Twins and more on a Tuesday: Post natal depression

 

Twins can be a gorgeous blessing but bring extra demands for the parents.

JENNIFER at Twinhappy has a Twin Tuesday event where she wishes multiple birth families, wherever they may be, a wonderful day.

Last Tuesday I recapped about sleep problems with my twins for Josie.

Josie's Sleep Deprivation Carnival had a wonderful response, with lots of experiences and advice shared.

This week, for Twin Tuesday, I hoped it may be useful to dig out one of the most popular posts from this blog, about post natal depression and how, not surprisingly mums coping with more than one baby at once can be more susceptible.

Miranda's story has attracted some very supportive comments and emails. There's still a need for it to be heard as Google continues to send people looking for relevant information our way.

Post natal depression in mums of twins, triplets and more 

 "I didn't want to get out of bed, I felt I'd let everyone down and just kept crying all the time," says Miranda.

How familiar does that sound? I know I've been there. Thankfully I'm better now but please, if you are suffering, do something about it. It's not your fault, you haven't let anyone down.

Miranda, mum to three-year-old twins Natasha and Bryony, adds: "The pregnancy had been terrible so after that, I thought I'd cope with anything. But the first seven months of my girls' lives were the worst I could imagine.

"Yet I kept quiet. I was a new mum with two lovely babies - who on earth would understand? The terrible stigma of being ill in this way meant I kept my fears and anxieties secret."

 "It was all a blur at first, an emotional rollercoaster of feeding, winding, changing. I had no sleep and my daughters seemed to cry all the time.

"My husband wasn't much help - he was out at work all day. I found myself getting moody and snappy. I was all churned up inside.

"I sat on my bed and sobbed with my head in my hands and couldn't see a future. I felt the fact that the washing up began to pile in the sink and my hair was a mess was all down to me being a useless mum who couldn't cope.

"But whenever I thought about how I felt, it made me even worse - what the hell did I have to worry about? I felt so guilty.

"Friends have been trying for a baby for years. Here I was with what they prayed for every day, but feeling terrible, how bad was that?"Yet I thought I was hiding my depression so well. People praised me on how well I was doing, saying they didn't know how I coped.

"It was only behind closed doors that I broke down and cried. Life was hell.""I should have had help from my health visitor, but mine didn't pick up on what was happening and I was too ashamed to say anything to her.

"My wake-up call came from my family doctor. I'm afraid as so many people do, I sobbed in her surgery. But she didn't judge me. Instead she asked me to fill in a questionnaire and from there, we discussed the best way forward.

"I was prescribed anti-depressants. I really wasn't bothered about all the horror stories of side effects and getting hooked, I just wanted to feel better.

"Today, a couple of years on, I'm happy to say I do. The pills took a couple of months to work but they have helped enormously.

"I've also spoken to my husband about being there more and confide in him more about how tough looking after two young kids can be."

Miranda's story is typical. Did you know post-natal depression was more common in mothers of multiple birth children? It's not exactly rocket science to understand that more than one baby means a greater chance of becoming ill, but still many mums struggle on, thinking they are to blame.

Mums of twins or more may be affected by:

* The increased stress of the reality of looking after more than one baby.

* Anxiety over their relationship or the financial pressure.

* Added worry over poorly or premature babies.

* Feelings of isolation.

* These feelings can be made worse by postnatal exhaustion.

Tamba reports that postnatal depression is more common among mothers of multiples, even up to five years after the birth.

The charity advises midwives to emphasise the importance of obtaining extra help to parents and to find time for their own relationship in the early weeks. Support from an extended family or friends and outside agencies is essential.

Initial problems that parents may meet include:

* Isolation, due to the practical difficulties of getting out and about.

* Less time to cuddle and enjoy each baby individually.

* Guilt at not being able to give each baby equal time if one is more demanding than the other.

* Exhaustion due to frequent feeding and baby care tasks and adjusting to new family relationships

* Babies’ sleep problems

* Jealousy and behaviour problems in older siblings

* Medical problems: Complications after birth and/or separation from babies while they are in Special Care, allowing babies home at different times.

* Some mothers have experienced a difficulty in bonding with the smaller baby where there is a significant difference in their birth weights.

