Well Women Newsletter Issue 4, Term 4, 2009
Helping You and your family cope with Antenatal and Postnatal Distress
When Sadness Takes Over It’s probably not something you’d like to hear about right now. Your baby’s just a few hours, days or weeks old, you’re excited and full of joy. How could anything get in the way of this newfound life of yours? The odds are actually very much in your favour - provided you live with your partner your chances of building a happy and successful family that lasts until the kids are grown up are 80% or more. Notwithstanding some rough patches that happen in the best of families, most men and women are happy with the outcome, even though they probably had quite different ideas to start with. Post-Natal Depression is much more than a rough patch in your relationship, however, and it strikes at a vicious time. About one in 10 women are affected and it can happen to men too, especially if they are in primary caregiver situations. There are degrees of this depression - in extreme cases a mother may not be able to adequately care for her child. But it is the milder forms that cause a greater danger to the relationship, because they are often not recognised by the woman concerned as depression. A post-natally depressed woman may very likely appear unhappy with what you do, regardless of how much you try to help. Spend all your time off from work with your baby to give your partner a break, and she might feel she is a bad mother and you don't trust her with the baby. But leave the caring to her and she may complain that you are unsupportive and not a good father. Quit your job and she will worry that your family won’t be able to make ends meet; work hard and she will be scared of the times alone when you are not around. Although not the only indicator for post-natal depression, the role change for a woman on becoming a mother plays a major part. And not only for the woman - role change is a big factor for depression in anyone, and the changes that parenthood brings can heighten any underlying
depression already there in men as well. The partners of post-natally depressed women often do not score much better on depression tests than their wives. Unfortunately, few treatment programmes for post-natally depressed women recognise the key role of the partner in overcoming the depression, even though research consistently points to father involvement and support as a major factor. As with other areas of parenthood, fathers are left alone with these problems. No-one supports the supporters. The most common misunderstanding by fathers is the attempt to try to find a cure. It is very important that you do as much around the home and with the baby as you possibly can even though you will most likely not be rewarded or praised for it. But your partner may at times not be able to provide the emotional involvement that a baby needs - you should not feel guilty about filling this gap, neither should you doubt your capability that you can. But what helps your partner most is not you taking over all her jobs, but simply listen to what she has to tell you. Talking itself has a healing effect on a post-natally depressed mother. Trying to find solutions for her problems may put her under even more pressure - the pressure to feel better, because you followed up on her complaint. It is hard to beat this "protector" instinct of many men. Try and get her to accept the support of other women or institutions like Plunket, who often run special post-natal depression programmes. Acknowledge her depression and - very, very important tell her that she will get better and that she has all the time she needs. If you go with her to doctor's and other appointments (normally a good idea, as it makes her feel supported) try to avoid the temptation to speak for her.
And don’t forget about yourself! When you want to give your partner a break and take the baby out, you may want to combine that with seeing a mate. If you know about a dads playgroup, give it a go. It makes looking after a baby feel not quite so “feminine” if you’re in the company of other guys, and you may come out with your batteries recharged. Is She Depressed? Here's some symptoms common in post-natally depressed women:
Rapid mood changes.
Difficulty with parenting, especially limit setting and coping with stressful behaviour.
Increase in appetite, heightened sensitivity of noise, weight gain.
Difficulty thinking clearly.
She doesn't enjoy doing things, especially sex, and sometimes not even enjoying the child.
How Can I Help?
Listen a lot and talk little, except for supporting and encouraging words and noises.
Do as much as you can around the house without being asked. Bring takeaways home instead of cooking.
Go out with your child as often as you can, both alone and with your partner.
Make time. If you can reduce working hours. Try to cut down on other activities.
Repaying the Credit Card overdraft will take a little longer.
Find support for yourself.
Source: Father & Child magazine
Supporting Families in Mental Illness - Peer Support Training For Families Thursday 19th November 2009 9:00am to 2:30pm Affinity Services, 17 Sultan St., Ellerslie There is no cost to attend. Tea/coffee/snacks & lunch provided. Registration by Friday 13 November 2009. Contact: Supporting Families in Mental Illness: 09 378 9134, firstname.lastname@example.org Do you feel that your experience with mental illness in your family has given you insights that allow you to empathise with others in a similar situation? Would you like to explore your own experience and connect with others through the sharing of your story? We all need support in our lives and at particular times we may need more support than at other times. When someone in our family develops a mental illness it can be isolating and confusing and it is important that we have a number of people we can turn to. Support is having someone to talk to, share with, off load to, someone who "hears" us, understands and is there for us. It can be an email, a chat on the phone or catching up over a coffee.
