Health

Prenatal depression: My fourth pregnancy left me blindsided — where is the support?

I

was on my way to work, stepping into a busy tube carriage when several people immediately jumped up to offer me their seat, smiling at me encouragingly. I froze, my heart sinking, and I stumbled off the train as quickly as I could. It felt impossible to move, and so I stood there on the platform for what felt like hours, letting train after train go past.

It was 2017 and I was expecting my fourth child. My previous pregnancies were easy and uncomplicated and very positive, yet this time I was utterly blindsided by extreme feelings of dread and despair.

I have since learnt that I was suffering from a mental health conditional called prenatal depression, a lesser-known form of depression compared to post-natal depression, but no less challenging. Studies show that one in five pregnant people develop mental health problems during pregnancy and a recent report found that the number of women suffering with various forms of depression or anxiety rocketed from 17 to 47 per cent during the pandemic. Considering that there will be many undiagnosed cases amongst women and in particular the trans community, that number is likely to be even higher.

My particular form – prenatal or antenatal depression – can come in all sorts of guises, from feeling extremely anxious to fear or anger towards yourself or the baby – often it’s accompanied by feelings of debilitating guilt. In my case, it felt as though an all-encompassing sense of hopelessness had descended on me, and I couldn’t get out.

I reached out to my GP, who examined my pregnant belly instead of actually speaking to me about my emotions. She filed my feelings away under “normal pregnancy hormones” which I knew was wrong, even at the time. But I felt too embarrassed to challenge her and I still had three children to look after and a job as an animator, filmmaker and educator to do. I carried on on autopilot, all the while increasingly unable to think clearly and imagining terrible things happening to my baby. I did not share this with the GP or any midwife out of fear of being dismissed again. In hindsight I think that’s because I was still “functioning” in the conventional sense – my state did not raise alarm bells with overstretched and overworked midwives who really were doing their best.

But while I might have seemed OK to the outside world, I increasingly felt like I was living in a sort of fog, and as the pregnancy progressed I found my thoughts spiralling into a very dark place – including thoughts of harming myself. Ironically it was during an idyllic summer holiday in Austria with my family, when I found myself on a picturesque mountain path drenched in sunshine, that I felt I was ready to end my life. A steep drop on the side of the path, I imagined jumping. I was holding my son’s hand and realised he would either fall with me or see me fall. So I carried on walking.

Back home, the dark thoughts continued. It was my husband who eventually called a crisis team from the local council for people in need of urgent mental health support. The following day a (well-meaning) member of the crisis team sat in my flat, pointing out how clean it was, saying that “things can’t be that bad” and prescribed antidepressants. There on my sofa, that same member of staff also casually mentioned that I might be suffering from something I’d never heard of before: prenatal depression. I was seven months into my fourth pregnancy, yet it was the first time I had even heard the term.

I started researching and Googling, but there was very little information out there. What little there was, was usually amalgamated with postnatal depression, like the two were the same thing. I was desperate for specific advice, such as the effect of medication on the baby, but couldn’t find anything. While there were quite a few forums online with people sharing their experiences of postnatal depression, I could not find an online community for prenatal depression at all.

I have always loved swimming in the wild – it’s free, you are not bound by opening hours and it’s beautiful. So in a way, I discovered cold water swimming by accident. It wasn’t really a thing back then. Then one day I bumped into my neighbour, Eleanor (who was also suffering with prenatal depression), in the street and she asked me to come cold water swimming with her – and a new routine was born. Being surrounded by nature felt immediately humbling and calming. A big part of this ritual was getting up before sunrise when the world and the household were still quiet. There is something special about connecting with that moment of the day. It gave me something to look forward to and the often ice-cold water reset the body and mind.

The way this idea came about was very instinctual, not based on research or the little information there is out there about how it can help with prenatal depression.

It was cold water swimming that finally helped me to feel better, and ultimately giving birth to my daughter, cured me. It was many months of swimming before she came along; you cannot overstate how helpful this was.

The swimming changed my entire outlook, but I still wish I’d had the professional support, too. If I’d had information about prenatal depression earlier on, my family and I could have tackled it much better – with more confidence and more hope.

There really is no need to feel so stigmatised and alone. There is a way out, and I have now been able to draw strength from the experience.

It is also important to note that of course swimming is not for everyone. Having had the opportunity during the making of this film to speak to so many affected people, it really became clear that in order to support yourself during those dark moments you have to find your thing – swimming, walking, boxing – something you truly enjoy and that is entirely yours, whatever that might be.

The idea for the film developed rapidly and organically, based on Eleanor and my close friendship, our shared experience of prenatal depression, and our shared artistic and social views. At the core of our conversations around this project is conversation itself. By talking and noticing how this helped us both process our feelings —with the complexities surrounding it in terms of expectations, social mandates, and lack of awareness — we realised how important it is to simply talk about it. Making the film was a way to keep the conversation going and expand the number of people involved in the conversation. There is a special kind of empowerment that comes from this act of sharing. Too many pregnant people suffer in silence out of fear and guilt, and we really hope to change this.

We must talk about prenatal depression to help each other, we must talk about it to keep each other company and teach each other, and ultimately, we must talk about it to save each other from the very real danger this illness poses.

Katharina and Eleanor’s documentary, Within the Water, is available to stream on WaterBear now

Advice for people who might be suffering with prenatal depression

Prenatal depression is a recognised illness, there are lots of ways to seek help. There is medication, talking therapy or somatic therapy, and lots of other ways you can be supported or help yourself. Here are three of my top tips for those who might be suffering:

Talk

Mental health is much less stigmatised nowadays, and if you don’t feel comfortable talking to your GP, reach out to a friend, a neighbour, family member or even a stranger if that feels easier. People are usually very keen to help when asked.

Take things hour-by-hour

Start small, take it step by step and think about the next hour ahead, rather than the big picture.

Find an activity that calms you or brings you joy

We met people who liked to walk in the woods, took up a new sport, or simply spent some time alone. Our advise would be to follow your instinct and find something that calms you, or brings you joy. There can be something empowering about finding your own thing which you might want to continue even as you feel better. But if you don’t feel you can do that, please reach out.

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