Illustrations by Tatyana Ospennikova

Muscovite Ksenia Krasilnikova, PR director at the bank, faced a severe form of postpartum depression in 2016. It took almost a year and a half to recover. The experience had such an impact on the life of the whole family that the girl decided to write a book about this “Not just tired. How to recognize and overcome postpartum depression ”, where she told her personal story and supplemented it with expert comments. It turned out a kind of handbook on all issues related to this type of disorder.

According to the World Health Organization, postpartum depression is one of the most common mental disorders in the world: every sixth young mother faces it. At the same time, women, due to the influence of stereotypes or lack of information, do not always seek help, because of which, in more than a third of cases, depression becomes chronic.

We talked with Ksenia Krasilnikova about her story and about how she can help young mothers in a situation of depression.

BBC: Information on postpartum depression can now be found on the Internet, there are articles in the media. Why did you decide to write a book, what exactly was it important for you to tell?

Ksenia Krasilnikova: When I gave birth to a child and faced with postpartum depression, I did not have enough information that I could google. The media really began to talk about it, but then, two and a half years ago, they simply postulated the existence of such a problem.

I lacked a single authoritative source who would tell me what to do, would help me cope with an eerie feeling of guilt, with which nothing could be done in principle.

In addition, I wanted the book to take the conversation about the problem to a more authoritative level. In the minds of people, since there is a book about this, it means there is reason to doubt the thesis that postpartum depression is a whim. And this is still a very common thesis.

BBC: For those who have not read the book, can you briefly outline your story?

K. K .: Yes. Bore a child. I quickly realized that I felt bad. At first, while still in the hospital, I had strange uncontrollable bouts of anger. Then we came home and it got worse and worse. Sleep and appetite completely disappeared, suicidal thoughts of a very practical sense came. I quickly began to search for a psychiatrist. I went to the first one, who agreed to accept me faster than the others, and I was recommended to be hospitalized. She lay in a psychiatric hospital for two weeks, then about four months. Saw tablets — antidepressants and neuroleptic — one and a half years. It was a really long treatment process. Now I am in remission, and I am very glad, because it is very good not to be depressed.

Illustrations by Tatyana Ospennikova

BBC: You write in the book that you first turned to psychologists who could not understand what was happening to you. And that, in fact, in order to distinguish postpartum depression from what is called baby blues (feelings of confusion, sadness, loneliness), you need to ask specific questions.

K.K .: It’s worth making a reservation here that I’m not a mental health specialist, but I’m talking about a problem based on experience and information I gathered. But first you need to ask about the duration of the symptoms — this is a decisive factor in the distinction between baby blues and postpartum depression.

In addition, during baby blues periods, let's call them periods of "bad mood", are replaced by the feeling that everything is in order, a feeling of joy from a child. And my picture was, as I understand it now, really quite heavy.

BBC: In the book you tell me that you were afraid of your own son.

KK: Yes, but this is my story, it’s not at all like that. Many are afraid for the child. It is often found that a woman has no motherly feelings, which she expects, as I did not have them in principle. But when I said that I was afraid of him, many people did not understand me — what does this mean? But I was afraid of him, nevertheless.

BBC: You were a young, prosperous woman from a loving family — how difficult was it for you to admit that you had a mental disorder? Was it difficult to decide to go to the hospital?

K. K .: Honestly? I went to the clinic with a feeling of wild relief, because I had to run away from the child, he was a source of incredible fear for me. And besides this, I well understood that psychiatry is a field of medicine, and since I have already been told by several specialists that I have severe postpartum depression, they probably have the experience and knowledge to make such diagnoses for me. I just relied on doctors.

Of course, everything was interspersed with guilt — in front of the child, in front of her husband, in front of her, because [из-за депрессии] I deprived my newborn son of my mother. And this at least affected our relations with him, which had to be difficult and long to restore. They recovered very recently. And it really was difficult. Already when I went to work, I came home, and he was crying. And every day he wept, weep, weep.

Before becoming a PR director at a bank, Ksenia Krasilnikova was a translator and dubbed films and series from English and Spanish. From the personal archive of Ksenia Krasilnikova

BBC: Why?

KK: He did not want to be with me. I come and he starts to cry. Obviously, that was the reason. Every evening he had to spend several hours alone with me, and I was an unprecedented person for him.

BBC: You talk about it very calmly.