Health visitors can also help prevent the debilitating disease of post-natal depression taking hold by encouraging families to make practical arrangements for coping.

Tamba urges them to:

* Encourage the family to accept all help offered and to seek assistance if it is not forthcoming.

* They may be able to benefit from local colleges running childcare or nursery nurses courses who have students needing family placements.

* Or they can contact Home Start whose volunteers are ideally placed to help new multiple birth parents, especially those who also have older siblings.

* Identify the problems and discuss possible solutions - the family may be too busy with the babies to do this.

* Clinic visits can seem impossible due to lack of transport, changes in routine, lack of practical help, restrictions on prams/buggies in health centres.

* Regular home visits for several months and/or extra pairs of hands at the clinic will be welcome. Babies may be less likely to miss developmental checks and vaccinations if visited regularly at home.

* Allow adequate time for discussion at health checks. Mothers may need to share fears and feelings of guilt and those in the early stages of depression can be more easily identified.

* Advise on how to deal with problems with older siblings - e.g. transport to school/nursery, jealousy and other behaviour problems that result from feeling overwhelmed or abandoned within the family.

* Parents should be encouraged to have some quality time alone with their other children to give them their full attention.

Jill Walton, Tamba’s honorary research consultant told me when I reported on another mum's depression: "PND has a gradual onset, somewhere between two weeks and several months. Two-thirds of sufferers recover within three months, although it can last for up to a year.

Symptoms vary, and can include anxiety, despondency, tearfulness, tension, inability to cope, irritability, panic attacks, tiredness and lethargy, loss of concentration, memory and appetite, loss of interest in sex, and loss of interest in the babies. Research shows that mothers of twins are more likely to suffer than single birth mothers.

"The onset of PND may be later and it may last longer. The sheer physical demands of having to cope with two or more babies at once make a mum more prone to PND. PND in mothers of twins is largely due to insufficient support at home, and the degree of disruption that twins cause to a family situation.

So please, please if you are reading this, do yourself a favour and read that last bit again - the degree of disruption that twins cause.

So you can forget any notion that it has anything whatsoever to do with you being a 'hopeless' mum.

Depression is a disease. Please speak up now, and get yourself looked after.

Be kind to yourself.

You know it makes sense! A cliche it may be, but you wouldn't ignore a broken ankle so don't ignore how you are feeling first thing in the morning - as that is when depression may have its strongest hold.

Sources of help and support:

Tamba Twinline and Meet a Mum.

Twenty useful posts about twins, triplets and more.

Comments

[TwinHappyJen]

Oh what a great article... I'll definitely have to share! I definitely had my own struggles with this... I know the name of my site "TwinHappy" might sound ironic when I tell people this, but I had a lot of problems with depression after my twins got here (and especially when they were 18 months old and we also had my two teenage stepchildren move into our little apartment with us :-p)... my most recent discussion of this was actually a vlog entry, in case anyone's interested in watching: http://twinhappyjen.blogspot.com/2009/08/vlog-entry-002.html

[Linda]

Thanks Jen, the vlog is very brave of you! Good luck with everything, I'll try and post something up every Tuesday, either a new slant on an older piece updated or something else...

[Dan]

I would add to this don't worry about social services taking away your kids because you are depressed. They won't. they won't even take them away if you tell people you sometimes feel suicidal.

I work with suicidal post natally depressed women regularly, and generally the only reason social services get involved is to support the mum and dad with things like free nursery placements and the like, not to remove the children.

If you have thoughts of suicide, go to A&E - you'll see someone like me. Or tell your GP, and they will refer you to someone like me.

There is help out there.

[Liz (LivingwithKids)]

This is such a valuable post Linda - not just for multiple birth mums but for single birth mums too. I know quite a few mums who have suffered with PND and it's so helpful to know about the support that's out there x

[Linda]

Thanks Dan, I can imagine that those suffering the stigma of mental illness may be scared of these sorts of perceived developments so it's great that you have taken the time to spell that out here.

Thanks Liz, yeah people are still looking for this information, it's a good few years since I first wrote about this for the Tamba magazine. It's good to see people are still finding it useful. x

[baby carriers]

Your children need your loev and attention most when they are young.