When Is a Mother Most At Risk of Postnatal Depression?

If I were to ask you at what stage a mother might be at most risk of postnatal depression, what would you say?

When her baby is 6 weeks old? 12 weeks? 6 months? 12 months?

What if I told you it was when her child was four years old?

A 2014 study of 1500 women by the Murdoch Children’s Research Institute found that women were more likely to report depressive symptoms when their child was four years old, than at any point in the first year of their child’s life.

Surprised? So were a lot of people when this result came out.

The study involved the use of the Edinburgh Postnatal Depression Scale, which is commonly used as a screening tool for women early in their postnatal period. This study had women undertake the questionnaire at 3, 6, 12 and 18 months, as well as 4 years post childbirth.

What they found was the incidence of depressive symptoms for mothers at 4 years post childbirth was 14.5 percent, more than at any of the other timeframes.

And it wasn’t about life getting harder with additional children either, as the study also found that women with just one child actually reported depressive symptoms twice as often as women who had gone on to have further children (22.9pc compared to 11.3pc).

So what does this study tell us about postnatal depression?

The most important thing is that it challenges the popular belief that women are most at risk of postnatal depression when their children are still babies. It highlights the very real need for awareness of postnatal depression in women further into their motherhood journey.

So often we have this stereotypical vision of postnatal depression affecting a first time mother with a small baby. That image is easy for us to grasp. The sheer anxiety of being a new, inexperienced parent, the sleeplessness, the fear of doing something wrong, the utter exhaustion that comes with 24/7 care of a tiny, demanding little infant. We can empathise with these women because it’s easy to understand how these demands can take their toll on exhausted, hormonally unbalanced, sleep deprived new mums.

So why don’t we have this empathy for mums when their children are older? Once they’ve got past that “fumbling new parent” stage? Perhaps it’s because, as a society, we are so accustomed to seeing mothers stretched beyond their means? We see mothers rushing around, visibly stressed and agitated, every single day – racing their children from school to sports practice, snapping at their kids in shopping centres, sipping glasses of wine every night once the children are FINALLY put to bed.

It seems we have much less empathy for mums doing it tough after those first couple of years. All of a sudden a mother’s exhaustion, dissatisfaction and frustration is no longer seen as a warning sign of depression, but rather something that is just expected as a normal part of motherhood.

I wonder, if this study had gone on to include mothers of 8 and 12 year olds, what those scores would have shown us? Would the rate continue to increase? And would we empathise so much with depressed mothers of 8 year olds, or would it be a case of “toughen up and get on with it”?

Let’s look at some of the screening questions used in the Edinburgh scale:

• Not being able to laugh or see the funny side of things
• Not looking forward with enjoyment to things I previously enjoyed
• Blaming myself unnecessarily when things went wrong
• Being anxious or worried for no good reason
• Feeling scared or panicky for no good reason
• Feeling like things have been getting on top of me
• Being so unhappy that I have had difficulty sleeping
• Feeling sad or miserable
• Being so unhappy that I have been crying
• Having thoughts of harming myself

How many of those statements can you identify with as a mother? One? Two? Eight?

How many of these warning signs do we fob off as just “a normal part of being a modern mother”?

And please understand that I’m not saying that every mother who is pushed to exhaustion or takes on too much has postnatal depression. I’m not confusing the two here.

But what I AM saying is that if we continue to view the world of motherhood through a lens of acceptable exhaustion and overwhelm, then it makes it much, much harder to see when someone is really, truly struggling and requires professional support.

At what point does a woman tip from simply being sleep deprived and feeling uncertain and unworthy, to being diagnosed with postnatal depression? It’s a fine line and one that appears to be getting finer with every passing year.

This is why I do what I do. This is why I created my business. Because I’m so, so tired of seeing mothers everywhere who are barely hanging on by their fingertips, but who think that’s okay, because “hey, I’m just a busy mum, it’ll be better when the kids are sleeping through/ toilet trained/at kindy/ at high school/ get their own drivers licence….”

My advice is that this is not okay.

It’s not okay to feel constantly stressed, exhausted, overwhelmed, and perhaps one sleepless night away from a meltdown. It’s not okay to accept a level of sub-standard wellbeing until your children graduate high school and you finally “have time for yourself” again. It’s not okay at all.

It’s time for us to start changing our culture of “Rushing Mummy Syndrome” to something else.

Something where women don’t slip through the cracks so easily. Something where we can tell with more certainty, the difference between a “normal busy mum of a four year old” and a mother of a four year old with postnatal depression. Because if we don’t, that line will continue to become finer, and many, many more women will fall through the cracks.