Many a mother may have silently wished her children at a stage of absolute despondency, fatigue and sheer disorientation – or perhaps even harbored dark thoughts towards them. A fleeting moment… and then the guilt sets in almost immediately.
Mental health experts say these thoughts are – believe it or not – completely normal.
What is not normal, however, is when a mother no longer feels guilty about those almost unimaginable thoughts towards her offspring, and no longer makes an effort to suppress them.
“Unfortunately, this happens in cases of serious illness, such as postpartum depression and psychosis, when a mother’s thinking is not normal. However, such cases are extremely rare,” says a psychiatrist from Pretoria about mothers who do the unthinkable: kill their children.
The trial of Lauren Dickason, the South African woman who is on trial for the murder of her three young daughters, began this week in the High Court in Christchurch, New Zealand. Dickason has pleaded not guilty to the charge of murder against her, arguing that she was mentally ill at the time of the murders and is therefore unaccountable.
According to the state’s version of events, Dickason likely suffered from major depressive disorder but knew what she was doing when the murders were committed. In addition, before the murders, Dickason apparently also stopped taking her antidepressants.
Medication makes a difference
Jerrie Bezuidenhout, psychiatrist and director of medical services at Vista Clinic in Pretoria, says that it is unfortunately the case in some cases that prescribed medication for patients with mental disorders means the difference between life and death.
“Antidepressants make a significant difference. This not only reduces the risk of suicide, but sometimes even means the difference between a happy marriage and divorce. This does not mean it solves the problem in the marriage. But it treats the disease that makes the problem worse.
“This prevents the person from experiencing the situation more emotionally and more negatively.”
Bezuidenhout does believe that society places too much value on that so-called motherly love that must kick in immediately after a child’s birth.
“Some are happy and bond with the baby immediately. Others simply feel so overwhelmed that they cannot show any feeling towards the baby. This does not mean that such a mother is not a good parent. Like any relationship in life, it forms over time.”
Yolandi Singleton, a social worker and head of Helping Hand’s Ons Center in the north of Pretoria, says she often sees at this children’s health care center that some new mothers simply do not have the ability to form a bond with their baby.
“This is often because the mother did not form a bond with her mother as a child either. They really just don’t know how,” Singeleton explains.
She says that doesn’t mean that there isn’t a maternal instinct.
“The maternal instinct is there, but unfortunately it is often suppressed by mothers’ trauma. Trauma plays a huge role.
“This does not mean that mothers who suffer from postpartum depression and struggle to form a bond are hopeless,” says Singleton. “It just means that mom needs to get help, either in the form of medication or therapy.”
Baby anxiety, postpartum depression or major depressive disorder
The experts say postpartum depression is often confused with baby distress, also known as “baby blues“.
Bezuidenhout explains that the so-called baby blues not persist for months. “It’s only for a few days. This is a physiological response. The mother’s mood drops after giving birth, because the high point of the birth unfortunately goes away, her body hurts and she struggles with feeding, for example.”
Bezuidenhout says that in such a case it is supposed to get better with the mother within days.
“If a woman is depressed and tearful for more than two weeks, has trouble eating and sleeping, is anxious and experiences feelings of guilt, there is probably something wrong.”
Bezuidenhout further explains that postpartum depression has “a biological (rather than physiological) aspect”.
“It’s more of a physical than an emotional problem.”
Singleton says that dark thoughts are to some extent normal when a mother has the so-called baby blues or in more severe cases suffer from postpartum depression.
“But when you want to take action and want to harm your child, a mother should realize that it has gone too far.”
The experts warn that postpartum depression can also lead to chronic depression if it is not treated in time. However, it should be noted that not all depressed mothers say in so many words that they are struggling and harbor gloomy thoughts.
Singleton says while some are verbal, others struggle to express themselves. “Some have already decided what they are going to do and don’t want to be stopped.”
It is therefore very important to note any behavioral changes in issues such as sleeping patterns and eating habits.
The effects of major life changes, such as emigration in the Dickasons’ case, and the responsibility as primary carer, should also not be underestimated, says Singleton.
“The older one gets, the more difficult it is to adapt to circumstances.
“I was very sad when I heard about the mother in New Zealand and what happened there. This could have been prevented if she had received medication and support in New Zealand.
“I don’t justify what she did at all. I just think there should be some understanding with someone struggling with mental health.”
Medication or not?
Bezuidenhout says that the “sicker” a mother is after giving birth, the longer she should use her prescribed medication. It is also very important not to stop medication in secret and to inform your partner and GP about this decision.
A patient’s behavior should also be closely monitored after the patient has been weaned from the medication.
Bezuidenhout explains that medication for, among other things, depression and anxiety should never be stopped summarily. “Discontinuing sedative medication can result in so-called emotional overload.”
He further explains that if a patient has been on medication for more than a year, the patient must reduce the dose over some time before he or she is finally completely weaned from it.