“I MET a woman recently who I haven’t seen for years. She introduced me to her daughter, and she said, ‘This is Madge; this is the woman that saved my life’.”

Twenty-five years ago, Cork woman Madge Fogarty couldn’t have anticipated that the support group she founded to help women like her, who suffered from Post-natal Depression (PND), would go on to help so many.

PND Ireland, 25 years old this month, is run by women with experience of the condition, to offer support, advice and a sense of community and friendship for those who battle with the condition, which is far more common than many people might think.

Almost one in five Irish women will experience some level of PND, according to a 2012 UCC study. Up until that point, the HSE had always reported rates of 10%.

It was Madge’s own experience of PND, following the birth of her second baby, Shane, that made her realise how urgently a support network was needed.

“I thought I was not only the only woman in Cork going through this thing, but the only woman in the universe,” she says.

“I was told ‘pull yourself together,’ or, ‘I had six children, and I never had that’.

“People were so judgemental. You’d think women would support you, but some women were actually worse to you.”

Although attitudes have changed a lot since 1992, it was still a highly stigmatised condition when Madge became a sufferer.

“You weren’t encouraged to talk about it,” Madge recalls. “Everything was a secret. Someone said to me, ‘If people find out, you’ll never work again.’ The stigma was really horrible.”

Suffering for six months in silence, Madge eventually went for help. In her case, her depression was so severe that she required medication to aid her recovery.

“I was on a truckload of medication,” she says. “It was very bad. I felt I was the only one on the planet going through this; there was no information at the time.”

Going public with her story, Madge eventually decided to found a support group; pre-internet, this required postering campaigns, media appearances and a public meeting to set up the group.

By this stage, baby Shane was two and Madge was well on the road to her own recovery, but she was fiercely determined that others wouldn’t suffer with no support network, as she had.

Now, PND Ireland has an office in Cork University Maternity Hospital, but in the early days, Madge’s phone was her office.

She laughs, remembering the challenge of manning the phone to provide support while also caring for Shane and his elder brother, Tomás: “If they heard the phone ring in the evening, they’d say, ‘Please don’t answer it.’ They knew I’d be on the phone for half an hour.”

Baby Blues

Most mums will be familiar with the so-called ‘baby blues’, which affects 80% of women, and has a physiological explanation: during pregnancy, mood-affecting hormones progesterone and oestrogen sky-rocket. By the time the baby is born, the placenta is producing an epic 1,000 birth control pills’ worth of progesterone each day.

After delivery of the placenta, the woman’s body experiences a huge hormonal slump and a drop in mood.

Most women will feel blue for a few weeks, may cry more easily or experience feelings of sorrow and struggle to adjust.

But for 19.75% of new mums, this experience will deepen and become a prolonged depression.

PND can last for anything upwards of three months, and require medical solutions as well as other approaches like Cognitive Behavioural Therapy.

A small minority of women may even experience puerperal psychosis: these sufferers pose a risk of self-harm and require intensive treatment and monitoring.

In fact, UK research has shown that 10% of maternal deaths — classed as deaths within one year of childbirth — are suicide.

“It’s the one thing you’d really dread, that happening to a woman who’s on our list,” Madge says. “Mercifully, it hasn’t happened, but it’s still the worst-case scenario.”

Madge’s struggle to spread the word that this is a treatable illness, that needs to be dealt with without stigma, has taken many years. Ironically, she found that she was promoting awareness not only amongst expectant mums and the public, but also amongst healthcare workers.

“Women need to be listened to more,” she says. “We’ve had far too many cases of women going to their GP and being told, ‘Don’t worry about that; it’s just a touch of the baby blues’, and sending them away, without even asking them to come back, or monitor themselves.

“When a woman is told that, they’ll think the doctor knows best and they’ll suffer in silence.”

These days, Madge takes part in the antenatal classes in CUMH, where she’s able to pre-warn expectant parents about the possibility of PND rearing its head.

“I’m really proud of the group and all it’s achieved,” she says. “I can’t believe it’s been 25 years! There’s been a lot of change, but it’s taken a long time.”

Cognitive Behavioural Therapy

Although for many women, PND manifests as classic symptoms of depression, for Elaine Horgan, from Blackrock, mum to Chloe, 10, Addison, 8 and Leo, 3, her PND emerged more frequently in the form of panic attacks and anxiety.

“I never experienced it with my first two children, but when I had my third I knew straight away that something didn’t feel right,” Elaine says.

“But I suppose that as a mother you just kind of put things to the back of your head.”

Three weeks after baby Leo was born, Elaine’s husband Mark fell ill. Although it would turn out to be a fairly low-risk illness — gallstones — the strain of his sickness and hospitalisation triggered panic attacks for Elaine, something she’d never experienced before.

Despite support from Mark’s parents, close neighbours, Elaine began to dread being alone, and to have terrible fears for the safety of her children. As many women will report, she also felt a lot of guilt.

“You put a lot of guilt on yourself when you realise it’s PND,” she says. You think, ‘I’ve been given this beautiful child, the best little fella, and I can’t enjoy it.’

“For those first couple of months when I really wasn’t myself, and as I started to get better, I felt guilty that I had lost out on those precious moments at the start.”

Elaine didn’t want to take medication, and a psychiatrist referred her to a mental health nurse for Cognitive Behavioural Therapy (CBT). 

“The CBT was brilliant, even though it felt like a lot of work in the start,” she says. “You learn coping mechanisms, and how to avoid triggers.

“The mental health nurse was also the one that put me in touch with Madge; I went to my first PND meeting when Leo was five months old.” “It was the scariest moment ever, going in, but the relief I got out of it was indescribable.

“There were women there going through what I was going through, there were women there who had recovered, who were coming back to help.

“It gave me so much hope that at all the panic attacks an anxiety would end, and I could go back to being me.” For Elaine, she remembers beginning to feel that she was returning to normal when Leo was around a year old: she realised she was making it through the day with no panic attacks.

Now, she’s one of the women who attend PND Ireland’s regular monthly meetings, to share her story and support women closer to the beginning on their road to recovery.

And her story has a message of hope, too.

“It does make you stronger. It has made me much more aware of myself, and it’s made me take time for myself; you can’t deal with your children or take care of anyone if you’re not well.

“I think it’s made me and Mark an even stronger couple to have come through this.

“You have to talk a lot of stuff out; now, anything life throws at us, we can deal with.” PND Ireland hold regular support groups and coffee mornings.

For further information on meetings, plus discussion forums and advice, visit: http://www.pnd.ie