Health visitors performing CBT? Please no…

I’ve had a read of the recommendations that the charity 4Children makes to improve prevention, diagnosis of and treatment of ante and postnatal depression. They identify roles of health visitors in providing practical support before the birth – something I wholeheartedly support, but also recommend training health visitors in CBT, which I think needs a lot more consideration. Health visitors are not trained therapists, and a short CBT course could, potentially, do more harm than good if they suddenly became the ‘experts’ in PND.

The charity is also calling for talking therapies to be better funded and more widely available. Realistically, a lot of women with new babies simply don’t have the time, and can’t access the childcare required to attend regular counselling sessions. The only way I can see this working is by providing some sort of helper or creche facility, which would immediately increase costs. I would also hope that antidepressants aren’t demonised too much. The report notes, in a somewhat horrified tone, that 70% of mothers with PND are taking medication. For me, no amount of talking therapy would have taken the place of my ADs, and in fact only when they started to kick in was I in a calm enough place to examine my thoughts, or speak the truth about my feelings.

I support the idea of a national campaign to raise awareness, and remove some of the stigma associated with the condition. Much as I loathe the deification of celebrities in general, I do think it would be helpful for some well-known women who have suffered from PND to acknowledge their situation. Motherhood is so exalted within the media, that I doubt any celebrity struggling to cope, not bonding with her child, feeling lost and tearful etc, would be keen to admit to it. That, in turn, would require a shift in society in recognising that bringing up babies is tough, and not every woman is a natural. And that we need support – social, emotional, and financial.

The old black dog’s still here…

I started reading a thread on the ante/postnatal depression section in Mumsnet last night and was very moved by how raw the poster’s feelings seemed, how desperate she was for help, and yet was struggling to seek it. It was lovely to see such a warm and supportive community responding with kind words and their own experiences.  It brought back my own feelings of shame and anxiety, and with both babies it took me until they were 6 months to finally see my GP. I remember writing in a notebook “I need help” as I sat crying. I covered the whole page with my plea. Everything hurt. Everything felt mad.

How far away from my current feelings, I thought. Then this morning, I totally lost it when trying to get my son off to nursery and me and the baby on a train to London to meet a friend. I rarely do anything like this, and it was a real expedition for me. I felt panicky, lost, out of control. The fact that I had a specific train to catch made me very stressed, I snapped at the children. I felt the madness return and almost burst into tears as I left the house.

Once on the train I was fine. But it felt like I had ripped a hole in the atmosphere of my bubble. The old pain returned, if only briefly, and I realised that I wasn’t as “cured” as I maybe thought. How ironic, too, as I think of my previous, pre-children London life. I lived there from when I was 17 until two years ago. My life was busy, varied, fun. I now appreciate how small my world has become. I find comfort in its safety and predictability. On any day of the week I can tell you what we’ll be doing. I know small children thrive on routine, but I wonder if I’ve been using that as an excuse not to venture out of my comfort zone. I wonder if I’m doing both them and myself a disservice by not being more adventurous.I’m going to have a think about this and see if there are some areas where I can push the comfort zone a bit further.

On another note, I’ve signed up for a PND research study – I’ll be given some CBT sessions and I guess they’ll monitor my progress. I don’t know much about the study yet but they’re going to call me next week. I have trained to practice CBT myself (as part of my lifecoaching diploma) and know it can be useful for a variety of things. It’ll be interesting to be on the receiving end of it and see how it helps my anxiety levels.