Sunday 9 October 2011

What's the Difference - Post Traumatic Stress Disorder v Post Natal Depression

As ever, this article is informed by my own experience and reading and is not a substitute for medical advice, if you have any concerns about your own mental health and experience please consult your GP.

I always knew I was at high risk of post natal depression. I have a history of depression, and it runs in my family. I was fully expecting that this might be an issue, and I was open and honest about my history on my antenatal notes. During my pregnancy it was suspected I had ante natal depression, and I had counselling for this, although it was never diagnosed.

When Joseph was born I was elated, absolutely bouncing and happy, apart from my crash on day 5, I was singing on the inside. Partly, I felt completely vindicated and relieved that I wasn't going crazy, there was something wrong with my pregnancy, and overjoyed that all had turned out ok, my baby was alive. My midwife was exceedingly concerned that I had the beginnings of severe post natal depression, and possibly psychosis. I was confused, and upset. Surely being happy was a good thing.

As time went on during our NICU stay I felt on an even keel emotionally. Yes, at times I was stressed, frustrated and occasionally angry, however for the most part I faced each day with a smile and got through it. My GP and my consultant kept an eye on me, but I never felt depressed. Once discharge was imminent, my caregivers relaxed. I was out of the immediate post natal period so surely everthing now would be ok. Wouldn't it?

When Joseph came home, over time, I started to deteriorate. And I felt totally confused. I wasn't depressed. I didn't feel sad, I didn't feel disconnected to my baby, or just "going through the motions". It didn't "feel" like post natal depression. I was totally and completely in love and bonded with my baby. What could it be?

I couldn't sleep. I was on high alert all the time, nervous, anxious, terrified that something would go wrong. When I did sleep I was plagued by stark, realistic nightmares. These had started when Joseph was in hospital. In one, Joseph had had an MRI scan, I had the films in my hand and I could see a break between T3 and T4 in his thoracic spine. I was so so scared about the ramifications of this. When I awoke I had no idea whether it was dream or real, so I called the unit who reassured me, and in the morning one of the neonatologists talked to me at length about Joseph's neurological state and the health of his spine.

The second one that sticks in my mind was my husband getting out of bed, running down the hallway with a brick in his hand to smash my skull with, so angry at my inability to sleep, and to be a proper wife and mother. I couldn't breathe, it took me ages to realise it was a dream, but still in my head that dream is processed as a memory. Horrific. However these nightmares only got worse when Joseph came home. I found if I slept in the day it was better. I was practically nocturnal.

Coupled with the nightmares were flashbacks, or as I called them, daymares. I had to seek alternative hand sanitiser as the one I had initially bought reminded me so much of hospital I would clutch Joseph to my chest and sob. The supermarket was horrendous. The beeping of the scanning machines sounded like a saturation monitor. The lights were so similar, and if I looked up, I would hyperventilate.

I used to panic when people wanted to touch Joseph. I'd worry at baby group if someone else held him, or if a baby was sneezing or coughing or had a rash. I used to go to weigh in at the clinic as soon as it opened and run away before anyone go there.

And the conversations from Joseph's time in hospital would play over and over in my mind. Things I should have said, should have done. I tortured myself for not trying harder with breastfeeding. Everytime I made a bottle I felt guilty, angry and upset with myself.  It was so tiring. If being a new mum isn't exhausting enough, my self punishment, my nightmares, my high anxiety was making everything worse.

What the hell was wrong with me? Finally I went to the GP. She took one look at me and said the magic words "oh your not depressed, your traumatised, lets' see what we can do to help".

And that was it. I had PTSD Post Traumatic Stress Disorder. Some mums (and lets not forget dads) get this either apart from, or with, post natal depression. PTSD is treatable, with therapy and/or medication and its important to get help. I was fortunate to have a GP who was very much aware of the difference, but not all are. And its important that the distinction is made as the treatment can be quite different. Also significant is that there is now research that shows mothers who have suffered from pre eclampsia are at high risk of PTSD. In addition, and this is very interesting and significant for those planning a second baby is that there is new research to suggest having PTSD in itself increases your risk of a premature baby.  Logic would suggest if you have untreated PTSD and are pregnant again, then this in itself may increase your risk of PTSD, highlighting the need for recongition and prompt treatment.

And now, it all seems a memory. I look on Joseph's time in hospital with fondness in a way, I am amazed at not only his inner strength and determination, but mine too. And the brain's abilty to heal.  However, I wish that I had been warned of this much earlier, as I would not have suffered for so long. I knew to look out for depression but not this. I hope that the existence of PTSD in mothers like me becomes a lot better documented, so that we all get the treatment that we need to be happy, content mums.

This article is a great one, and handy for showing a GP, although it is Amercian.


