Got Post Natal Depression? I Have Now!

Got Post Natal Depression? I have now!

So, what happens when your GP has diagnosed you with post-natal depression? Well firstly, your health visitor will come and visit you every fortnight. I don’t mind this- my health visitor is very nice and helpful, and not a bit like the busybody health visitor stereotype (although I have met that sort as well). And secondly, you will be given a place on the golden waiting list (roughly a couple of months) for Cognitive Behaviour Therapy, or CBT. CBT is a practical, solution-based therapy that focuses on the here and now rather than things that have happened in the past. It aims to develop positive thinking strategies, and challenge negative or self-sabotaging behaviours. Sounds great, doesn’t it? I thought so too, and was much more keen on the idea of developing positive strategies than I was on taking anti-depressants (still haven’t touched them!). And I’m not against CBT as a concept, I’m really not. I’m sure if you had a really good therapist it would be, well, really good. However, in my experience, the local council run CBT service leaves a lot to be desired.

My disillusionment was almost instant when I met my “graduate” therapist (let’s call her Sarah). Not only did she look alarmingly young (not her fault I suppose), she also had the appearance of someone who has spent the night in a mosh pit and not been home yet. We were all students once, of course, but most of us ditch the ripped tights, chipped nail polish and mismatched earrings once we take our first tentative steps into our chosen career. Sarah clearly didn’t give a monkey’s uncle what she looked like, which I suppose was a bad sign from the start.

The first thing she asked me to do- the first thing you do every session- was fill in a questionnaire, and this acts as a little analysis tool for the therapist. It asks all the usual stuff- do you find it hard to get up in the morning, have you considered jumping off a bridge etc. Once I had completed it, and Sarah had generated a score, she told me that I didn’t have depression after all. However, my anxiety score was high, so this meant I had a severe anxiety disorder. I didn’t disagree with this- I’ve spent long enough experiencing that sick knot of dread in the stomach to know that I probably have some anxiety issues.

Sarah asked me to immortalise my self-destructive musings in a “thought diary”. This was difficult for me, as I prefer to forget negative thoughts as soon as I’ve had them, and usually try to focus on something positive instead. When I took the thought diary to my next appointment, she looked genuinely perplexed. “All these thoughts point to depression,” she said. “But your main problem was anxiety.”

And this is where the analysis system is flawed. The questions on depression focus on how much depression is affecting your life and what it prevents you from doing. For example; “Do you avoid leaving the house?” In other words, the current professional stance is that a person with depression won’t open the curtains in the morning and mopes about the house all day. There’s no allowance for the possibility that a depressed person might get up in the morning, go to work, do the shopping on the way home, and generally get on with life. I’ve got a baby girl, as you know. If I didn’t get up in the morning, get dressed, get her dressed, feed her, play with her, and take her out in the pram, then I’d be neglecting her needs, and I don’t think I would ever do that, no matter how depressed I was.

The weekly sessions are supposed to be thirty minutes long. But they’re actually twenty-five minutes. Five minutes of that is spent doing the questionnaire. That only leaves twenty minutes, which isn’t really long enough to get a productive dialogue going, especially when I can’t stop staring at Sarah’s dirty fingernails.

Maybe I expected too much. I had hoped for a revelation, to be told something that I didn’t already know. What I actually got was Sarah explaining the fight or flight reaction to me, which wasn’t really necessary, since I learned about it in GCSE Science. She advised me that I was self-sabotaging and catastrophising, which wasn’t really helpful as I’m already aware that I do that. She suggested that I “challenge” my negative thoughts, which something I have been doing ever since I read about thought-challenging in the pop psychology section of my mum’s magazine in 1998. So far, my health visitor has been much more help to me, because at least she listens to me and offers sensible advice, instead of labelling my thoughts and telling me to stop thinking them. And as anyone who has ever suffered from depression or anxiety will know, there’s nothing more crushing than being told to stop thinking what you think. If only it was that simple. For anyone who is in the same position, I would say definitely try CBT. Just don’t expect it to be the slightest bit of use. ;-)