In light of this we are offering a family-to-family training course in the Counties Manukau region. Through this training you will have an opportunity to look at your own experience and how it has impacted on your life, and to identify strengths and skills that will enable you to support others in your community.
Inside this issue: When Sadness Takes Over
Supporting Families in Mental Illness - Peer Support Training For Families
Postnatal depression has wide-reaching effects
Tuakau Homebuilders Budgeting Service
Birth Order of Children
To feel confident about setting boundaries
To understand confidentiality and it limitations
Who Are Well Women?
The objective of this course is :
To gain an understanding of what peer support is, the benefits and the challenges
To have an understanding of the grief process and it's impact on you as peer support workers
To understand how stress affects us and its signs and symptoms
• • •
To feel secure in communication skills
Postnatal depression has wide-reaching effects NZ Herald, Tuesday March 17, 2009
Many people expect new mothers, especially those with their first baby, to be happy and excited, get over their first few days of "baby blues" and get on with the job. However, a stressful pregnancy or birth experience, lack of support and other factors can contribute to the quiet development of postnatal depression. Postnatal depression can be an insidious, difficult to diagnose condition that can slip past many people around it including health workers. Its ability to affect the immediate family and have far-reaching effects, is underestimated. Some women may have a prolonged relapsing illness that can affect them for several years. The statistics for postnatal depression seem to indicate around 15 per cent of women develop this problem in the first six months after the birth. However, the depression can be delayed and can even occur several months after birth. Here in New Zealand, in a study of Pacific Islanders in 2006 published in the Australian and New Zealand Journal of Psychiatry, the average rate was measured to be 16 per cent. The rates in this study varied from 7.6 per cent for one Pacific Island group to 30.9 per cent in another Pacific Island group.
New fathers can be affected because they may need to take time off work to care for the woman and the rest of the family. This problem can have flow on effects such as a reduction in family finances, which in turn affect work, home life and even the marriage. Statistics have also shown increased visits to the doctor and increased child ill-health in these families. The treatment of postnatal depression is urgent because the consequences can be severe - in some extreme cases suicide or harm to the baby has been a result. An important tool that can be used to help identify postnatal depression is the Edinburgh Post Natal Depression Scale - this can be easily filled in while waiting for the doctor's or midwife's appointment. In 2004 the Australian and New Zealand Journal of Psychiatry recommended that the treatment of postnatal depression should include antidepressant medication if the depression is moderate or severe, and that psychological support and therapy can be useful. What to look out for: • A new mother who is not coping in any way.
In Pacific Islanders, significant contributors included it being the first birth, stress from not having enough food, stress from a household income less than $40,000 per year, and difficulty with transport.
• A new father who is not coping. • A baby that keeps getting sick. • A mother needing more visits to the doctor.
In everyone, the risk factors for postnatal depression can come from having been depressed or anxious during the pregnancy, being young, having a low income and having problems with the pregnancy itself.
It is relatively straightforward for a woman to be seen and assessed by her family doctor and appropriate treatments given . This condition is an important life altering condition, not just for the sufferer, but also for many people associated with her.
In addition, low self esteem, low social support and a history of childhood abuse can be in the background. During the pregnancy, any stressful life events and having a poor relationship with the partner can be very important.
If you know anyone who might have postnatal depression, a proactive supportive approach to get help for her (and possibly her partner) could make a world of difference.
After the baby is born, difficulties with the baby's temperament, childcare and any major life events can significantly contribute. The scientific literature debates whether hormones are involved, but in particular, progesterone, prolactin and a brain chemical called tryptophan have been mentioned. Some studies have shown some benefit in using natural progesterone as part of the treatment. Postnatal depression also causes significant parenting stress and, as such, affects the rest of the family and in particular, the partner. It is so severe that an Australian group reported that, of 15 per cent of new mothers diagnosed with postnatal depression, 10 per cent of their partners were also affected.
