Lost & found

Posted on 1 March 2015

When actress Marisa Drummond suddenly went silent, it was the start of an unexpected journey through postnatal depression (PND). Now she’s devoted to giving PND a voice.

Words Rose Cohen Photographs Melanie Maré

To the outside world, it seems unlikely that a successful soap star, singer and healthy young mother should fall into the dark clutches of depression after giving birth to a beautiful baby girl, but postnatal depression (PND) doesn’t discriminate. PND strikes almost a third of all new moms in every circumstance and persists for up to five years in half of those. Dr Belinda Bruwer, a psychiatrist at Mediclinic Windhoek, sheds some light on Marisa Drummond’s struggle.

The pregnancy
What Marisa says
‘I had the perfect pregnancy. My husband Christopher and I had only been trying for a month when we conceived Annabel. We were so excited. We did up the nursery and attended baby expos. It wasn’t a stressful time and my career was on track – the scriptwriters of Isidingo skilfully found a way to work me out of the plot so I could go on maternity leave. I was only the teensiest bit apprehensive about having a baby who would suddenly depend entirely on us for everything and I felt a touch nauseous in my first trimester, but that was all.’

What Dr Bruwer says
‘Approximately 15-20% of expectant mothers experience depression during their pregnancies. Marisa had no symptoms of depression while pregnant, but if she had exhibited these symptoms I would have recommended treatment:
– persistent changes in mood
– incapacitating anxiety
– an inability to function or feel, and/or experiencing suicidal thoughts.

Untreated maternal depression is likely to be more harmful to the mother and baby’s health than antidepressant treatment during pregnancy and while breastfeeding.’

The birth
What Marisa says
‘In my final trimester I developed pre-eclampsia [a potentially dangerous condition characterised by high blood pressure]. I went into labour three weeks early and had to have an emergency Caesarean section. The spinal-block anaesthetic didn’t take properly and I could feel pain. My gynaecologist talked me through the surgery, but it was seriously sore and something inside me switched off during the process. I became emotionally numb and when Annabel was handed to me to hold I remember thinking I must smile for a photo and that was it. Christopher and Annabel then disappeared and I was all alone.’

What Dr Bruwer says
‘Emotional numbness is a common and worrying symptom of PND, but it’s important not to confuse it with regular baby blues. Low mood and a certain degree of heightened anxiety are completely normal and occur in 90% of women who have just given birth. However, these baby blues, as they call them, only last three to five days and subside completely in two weeks. A case of the baby blues doesn’t interfere with your ability to function – but PND does.’

The homecoming
What Marisa says
‘Baby Annabel was a trouper. She fed well and she gained weight nicely, but when we got home things deteriorated on my side. I knew something was wrong and yet I just couldn’t communicate. I went quiet. I felt nothing. I became fearful and had panic attacks – especially at night. I was scared of the dark and would walk around switching all the lights on. I didn’t want to be alone with my baby. I didn’t reject her and I wasn’t angry with her, I was just dead inside. I couldn’t sleep and I stopped eating.’

What Dr Bruwer says
‘PND is a major depressive episode that includes symptoms such as severely depressed/low mood, low energy, loss of interest in and enjoyment of activities, changes in appetite and sleep, feelings of guilt, suicidal thoughts, negative thoughts about oneself and the future, feelings of agitation or psychomotor slowness and lack of concentration – and it occurs in the period after a baby is born. Anyone can develop PND, although the following risk factors increase susceptibility:
– previous psychiatric illness
– history of illness in current pregnancy or past pregnancy
– an unwanted child
– poor social support
– substance use.’

Finding help
What Marisa says
‘Christopher carried me through that tough time when I felt like I wasn’t good enough to look after our baby. He took leave for a month and after that I eventually phoned my mom. All that came out were these words: “I want to love my child.” And yet, it wasn’t that I didn’t love her, it was just that I didn’t feel anything.
‘I needed to feel something. My mom called the gynaecologist and told her I was in trouble. She diagnosed PND and referred me to my GP, who has experience in managing the condition.’

What Dr Bruwer says
‘If you suspect that someone you know may have postnatal depression, you need to refer them urgently to a GP or psychiatrist for a thorough assessment, as the mom and baby may be at risk if the depression is severe. Untreated mental illness increases the risk for complications such as:
– alcohol or substance abuse
– increased risk of physical health problems
– suicide or filicide (killing your baby)
– poor self-care and nutrition.’

The road to recovery

What Marisa says
‘It was difficult at first. The medication made me feel ill and it took three weeks before I felt better, and a year before the clouds lifted. Those who know me say it was like I’d been in a car accident – brain-damaged and cut off from reality. I didn’t speak because I couldn’t find the words. I now know it’s a chemical imbalance. I’ve learnt how to manage my lows and anxieties, and I surround myself with positive people.

‘I have an amazing support structure in my family and friends. It’s been a real learning curve for me, the one who’s usually the agony aunt helping others.’

What Dr Bruwer says
‘A combination of medication, psychotherapy and social intervention is used to treat PND. Several antidepressants are safe in breastfeeding as long as the baby is feeding and a baby clinic nurse regularly monitors weight gain and sleep routines. Electro-convulsive therapy (ECT) may be indicated in very severe cases and referral to a support group or social worker is often beneficial. Left untreated, PND can persist for months and have a significant negative effect on the wellbeing of the mother, her baby and other family members.’

The 26-minute short film Stom stars Marisa and documents the downward spiral of a mother battling with PND. It was nominated for Best Film, Best Actress and Best Director at Kyknet’s 2014 Silwerskermfees. Marisa, who also plays Saskia in Villa Rosa, says the last step in her journey to healing is therapy, and she plans to share her experience with as many moms and moms-to-be as possible.

PND: What can dads do?

When it comes to postnatal depression, fathers have their own story to tell and they hurt through the process, too. Read Marisa’s letter to her husband Christopher and tips for fathers.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.

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