Returning To Work With Postnatal Depression

“You are still a good mother and a good person no matter what you’re currently feeling. As with many challenges in motherhood, this too will pass.”

Postnatal depression affects up more than 1 in 10 women within a year of giving birth, according to NHS statistics. This can make going back to work challenging to say the least, especially as a healthcare professional. In this candid article, Rachel shares her experience and her advice for returning to work with postnatal depression.

In May 2019, I found out I was pregnant with my first child. We were over the moon, but the pregnancy was anything but straight forward. I had to have quite a lot of time off work and adjustments made throughout the nine months, including a secondment into an office job for 3 months so that I could stay at work.

Thankfully my employer was mostly very accommodating at the time. Although the birth was very traumatic, my daughter was born healthy and well in January 2020.

The Impact Of Covid

Little did we know what was to come. She was 8 weeks when the country went into the first lockdown and the seriousness of the Covid pandemic situation really hit home. My maternity leave went from coffee dates and pram walks with friends to worrying about my baby getting sick, family members not meeting her for months, and an overwhelming feeling of loneliness and isolation as I tried to navigate motherhood on my own.

Hearing what my colleagues and friends were dealing with in the NHS made me feel guilty that I wasn’t doing my bit in the fight against Covid, but also a huge feeling of relief that I was largely sheltered from the death and endless PPE for a while.

When the time came for me to go back to work, I had already started feeling like something wasn’t quite right in myself- but for a long time I put it down to the fact that everyone was feeling the strain of the past year.

I had a lot to get used to as almost everything had changed in the time I had been off. Donning and doffing were phrases I had only really heard in theatre, restricted and virtual visiting in a hospice was something I never imagined would happen and the endless amount of testing of myself, relatives and patients was exhausting.

Returning To Work & Mental Health Struggles

It was after a month or two of being back at work that things with my mental health really started to escalate; I became very anxious before a shift, particularly a night shift, even having panic attacks on some occasions. When I was at work my brain was foggy, I couldn’t concentrate on some tasks, and I struggled to care for my patients in the same way I had done before.

On my days off I was tearful, irritable and had very intrusive thoughts about something happening to my family. I was convinced my daughter was going to be kidnapped at day care and made constant phone calls to the nursery to make sure she was ok. I couldn’t walk across bridges as I thought they would collapse, and the pram would fall into the river below. Going out in the car after so many months of staying at home was also a mammoth task.

At first, I called in sick for the days or nights when things were particularly bad, but I knew that wasn’t a solution. I needed help. I spoke to the ward manager and explained how I was feeling, she was sympathetic but like a lot of people, was under the impression it was just stress from covid and the fact I had a small child. She recommended that I try and make the most of my days off and get lots of rest.

Where Did I First Go To Get Help?

My husband urged me to contact our GP, which I did. But given the current situation, getting a face-to-face appointment wasn’t going to happen and I couldn’t seem to explain my feelings well enough on the phone.

He prescribed me mirtazapine for my low mood and that was that. The problem with that particular antidepressant is that you take it at night as it can help you become drowsy to aid sleep. But when I was on night shifts, I couldn’t take it until the morning I was finished a shift. This meant there were long delays in between the doses and the constant changing meant it proved not to be as effective. I changed to a different antidepressant to try and combat the problem, but I didn’t feel it was as good.

I talked to my manager about the possibility of coming off night shifts for a while as my panic attacks before work were getting worse and when I was in work all night I couldn’t concentrate on my job and my anxiety was overwhelming. Unfortunately, because of the high level of sickness due to Covid and staff isolating, the manager felt it wouldn’t be in the wards best interest to take me off nights. This started to affect my day shifts as I was still up a lot in the night with my little one and struggling to switch off.

You are still a good mother and a good person no matter what you’re currently feeling. As with many challenges in motherhood, this too will pass.

Therapy & The Start Of Recovery

I tried to access NHS counselling to help with the anxiety, but the waiting lists were so extreme I had to pay for private care. It was on the very first session that the therapist mentioned the term postnatal depression. It hadn’t even occurred to me that I could be suffering from that; I was a year post-partum and assumed it only happened in the early days after birth.

The therapist explained that I had probably been struggling with it for a long time but because of Covid I hadn’t recognised the signs and symptoms. It also didn’t help that we didn’t have any face-to-face appointments with a health visitor or midwife after the birth so again no one realised what was happening.

As well as the counselling I switched to a different antidepressant that wasn’t affected by my shifts and was known for targeting anxiety rather than just depression. Although it took longer to shift the anxiety it enabled me to come out of the fog of depression and focus on getting the help I needed to look after my daughter and stay at work.

Positive Changes

I made the decision a few months later to change jobs as the night shifts were definitely hindering my recovery. I was very open with my new manager about the struggles I had had and was still going through and made sure that I put measures in place to help me cope in my new role.

After almost a year of counselling I felt well enough to trial coming off the medication and reduce my sessions. The safe space that the counselling provided had allowed me to explore all my feelings to someone who wasn’t judgemental, opinionated, or trying to push her own experiences on me. The therapist helped me realise that postnatal depression and anxiety affects women differently and it doesn’t make me a bad person.

It also helped me communicate better with my manger and colleagues about the struggles and challenges of coming back to work after maternity leave; hopefully they will have learned how to support returning colleagues a bit better, especially through a pandemic and with postnatal depression.

My Advice

I should have gotten help sooner. But too often, women who’ve become mothers are expected to just to get up and get on with it, even if they are sleep deprived and emotional, or worse. That’s not always the case and can be very damaging.

My advice to anyone who is pregnant or has given birth recently and thinking of going back to work is:

1. Educate yourself on the signs and symptoms of postnatal anxiety and depression, especially the difference between that and the ‘baby blues’.

2. If you notice any of the signs, or you just don’t feel right, then access help sooner rather than later. No one should tell you you’re being silly or to just get on with it. Your feelings are valid, and they need sorting.

3. Don’t be afraid to try medication, it does take a while to work, and it can make you feel worse before you feel better but in the majority of people it does work and it doesn’t have to be forever.

4. Talking helps. Even if you don’t feel like seeing someone professionally then reach out to trusted family and friends.

5. Tell your employer what’s going on and take the advice of the health professionals about how best to manage things at work. If you need time off, then take it. If you need adjustments made, then ask for them. Mental health is a big problem in our society but there’s lots of help available for both employees and employers.

6. You are still a good mother and a good person no matter what you’re currently feeling. As with many challenges in motherhood, this too will pass.

We hope this helps and wish you luck returning to work.