KK: I just assume that everything is fine now. Now I have his beloved mother, if he is scared, he runs to me. It just took about a year to do this.

BBC: You went to the hospital twice. Why?

K. К .: When I went to the hospital, I had doctors, there were several of them, they were all attentive to me, deeply penetrated into my illness, my disorder and the history of my life.

Immediately, on the very first day, they gave me an antipsychotic, and I slept for the first time in several weeks. Then they collected anamnesis, I passed the tests, and I was prescribed antidepressants.

It was a period right before the new year, and, of course, I didn’t really smile at the prospect of spending holidays at the hospital, especially since there were only doctors on duty at that time, and I didn’t assume that some kind of emergency situation could happen to me. Doctors told me: “It's too early for you [выписываться]", but by the time I was discharged, two weeks had passed, and it is believed that on average two to three weeks is necessary for the antidepressant to work. And I thought that I would write out now and everything would work. It was not like even natural optimism, but simply the belief that depression can be cured quickly.

On this enthusiasm, I rode for some days, probably three weeks. Sleep problems did not return, because I drank a neuroleptic, but returned with an appetite — I stopped eating again, I realized that I was in a bad mood, and went back. And already lay a long time.

BBC: You were in a regular state psychiatric hospital in Moscow?

K. K .: Yes. For a while I paid for staying in a paid ward. The main advantage of the paid chamber is the presence of a shower, which had a door, and a toilet, which had a door. They could not be locked, but it was possible to cover them, because all the other rooms, including the shower and toilet, are common. But then I transferred to a free one, because it became expensive, I didn’t expect to lie there for so long. In the free ward, for you to understand, there were 12–14 beds each. But, in general, I was fine.

Illustrations by Tatyana Ospennikova

BBC: Did I understand correctly from the book that your husband quit to study his son while you were ill?

K. K .: Yes.

BBC: How hard was that decision?

KK: I can not assess how this decision was difficult for him. It was then that he didn’t tell me anything, he was taking care of me, and I didn’t describe the horrors that happened to him at all.

He always said that everything was good, but in fact everything was very bad, it was very difficult for him. He, in fact, got into a situation in which the majority of mothers in our country end up — he was alone with the child. He was helped by relatives, but the responsibility for the child and for everything related to caring for him was on him. Very often they were left alone for a long time. When this baby, whose colic, which can not be called a gift — cries a lot and sleeps a little — it is very hard. And still severe sleep deprivation is tolerated.

As for the financial side, we coped because I had freelancing and had a regular allowance, albeit a small one, which is paid on a decree for the first year and a half. In general, they did it. This was an absolutely necessary step, the only possible one.

BBC: There are phrase books in the book — ready-made formulations, how to ask for help, how to respond to criticism, and so on. For example: “Let's order food today, and I will lie in a bath instead of cooking. This will help me a lot. ” Unfortunately, it seems that help with postpartum depression in our country is available for a small percentage of mothers: the family should be sufficiently secure, as a nanny and food delivery cost money, a partner or grandparents should not be too patriarchal and take care of child What other mothers do? Is there free support?

Illustrations by Tatyana Ospennikova

KK: Yes, there is a Doulay Utkina created on Facebook a support group for women with postpartum depression "Carefully to yourself." This is an online group, but it gives, judging by the responses, really tangible help.

There are moderators in the group, and we make sure that people share not advice, but experience, that everyone communicate on equal terms, so that, of course, there is no depreciation, condemnation and insults. And it works, it really acts as a source of support for women, they talk about it themselves.

Now there are 4,500 women in the group, and this is an extra reminder that postpartum depression is a disease, a disorder. He has a characteristic set of symptoms, and many of these or other details are the same. And when a person is in an environment where his difficulties are denied, and suddenly he comes to a group where they say to him: “Yes, it was with me, and it was with me, and it was with me,” he realizes that he not one, and, therefore, he has much less reason for this terrible all-consuming guilt. He can look at the whole situation differently, understand what ways there are to help himself.

There are also volunteer social projects for mothers. There are psychologists who make free programs and support groups, including when they learn new practices. Well, help in the neuropsychiatric clinic is free. Another question is that it is not always possible to understand exactly which doctors work there.

Illustrations by Tatyana Ospennikova

BBC: A separate chapter of the book is devoted to relatives — in particular, there are monologues of your husband, mother, sister. What things should close relatives pay attention not to miss the symptoms of depression?