  1. ghostwritermummy9 October 2011 at 16:23

    Thanks for sharing Kylie. What you went through sounds a lot like how I was feeling after Luka was born, only it took me so long to bond with him. I did the motherly stuff because it was ingrained and not because I felt it. I too suspected ante-natal depression but I never shared my fears with anyone because I had Eva and I didn't want people to be concerned that I wasn't going to cope with another child. When my doctor diagnosed PND Luka was 8 months. He reeled off a list of symptoms which didn't fit and I left feeling so upset and angry. I have never since asked a medical professional for help in dealing with what happened and now I fear that it will bite me soon. The nghtmares are coming back and each time the new baby kicks, I'm reminded of the dark days of last time. I need to find a dr who I can trust to take me seriously and not just tell me I should be grateful my baby is alive. I don't feel as though they understand but your story gives me hope that there must be a doctor out there who will. So thanks again for sharing this. I feel a post of my own coming on, plus an appointment with a different doctor. XxX

  2. My GP was awesome, absolutely reassuring, matter of fact and so lovely. If your in the position to look at private treatment I can recommend the (mad as a box of frogs) counsellor I saw, he was so helpful.

  3. This is a fascinating read for me.

    The Boy was born 'naturally' under traumatic circumstances. His heart-rate fluctuated from 80-200, always dropping during a contraction (which they said was opposite to what it should do) and they waited for 3 hours between first being concerned & ripping him out of me. I said 'ripping' because he had shoulder distocia (it was stuck in my pubic bone) and when they finally got my 10lb 5 & half oz baby out, they had misplaced the forceps; one was over his eye & he had a cut at the corner of one eye, and cut & dent in his forehead. I had a grade 2 episiotomy & further grade 2 tear which they mis-stitched (it later broke down, I had an infection, ripped the stitches out when I fell down the stairs, and had to heal naturally). The Boy needed oxygen because he was slightly purple. His temperature was also 33 degrees, so he needed to be in an incubator for four hours.

    Twelve hours later he was taken to see the paediatrician as he had a yellowish patch behind his ears. Guess what, turns out he had an infection from the forceps and was on an IV antibiotic drip for 3 days. My perfect newborn was cut, bruised, dented, infected by that hospital & it's horrendous doctors.

    Three weeks later he returned there unconscious having had a reaction to the formula he'd just started (

    I often think I might have a little PTSD from this month of trauma. I want another child but am petrified. I've already told my doctor that I will not set foot in that hospital again & that I want a C-Section. However, I'm terrified that I won't be able to deliver him into this world safely. When I have to move for an ambulance, my heart races, eyes fill and I start hyperventilating. I'm petrified of breast-feeding because of the experience described in that link. However, this has all only started this year.

    I'm sorry, I've waffled.

  4. I suffered terriBly with post traumatic stress disorder after my second daughter was born. Different circumstances brought it on to yours but horrific nightmares, unable to go to the supermarket, even walking down a busy street would put the fear of god in me. I rowed with my husband for no reason and I felt everyone was against me. I had councilling for 6 months. It helped me to put the whole experience into perspective and to stop blaming myself for what had brought to me that place. In a way I am thankful I endoured it, it shaped me into the person I am today, I do have moments now where I feel I can't cope but now with 3 daughters and a small business I just take myself aside and put it into perspective. Counselling taught me how to manage my emotions and that in itself has helped over the last 5 years.
    It's good to see women talking so openly about it, it seems we are all to scared to admit our flaws.
    Great post :) I'll stop waffling now x

  5. Delayed onset is completely normal. When you have a new baby you just have to get on with it, often its only when things have settled down that it hits you.

    What happened to you is horrible. Mine is different as the actual delivery bit was fine, I was well prepared, had seen a member of the neonatal unit and a paediatrician and was very well versed in what would happen. It was the aftermath that was so traumatic, the not knowing whether my baby would live or die, the daily agony of seeing my baby hooked up to machines and enduring tests.

    I think its important you try and find help, so that you can be in a good psychological position to go again.

  6. Thank you for sharing, and its great that we can talk about it, too often we think "keep calm and carry on" is the way to go, but other traumatic experiences are so much better dealt with than child birth, and it can be traumatic for all sorts of reasons, not just due to prematurity.

  7. Very interesting post. There but for the grace of god go I. After a 4 day labour ending in an emergency c-section, there were some very bad nights, and some flashbacks when I saw my c-section scar. But I didn't go on to develop full-blown PTSD.

  8. Yes, its interesting how the brain works, some brains respond to trauma in a healthy way, like yours seemingly did, then others don't. I am glad you didn't go on to get full blown PTSD

  9. Wow thanks for sharing this story. I had pnd and can relate to some of it but a lot of it i cannot. I think I would be quite scared in some of those situations. x