With Dr Jo Gee, as told to Anna Ceesay
THE VIEWS THAT Dr Gee EXPRESSES IN THIS PIECE ARE HER OWN, BASED ON HER PROFESSIONAL EXPERIENCE. This content is for general information purposes only and is in no way a substitute for medical advice or treatment. YOU CAN VIEW OUR FULL DISCLAIMER HERE.
What are we actually talking about when we say ‘maternal mental health’?
We’ve heard about the illnesses you can be diagnosed with, or the labels you can choose to identify with. Like all mental health, there’s a spectrum from mild/moderate experiences, to severe and potentially life-threatening conditions. These include antenatal/postnatal depression and anxiety, maternal OCD, PTSD, birth trauma and postpartum psychosis. But even if you’ve never experienced anything like this, you can still work on your own mental health as a parent.
Motherdom surveyed 1000 parents in the UK with kids under 5 in March 2019, and found that:
54% of you have felt anxious
45% of you have felt low
35% of you have felt depressed
So we need to ask someone for help, right?
Dr Jo Gee is a clinical psychotherapist with a specialist interest in perinatal mental health. She told our Founding Editor Anna Ceesay about her view of maternal mental health.
What is maternal mental health?
“At my practise, we look at maternal mental health with regards to mums feeling they can manage and function in the everyday world. We want women to have the support they need, and ensure that they don’t feel they’re going to places of crises and overwhelm. The other way our service might look at it is more diagnostic criteria, so specific mental health disorders, and specific symptoms, such as pervasive low mood. We offer a range of NICE guideline informed talking therapies to support mums, as well as alternative approaches such as reflexology, nutrition and exercise. If women are seeking a diagnosis and medication, we work closely with the NHS and private hospitals and would refer on to a GP or psychiatrist.” (NICE guidelines are evidence-based recommendations for health and care in England.)
What do people come to you for?
“Women come to us for a wide range of issues. We often see women during pregnancy, experiencing depression or anxiety. Women also seek help because of birth trauma they’re struggling to process themselves, or depression following birth. We see a lot of mums whose children could be anything from 3 months to 10 years old, who have postnatal depression or a delayed postnatal depression which they haven’t realised immediately – they’ve had a low mood for a long period and they’ve only just felt they can deal with it. So quite often we might get someone presenting with anxiety or depression when their children are 4 and 6. And the thing that I see most of at the moment is postnatal OCD. The symptoms manifest to manage an anxiety that’s not met, so people might start engaging in compulsions or rituals, and having very obsessive thoughts to manage. They come to us eventually when that breaks down and they don’t feel that they can manage anymore.”
“People are probably much more clear nowadays that if they’re feeling so low they can’t get out of bed, or they’re having panic attacks they need support. But actually, treatments for maternal mental health are much better if we come at it from a preventative approach.”Dr Jo Gee
Do you think we talk about maternal mental health enough?
“I think it’s getting better, I think we’re starting to talk a lot more about it. I don’t think it’s always clear what it includes. People are probably much more clear nowadays that if they’re feeling so low they can’t get out of bed, or they’re having panic attacks they need support. But actually, treatments for maternal mental health are much better if we come at it from a preventative approach. So we’re saying – do three minutes of mindfulness a day to avoid overwhelm, or sit down and get some me time or self-care, find a way to let go of a busy mind. We encourage our mums, where they can, to think about their mental health just like they might think about their physical health. But we also recognise there are rare but serious mental health illnesses, such as postpartum psychosis, which require immediate treatment. So we always urge mums and their families to seek prompt support and advice if they are concerned.”
Will you become a better parent if you’re feeling better mentally?
“Absolutely. I run mindfulness for mums, and I always say, mindfulness is not to make you better – you don’t need to be better as such. But when you actually start to manage those feelings of tension which lead you to shout and then you feel a shame cycle, all round you’ll be calmer. Mindfulness is one of those practices that’s brilliant with children. Children are very mindful by nature. They don’t go into a room and think ‘oh, she’s probably judging me and she probably doesn’t like what I’m wearing’. A child senses – they’re an emotional being. They’ll look around and they’ll notice sounds and smells and sights, and they’ll feel more grounded. So we can practice mindfulness and feeling grounded with them. Whatever that is – rubbing a hand cream in, playing I spy, going out into the garden and feeling the breeze. All these things that we lose connection and contact with as adults. We’re too busy, too much to do, too much to be, too much responsibility.”
You say that all mums struggle in some way – why is that?
“If we’re really honest with ourselves, it’s a huge thing to adapt to. When we buy a new car, for example, we might try it out a couple of times, get a feel for it, do some research online. Having a baby is one of those things where you can’t do that. You’re handed your baby and told to take them home and no matter what anyone tells you about being awake in the night, you can’t feel that until you go through it. I remember thinking “Oh, I’ll sleep! Oh I’m sure I’ll be fine!”, and then six weeks in thinking, “Oh gosh, this is chronic lack of sleep!” If you have a partner, they might go back to work, and you’re left, without any time to adapt. It’s almost like, if someone said – pause, and we’ll give you five days to get used to this, we’d all be a bit healthier, but there’s not the chance for that. I would be absolutely shocked if there’s any mum who took their baby and didn’t feel overwhelmed, didn’t feel out of their depth, didn’t feel confused at some point. And what we’re trying to say is, that’s totally normal. Everyone will have a struggle in some way. And that’s maybe what we don’t talk about. But if your symptoms are starting to get in the way of your daily life, please seek help.”
What should a mum do who’s struggling right now?
“First of all, stop. Take a few minutes to weigh up exactly what’s going on. Take a piece of paper and write down how you’re feeling, what symptoms you’re feeling and what’s going on. Sometimes that’s enough to make it concrete and to come up with a plan. If on assessing how you feel, you’re noticing that it’s a mood that’s not shifting, it’s a struggle you feel daily and it’s getting in the way of any of your daily functioning, so you start going “I can’t do that. I can’t go to that toddler group”, “I can’t make dinner now”, that’s when you seek support. It’s strong, not weak, to seek support. It’s you saying, brilliant, I need some help. In the same way that we go to school, we have a teacher. If we want to learn tennis, we get a coach. It’s no different. And it builds up our capacity to deal with things. So although there are some things we can do ourselves, if it gets in the way of daily life, reach out.”
What can we do to stay mentally well?
Exercise – it’s really well evidenced that exercise can help many mental health issues.
Mindfulness – noticing our judgment thoughts and letting go of how critically we view others and ourselves.
Engaging with our world a bit more – getting outside, getting fresh air.
Hobbies and interests
Self-care – practices like reflexology and massage, which alleviate pain and increase our levels of serotonin or dopamine.
Therapy – evidence based talking therapies are really helpful for changing thought patterns, lifting mood, and managing symptoms.
Medication – may be prescribed by a GP or psychiatrist where appropriate.
“All of these things are really good for us, they don’t have to be, ‘oh I’m selfishly taking the dog for a walk’ or ‘I’m selfishly having a massage’, it’s a good thing for everyone. It’s like needing to put our oxygen mask on in the plane before trying to put it on someone else, this means seeing yourself alongside your children, not suddenly subservient or passive to their needs.”
Jo’s advice on where to get help
Your GP is your first port of call. You can visit your GP to discuss options such as referrals for therapy and medication.
Trust your instincts – if what you’re being offered doesn’t feel enough for you, do explore other options.
Perinatal mental health services – The NHS has introduced a new service in some areas that supports women in pregnancy, up until baby is 12 months. Ask your midwife or GP about this service.
If you’d like to see a psychotherapist or a counsellor privately make sure they have specific evidenced, perinatal experience.