KK: Oh. You asked a question, and I immediately recalled the material on The Village — a monologue of a husband who lost his wife, who did not cope with postpartum depression and committed suicide. From this text it is obvious how much he really is a caring and supportive husband. There is no such thing that some actions will definitely be able to protect, protect.

It is clear that you need to pay attention to the alarm bells. These are usually noticeable changes in the way a woman behaves, in her mood, especially if periods of anguish and anxiety do not give way to lighter periods. The most striking alarm bells are physiological changes: sleep, appetite. These are just symptoms of clinical depression that cannot be ignored in any way.

Well, you need to listen carefully to what she herself says: if she says she does not cope, that she does not have maternal feelings. Another issue is that some women simply because of shame and stigma can not even talk to their relatives about it. Already after I came out and wrote that I had a book about postpartum depression, two girls from my closest circle confessed to me that they survived it and did not tell anyone. It is difficult, it is difficult to admit it. I understand them well, I sympathize with them dimensionlessly. But it is super important to do it, because everything is at stake, in general.

I also started a book for this — when you can bring it to your partner or mother and poke a page, it gives you the most, well, your condition, some value, the ability to talk about it in general.

What not to say? “You're just tired, get some rest,” “It’s all so, it will pass,” “Pull yourself together,” “Everything will be fine.” Any comments that devalue the situation are only harmful. Well and naturally, the judgment is harmful. And condemnation is a very frequent reaction of relatives and the environment, if a person dares to admit that something is wrong with him. And this is the most harmful that can be. So I honestly can not imagine how to cope with such.

Bi-bi-si: How does the postpartum depression of the mother? And what should a woman do if she has to choose between her health and caring for a child?

KK: Attachment theory claims that the presence of a meaningful adult plays a crucial role in the development of a child. It doesn't matter what gender this person is. It is important that he reacts promptly to the needs and demands of the baby, basically treats him kindly and understands that the crying child needs to be reassured that he needs to be fed, that he needs to change the diaper, bathe him sometimes and generally help him cope with it incredible stress of the newborn.

There are studies about what happens to mothers' children, who stay with them in postpartum depression and become their main significant adult. It is believed that this rather affects the children, including their development, simply because the mother can not be emotionally involved and, accordingly, can not sensitively respond to his needs.

This is a situation in which, contrary to tradition and custom, one must put oneself first, not the child. This, of course, does not mean that the child should be left, but if there is a need in some sense to deprive him of the mother, then this need should be accepted and thought out how to arrange his well-being.

Illustrations by Tatyana Ospennikova

In addition, not always people with a diagnosis of "postpartum depression" are in the hospital. Depression is not even always treated with medication, you can often get by with psychotherapy. Accordingly, in this case, probably, for the child everything can pass almost unnoticed.

BBC: How old is your son?

K. К .: Two years and five months.

BBC: Do you plan for him at some point to tell about everything he has experienced?

K. K .: Of course.

BBC: Why?

KK: Firstly, for me it is a question of knowledge transfer — simply that there are mood disorders, mental disorders. Secondly, this is a fact of our family history. He influenced us very much. It is still not clear what the consequences are, what they will be.

I know what to tell him, I do not have the feeling that he will not understand me.

BBC: Did you come up with a universal response to comments in the spirit of "our grandmothers in the field gave birth to nothing" during the time of recovery or work on the book?

KK: “Sorry, you *** [обалдели]? ”When I read this, my eyes hurt, I want to shout loudly at the people who write this. It is clear that this is from my imperfections. So, the answer to these people: “Please read reliable scientific sources. Please refer to evidence-based medicine. ” You do not want? Ask friends. Be sure someone will tell you that some girlfriend had a similar one.

Postpartum depression all the time, it's very sad, and you have to do something about it. People are not ready to admit to themselves that this happens with them, that they need help, because the feeling “I am a bad mother” and even not “I am a bad mother”, and “I am just not a mother” is terribly destructive, it’s wild feeling of guilt and talking about what you feel in such a state is difficult, very difficult. How to talk about this with people who, in principle, are not ready to hear it, I cannot imagine at all. I have so many experiences, in fact, about this. I very much sympathize with these women, and I want to reach out to everyone, hug and say: “You are sick”.

See also: Who faces prenatal and postpartum depression and how to avoid it.

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