Keeping You Safe: Away from Harm?

A Review of No Other Darkness by Sarah Hilary: a whole new meaning to the phrase ‘keeping you safe’. Net galley review. 4.5 stars.

Keeps you wondering just what can happen next. Some notes about Post Partum Depression (PPD) follows – don’t read this if you are pregnant

  • For the mother, PPD may result in sleep disturbance, feelings of worthlessness, diminished concentration, recurrent thoughts of self-harm. Mothers with PPD can become withdrawn, socially isolated, and have difficulty caring for themselves and their children. Severe cases may feel helpless, despair and shame, even leading to suicide attempts.
  • The PPD can exacerbate her social isolation (which may also have contributed to its development in the first place). The birth of a child often entails leaving work, narrowing the mother’s social network.
  • Postpartum depression can also significantly strain relationships within the family, and is associated with the father developing a depression or other psychiatric problems (Condon, J. Australian Family Physician 2006;35(9):690).
  • http://www.med.uottawa.ca/sim/data/Depression_postpartum_e.htm
  • No one single cause of PPD has been identified; a number of biological (e.g., hormonal changes), social and psychological factors have been implicated. Plausibly social, psychological and biological factors need to be linked in a causal chain.
  • Puerperal psychosis is more severe and involves fluctuating extremes of elation and depression with delusions and hallucinations. This rare condition may affect about .01% and requires extensive medical intervention.

Looking at the issues highlighted in this book and the evidence presented about the mother it is clear that this is not a normal case of post partum depression but rather puerperal psychosis. (I checked this with my handy clinical psychologist just to be sure that I was identifying everything correctly.) Puerperal psychosis can be associated with late onset bi-polar and in this book we see a dissociative personality split – the before and after of the behaviour and person. We also see a mother who is unable to set and keep to appropriate boundaries.

One major issue highlighted in this book is the lack of support for the husband who does not reach out himself. Whilst there are a number of online support groups for the husbands of wives suffering from PPD there seems to be little intervention from health care officials for these husbands. Additionally, most of the internet support groups are aimed at wives whose husbands are not sufficiently supportive. Many husbands do not know how to be supportive of their wives.

What happens though to the self-worth and emotional and mental health of a husband whose wife actually kills a child /children through PPD is seems to have very little written about. They are survivors and must suffer survivor guilt as well as the guilt that comes from not keeping their children safe from their wives. The depression must be severe and the over-compensation if they start a new family must be expected though as in this case, if this mental over-compensation – obsession is not dealt with then it can in itself turn into a form of mental illness with associated problems as is shown in this book.

The book threw up for me a lot of points – I shall write about the Thames and what lies under London in a different blog as it would take too many words to add to this review. But the book really gave me a lot to think and ponder about and to look into. One of my childhood-friend’s sister had PPD and was hospitalised with both children she bore, which must have been devastating for the family I now realise though at the time she was somewhat older than me, although living still in the same road – presumably now to keep close to her parents to look after the children whilst she was away.

This book raises so many good points that perhaps there is too much to think about? But it all links in so well and fits like a glove in the story which is told in such a way that the true horror only hits you part of the way through when you read the characters’ stories. Overall a well crafted novel and I look forward to reading more in this series.

 

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