My suggestions are: 1. Get a medical assessment - if seriously depressed, this is urgent, and possibly life threatening condition. 2. Obtain psychological support from a counsellor psychologist 3. Give practical support to the woman. Eg. mind the baby she can sleep, place food in the freezer, clean the house, some shopping for her. 4. Support her husband/partner or other family members appropriate.
an or so do as
- Dr Frances Pitsilis www.drfrances.co.nz
Update GPs with patients in the CMDHB region are now able to access funding for short term practical supports for patients with a moderately severe mental health condition. Counties Manukau District Health Board are piloting a scheme aimed at supporting people with mild to moderate mental health concerns. The scheme, Primary Options for Mental Health, is aimed at those who are in need of immediate practical support and includes women suffering from Ante and Post Natal Distress. Well Women Pukekohe welcomes this move and anticipates that the scheme will assist people when at their most vulnerable. Available free of charge, the support can include general housework, child-minding, meal preparation, shopping, time out for mum and any other service deemed necessary to get the patient through the crisis. Patients must be aged between 18 and 64 and live in the Manukau DHB catchment area and be currently enrolled with a GP. They must be linked in with their GP, who will be aware of the distress. The maximum amount of time the support can be utilised is 6 weeks and to a sum of no more than $600. Referral process is simply via your GP or directly to the following e mail address: email@example.com, contact Deanna Williams, or phone 09 535 7218 or fax 09 535 7154. The co-ordinator will liaise with your GP, complete an assessment and get the services that are needed, in with you as quickly as possible. A range of suitably qualified Home Care Providers and nannies have been employed and all are professional, reliable and trustworthy. All of them have been Police Checked and offer a quality service to patients.
Tuakau Homebuilders Budgeting Service If you think budgeting is only for poor people, think again. Debt has no prejudice, sucks in all ethnicities, all social sectors, and has no gender bias. Seeing a Financial Adviser, as budgeters are now called, is the new cool and budgeting services are doing a booming trade as debt, misery and hardship cuts a swathe across New Zealand. In a nutshell, budgeters are helping thousands of people dig themselves out of poor financial choices. Te Whare Whakau , formerly known as Tuakau Homebuilders, is the only Budgeting service in Franklin that is professionally affiliated to the New Zealand Federation of Family Budgeting Services. This means you can be assured of the highest standard of care. All the budgeters are comprehensively trained and go through a year long probation period, supervised by qualified Federation Supervisors. Te Whare Whakau is also fortunate enough to have one of only four Summary Instalment Order Officers in the Auckland region. This means that clients can have all of their debts frozen, so that they can pay off the amount owing without worrying about exorbitant interest rates. When some of the interest rates are coming in at 40% and 50%, this is a huge relief to many of Te Whare Whakau’s clients. Kathryn Burton, one of Te Whare Whakau’s five Budgeting Federation Advisors, has seen a huge increase in people needing assistance from the service: “People often come in overwhelmed, controlled by the money in their lives, stressed out and chaotic. Their health is being affected. We are seeing people from all walks of life and if they are in the habit of being in debt, it can take quite some time to turn them round”
Kathryn and the team,begin by finding out what their client's goals are. Do they want to pay off their debts? Do they want to be able to pay bills? Do they want to save money? Are they afraid of calling creditors? Success is defined differently for each client. For some it may mean not owning a credit card whereas for others it may mean sorting out the finances post a marriage break up. For others it is about gaining assistance in structuring a repayment plan. With a 90% engagement rate at Te Whare Whakau, Kathryn Burton and the team certainly get to know her clients: “On average, we see them for about 20 hours over a number of months from start to finish. We initially spend time getting to know who they are and how they work and how their family/whanau works. By coming from where the client is, we aren’t judgemental. There is no point in telling them they are doing it all wrong as they already know they’ve made poor choices. What they need is help in changing that. If someone has to pay $300 week out to creditors but only has $200 coming in, there is no point in saying to them, eat less, get rid of the car. The fact is they need to work with us on maximising what cash they do have coming in. Living in Tuakau or in any rural community is difficult without a car and we understand this.” The core message from Te Whare Whakau/Tuakau Homebuilders is that debt is solvable. There are many forms of help out there from Summary Instalment Orders, No Asset Procedures, insolvency and bankruptcy routes, to telephone discussions with the relevant creditors and budget planning. The first step is a meeting with a Financial Budgeter and the courage to front up and put all that debt down on paper. We can guarantee an appointment within a week and there are no long waiting lists for our services” Call Te Whare Whakau/Tuakau Homebuilders on 09 236 9615 for an appointment and put the flow back into your money situation. by Well Women Report, Andi Chapman
Birth Order of Children 1st baby: You begin wearing maternity clothes as soon as your pregnancy is confirmed 2nd baby: You wear your regular clothes for as long as possible. 3rd baby: Your maternity clothes ARE your regular clothes... The Layette: 1st baby: You pre-wash newborn's clothes, colour-coordinate them, and fold them neatly in the baby's little drawers 2nd baby: You check to make sure that the clothes are clean and discard only the ones with the darkest stains. 3rd baby: Boys can wear pink, can't they? Dummy: 1st baby: If the dummy falls on the floor, you put it away until you can go home and wash and boil it. 2nd baby: When the dummy falls on the floor, you squirt it off with some juice from the baby's bottle. 3rd baby: You wipe it off on your shirt and pop it back in the baby's mouth. Nappies: 1st baby: You change your baby's nappies every hour, whether they need it or not. 2nd baby: You change their nappy every two to three hours, if needed.
