Postnatal depression: it can strike at any time, but sharing experiences allows women to help each other

When Dr Katie Larson discovered she was pregnant, she asked her friends, family and midwives to monitor her for any signs of post-birth depression. Having witnessed her own mother’s two-decade battle with postnatal depression, which came to light when she attempted to take her life, Larson understood the need to warn her support network of the signs and how best to support her. But Larson’s depression went unnoticed because it came on a year after her child was born and the symptoms were unlike her mother’s which were more mental – negative thoughts and worry. Larson felt exhaustion, apathy and a lack of emotions. “I did not show any signs of depression for a year, so when it hit me, it was hard for my support network to take notice and help,” says Larson, a growth transformation coach at GrowthQuests in Hong Kong’s Central district. “Luckily a friend confided in me that she was struggling with depression and when her description matched my experience, I realised I also needed to seek help,” says Larson. Larson attributes her depression to the lack of a creative outlet outside the home, which led to boredom and exhaustion.“Although I was doing loads of things inside the home to care for my child, I found it wasn’t stimulating enough for my whole being, so I was getting tired of only using the mother side of me all day. This was depressing because the sides of me that had historically given me the most joy were dormant,” she recounts. She took a “tour-de-wellness”, which included seeing a general practitioner, a naturopath, an osteopath, a physical therapist, a counsellor and a spiritual healer. She also takes regular baby-free staycations. Larson established Mum-Quest earlier this year. Mothers leave its monthly sessions with a toolkit of realistic, pragmatic self-care tools that allow them to practise healthy boundaries, trust their intuition, communicate their needs, and receive help without guilt. While there’s an assumption that mothers may experience mental health challenges days or weeks after the birth of a child, the reality is such challenges can strike at any time, says Melissa Shadforth, an integrative counsellor at IMI in Hong Kong and the founder of The Collective Journey, a platform that offers mentorship experiences for children and adolescents. Sophie (name changed to protect confidentiality), a mother of three, says the daily nagging that comes with motherhood, sibling squabbles, and juggling everyone’s needs recently caused her maternal anxiety. “My children are great – it’s the developmental phases that are overwhelming. My four-year old throws tantrums, which turns our home into a battlefield. My tween can cry for weeks because of friendship issues. My 13-year-old is on her own hormonal roller coaster. I carry all their frustrations. “My husband isn’t attuned to their feelings and my family live abroad. I love being a mum but some days I feel resentful and miserable,” says Sophie, who is currently working through her anxiety with the support of a psychologist. The demands in the first few years of parenting are significant and often layered with the weight of marital conflict, perceived loss of personal freedom, juggling work and family commitments, says Shadforth. “More recently, I am seeing in practice that a mother’s distress can peak and well-being bottom out during her child’s early adolescence,” she notes. Research confirms Shadforth’s observation. Mothers of middle-school-age children are at the greatest risk of stress and depression due to feelings of emptiness, reduced life and parenting satisfaction, and maternal rejection, according to an online survey carried out in the United States, entitled Moms As People. Mother-of-two Rachel Van Caeseele Middagh, an administrator for Facebook group Hong Kong Parents of Tweens and Teens, says that, as wonderful as parenting tweens and teens is, it’s challenging because of the changes that kids go through. It is also a difficult transitional time for parents. “It’s exhausting as children begin to psychologically leave the nest. Puberty, experimentation, a child seeking independence and their own identity can feel scary and difficult to talk about with other parents. Sometimes it’s difficult to articulate your fears, and even understand the full scope of your concerns. “The effects of social media, online gaming, teen relationships, and reflections on parenting this age group – these are the kind of things I post on the forum,” says Middagh, who says the forum is a supportive, non-judgmental community of parents with a great sense of humour. Sophie says she feels lonely as she navigates the challenges that come with the teenage years. Her loneliness is exacerbated when her eldest child occasionally pushes her away. This makes sense given that research shows that mothers tend to be more affected than fathers by emotional distance from teenagers, as their identities are strongly associated with the maternal role. As daughters transition into womanhood, mothers are going through their own transitions too. They’re grappling with ageing – both physical and cognitive – they’re seeing the changes to their own bodies; and depending on when they had children, they may be peri-menopausal or menopausal, Middagh notes. Adolescence in the home can also overlap with a “mid-career crisis” or a return to work after a period of extended “time out” or phased maternity leave while in the primary carer role, Shadforth adds. “While trying to recover perceived ground lost while absent from the workplace for any length of time, women can feel the need to over-promise and over-deliver to justify their place in the organisation or the business they have created, all while juggling family commitments that grow in significance as education, peer, sporting, and other extracurricular demands increase. “The intellectual, emotional, and physical load on the primary carer of this work is becoming more widely understood and should not be underestimated,” she says. Sometimes as parents we aren’t doing or feeling well, and we’re not shining, and that’s OK. Reaching out for support from friends, mentors, counsellors, or other professionals when we need it and receiving it without judgment is a compassionate act Melissa Shadforth, integrative counsellor The African proverb “It takes a village to raise a child” is relevant today for mothers of children of all ages. “With the pressure and pace of modern life, it’s easy to disconnect from our village. We slip into survival mode while feeling we need to be everything to everyone, which serves no one,” Shadforth says. “As parents and carers, we’re not wired to carry this responsibility alone. It is a collective journey. Each mentor in the village has their perspective to share, skills to teach and way of being to model.” Middagh agrees. “I have friends with older children. Everything they share with me, I file in my head. We may have different parenting challenges, but it is a big comfort to have these women in my life,” she says. Authenticity in relationships, satisfaction with friendships, feeling unconditionally loved, and feeling comforted when in distress are all important factors to support mothers’ mental health, Shadforth says. To support the well-being of parents and carers of adolescents, Shadforth intends to launch an initiative called Compassionate Connections in August 2019. The in-person and online sessions will allow mothers to reach out and receive support without judgment. “Sometimes as parents we aren’t doing or feeling well, and we’re not shining, and that’s OK. Reaching out for support from friends, mentors, counsellors, or other professionals when we need it and receiving it without judgment is a compassionate act that can benefit all family members as we navigate challenging times,” she says.