9780471485278

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 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 percent 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.

About the author

ix

Foreword

xi

Acknowledgements

xvi

Introduction

1

(1)

Who should read this book and why

1

(10)

Being depressed

11

(14)

What is depression? - official and unofficial definitions

11

(4)

What it feels like to be depressed

15

(1)

Who gets it and what causes it?

16

(3)

Explaining depression

19

(6)

What is postnatal depression? Discovering the paradox

25

(16)

Different theories and different kinds of depression

25

(4)

The baby blues

29

(3)

Postnatal distress and depressed moods

32

(4)

Postnatal depression

36

(5)

What causes postnatal depression? Why me? Why now?

41

(34)

Different approaches to understanding women's postnatal experiences

41

(1)

Trauma following birth

42

(7)

Factors influencing PTSD

49

(2)

Worrying about the baby's health and welfare

51

(2)

Getting the best support over the postnatal period

53

(2)

Coping with depressed moods

55

(2)

Finding social support

57

(1)

Not all company is supportive

58

(2)

Getting support to prevent PND

60

(2)

What has happened to me?

62

(11)

Motherhood and the arrival of self-confidence

73

(2)

Happiness and loss: the paradox of postnatal depression

75

(32)

Introduction

75

(2)

The experience of loss

77

(2)

The healthy grief reaction

79

(3)

Losing sleep

82

(1)

Losing time

83

(2)

Bodies

85

(2)

Breastfeeding

87

(3)

Feeling too fat

90

(2)

Losing your looks

92

(1)

Losing your `mind'

92

(5)

Losing my self

97

(3)

Being clear about who you really are

100

(5)

Finding yourself as a mother

105

(2)

Being a `good' mother: the paradox of sacrifice

107

(30)

Introduction

107

(3)

What is the truth about the maternal instinct?

110

(1)

Is maternal instinct a biological drive?

111

(4)

Is there a paternal instinct?

115

(1)

Is biology destiny?

115

(2)

Were you born knowing how to bath a baby?

117

(1)

The father's role

118

(2)

Is a good woman the same as a good mother?

120

(3)

But, what does make a good mother?

123

(4)

Negotiating the boundaries between self and other

127

(5)

Voices of the experts

132

(5)

Postnatal depression by proxy

137

(28)

Introduction

137

(3)

The paradoxical burden

140

(3)

Women's rage: gender relations or PND by proxy?

143

(7)

What do women expect?

150

(1)

Penelope's story

151

(5)

Wendy's story

156

(4)

Isobel's story

160

(4)

Understanding PND by proxy

164

(1)

Challenging the paradox and getting on with your life

165

(18)

Introduction

165

(1)

Taking control: when and how?

166

(3)

Social support

169

(1)

Emotions fitness

170

(3)

Finding the help you need

173

(1)

Cognitive-analytic therapy (CAT)

174

(1)

Cognitive-behavioural therapy (CBT)

175

(1)

Physical fitness

176

(2)

Where to go from here?

178

(1)

Conclusions

179

(4)

Portraits of the women

183

(30)

Useful books, addresses and websites

213

(2)

Notes and references

215

(6)

Index

221

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Postnatal Depression : Facing the Paradox of Loss, Happiness and Motherhood

0471485276

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