;
• Frightening thoughts – for example, about hurting your baby; these can be scary, but they’re very rarely acted upon;
• Thinking about suicide and self-harm.

Could you ‘miss it’?

Now, I’ve had three children, and I feel blessed to say that I don’t think I experienced PND with any of them. Of course, I was aware of the risk of developing PND, especially the first time around. With my subsequent two children, I felt more confident, more able to handle the early parenting days, and I felt I knew how and where to find the support I needed, when I needed it.

But if I never experienced PND, to absolutely no degree or extent, then by definition none of the above symptoms or signs should ring true to me, right?

Well, no. Not quite. With the exception of the last statement, I can probably relate to all of the above in some shape or form, at least some of the time. Does it mean I had depression and didn’t know? Well, we’ll never know now I guess, and if I did have some mild symptoms, I’m lucky to have moved on from them in my own in time. As Emily pointed out to me, things aren’t as black and white as we think they might be. You can think of depression and anxiety as different degrees of a spectrum. But the concerning bit for me is this – could I have totally missed or misread the signs, a bit like I did years later (last year) with stress? And if I did, maybe other people do too. Isn’t that a bit worrying?

Do mums feel they can talk about it? 

As expectant and new mums, we tend to be aware of the risk of PND. But do we feel we can open up? Do we feel we can talk about it? To our Health Visitor or GP? Or to family and friends?

I asked Emily, who obviously knows a fair bit about PND, not just from personal experience but also from the many connections she’s made through her work, and she told me mums are quite simply scared. Of course, this is a generalisation, and everyone’s experience is totally personal and different. But no, we don’t really feel like shouting from the rooftops that we think we may be struggling with our mental health.

Emily told me: “When you are depressed, you’re so wrapped up in yourself that you think you’re the only one who feels like that, but if one in five mums develops post-partum depression, it means that not enough people who do have it are talking about it. They’re dealing with it on their own. People feel judged, scared, and the comments people make, including the expectations you’re put under, don’t help”.

The Edinburgh Postpartum Depression Scale questionnaire

At my 6-week post-partum check, I remember the GP asking me: “Are you depressed?”, to which I said no. In all honesty, even if I had thought I might be, I probably would have said no anyway. But is that it though? Is the idea to self-diagnose? Do we have the tools to self-diagnose?

Emily told me that she specifically asked her GP to be tested. It was her own husband who spotted changes in her that made him think that ‘this wasn’t her’. So she answered the questions in The Edinburgh Postpartum Depression Scale Questionnaire. It’s a set of 10 questions which returns a score up to 30 and tells you whether your results are or aren’t indicative of depression.

However, as Emily pointed out to me, someone with depression could be worried about its implications in terms of others knowing about their condition, how it would impact their parenting, or the fact they may be put on medications they may not be sure they want to take. So it’s quite common for women (and men!) experiencing PND to potentially want to hide it. In which case, it’s really easy to ‘trick the questionnaire’. I’ve tried it myself, and you know what kind of answers would put you at low vs high risk!

So what support is available? 

Of course, we know that good medical support IS available when we seek it. But it’s not just about that. It’s about taking it a step back and helping mums feel ‘safe’. If fear of being judged, blamed, labelled as ‘bad parents’, or even fear of having their children taken away is stopping mums for being able to recognise their own struggles, something has gone a bit amiss with the society we’re in.

“We no longer have a village”, I said to Emily.

“But I think the village is coming back”, Emily said. “It’s just different”.

And it’s true. More and more initiatives are coming out to put women together again. To support each other in our journeys. As Emily said, “We are not raised to be mothers anymore. We are expected to achieve, to have successful careers, to not appear as weak, and to do everything. But most of us are now raising children on our own, with our partners typically at work, and often living away from our families. This loneliness is definitely a precursor to mental health struggles.”

Let’s bring the village back!

So let’s join forces to bring the village back, Ladies. It’s definitely something that’s been on my mind for a while. We are all ‘real people’ being open and honest about our struggles. Emily struggled with PND and anxiety. I struggled with stress and an inability to dial down my perfectionism and need to achieve, which led me to become so overwhelmed and frazzled that I had to be stopped by an injury. While Emily has been building her fantastic network through MummyLinks, I’ve been sharing my journey, my challenges, and the changes I made to my life here on this blog.

Let’s bring the village back.

Please come and find us.

You can connect with me on Instagram, Facebook, or Twitter. And you can find Emily on Instagram, Facebook, and Twitter too. Make sure you come and say hi!

Do you have or know of an initiative that is aimed at supporting mums in a safe, non-judgemental space? Let us know!