3rd baby: You try to change their nappy before others start to complain about the smell or you see it sagging to their knees.
Exciting new from Counties Manukau DHB. They have just launched a new Perinatal team called Nga Whetu O Te Taiohi (Family of Young Stars) and under this umbrella group, sits Maternal Mental Health and Infant Mental Health creating what is hoped to be a seamless service for mums, families and children suffering with Post and Ante Natal Distress.
Activities 1st baby: You take your infant to Baby Gymnastics, Baby Swimming Classes, Baby Zoo, Baby Movies and Baby Story Hour. 2nd baby: You take your infant to Baby Gymnastics. 3rd baby: You take your infant to the supermarket and the dry cleaners.
The team consists of a Psychologist, Psychiatrist, Occupational Therapist, Child Psychologist and Family Therapist and they will be taking referrals from November 2009 onwards.
Going Out: 1st baby: The first time you leave your little one with a baby sitter, you call home five times. 2nd baby: Just before you walk out the door, you remember to leave a number where you can be reached. 3rd baby: You leave instructions for the baby sitter to call only if she sees blood.
They will be officially launching at the end of November 2009 and will be taking referrals from Maternal Mental Health workers. In the Pukekohe area, this will be our Psychiatric Nurse Specialist Angela Sherridan.
Swallowing Coins: 1st child: When first child swallows a coin, you rush the child to the hospital and demand x-rays 2nd child: When second child swallows a coin, you carefully watch for the coin to pass. 3rd child: When third child swallows a coin you deduct it from his allowance!
CMDHB have mandated the team to work with families and whanau around relationship and attachment issues and their aim is to promote the social and emotional wellbeing of families and infants.
Other referrals will come directly from Kidz First Paediatrics at Middlemore Hospital. It is an exciting and forward thinking move and is welcomed by Well Women Franklin, the support group for Women struggling with Post and Ante Natal Distress in the Franklin area. Please call Awhinitia for more details on 09 295 1200 and ask for the Perinatal Team or Whakatupu Ora Team (Growing Wellness)
Useful Contacts Phone Numbers
• Well Women: Phone: Kim Myhill 0211588134 (daytime) Or 09 2328581 (evenings and weekends); E-mail: firstname.lastname@example.org; • Awhinatia Community Mental Health Centre - 09 2951200
• Mental Health Foundation of New Zealand • •
Susan Goldstiver Psychotherapist
Phone: 09 300 7010 Lifeline - 09 5222 999 Manukau Community Mental Health Team 09 261 3700
www.webhealth.co.nz www.mentalhealth.org.nz www.depression.org.nz www.mothersmatter.co.nz www.outoftheblue.org.nz www.spinz.org.nz (Suicide Prevention) www.centreforattachment.com www.pnd.org.nz www.pnpsupport.org.nz (Postnatal Psychosis support group) • www.fatherandchild.org.nz • www.lifeline.org.nz • • • • • • • • •
Please support those who support us!
Bogaart's Hair Design & Tanning Studio 42 Edinburgh Street Pukekohe (09) 2388766
www.881homestay.co.nz 09 232 8581 or 0211 635 606 accommodation@881homestay 881 Tuakau Bridge – Port Waikato Road, Te Kohanga, Tuakau, RD3
Who Are Well Women? Well Women is a group for women who are suffering from (undiagnosed or diagnosed) Postnatal Distress. We meet every week (during the school term) at a venue in Franklin and have a group discussion facilitated by a qualified Social Worker. We discuss anything that is ‘on top’ and playing on our minds. On three occasions throughout the term, we have a speaker who is invited to come along and share their expertise with us. This could be a clinical psychologist, dietician, someone specialising in bonding & attachment, play therapist, masseuse or anyone who might be able to assist with the path to recovery for PND sufferers. We are a Non-Profit Organisation who rely on sponsorship for childcare - an essential component in the effectiveness of the group sessions - and for other aspects of running the group. We welcome new members and offer an initial discussion with a social worker, who can assess the needs of an individual more effectively. Contact us via any of the following means: Phone: Kim Myhill 0211588134 (daytime) Or 09 2328581 (evenings and weekends) E-mail: email@example.com