Family and parental mental health
Peripartum and postpartum depression
Being pregnant and giving birth to a child is a time of great celebration and hope, but it is also a time when women are very vulnerable. Depression and anxiety is common during pregnancy, and may affect as many as 40% of pregnant women in South Africa. Untreated this can develop into postpartum (post-natal) depression. Symptoms can range from extreme sadness and feeling like you have no connection with your baby, to severe anxiety and panic, to extreme irritability and anger and feeling like you may even hurt your baby. For a detailed list of these feelings and symptoms consult the PNDSA website.
Many women suffer in silence because they feel ashamed or guilty at being depressed when everyone around them is overjoyed. In addition, partners and families may not understand how the mother is feeling, and may try to tell her to "count your blessings”. Given the knock-on effects of postpartum depression to the emotional well-being of the mother, her baby and the family as a whole, early intervention and diagnosis is essential. Supportive psychotherapy which offers a holding environment for the mother together with psychoeducation is an effective treatment for peripartum and postnatal depression either alone or in conjunction with medication. Once the mother has sufficiently stabilised, the opportunity for more in-depth psychotherapy is recommended so as to protect against future episodes of depression.
Mental illness of family members
The mental illness of a family member can have a profound affect on the well-being of any family. These families often have to deal with instability or unpredictability and often there is confusion in family roles, and children or other family members may have to take over many of the adult responsibilities. Families often have to accept a changed future and expectations. Where the illness impairs the person's ability to function and participate in the normal activities of daily life, families often struggle to accept the realities of an illness that is treatable, but not curable. In many ways families grieve for what might have been and find it difficult to focus on the possibilities that remain for their loved one. Psychotherapy not only provides psychoeducation on the illness in question, but it also provides a supportive environment within which the family are gradually able to work through their grief.
Psychologists who work with families usually see them as a unit - a unique social system with its own structure and patterns of communication. These patterns are determined by many things, including the parents' beliefs and values, the personalities of all family members as well as their different habits, perspectives and interpretations of events. What one member does or doesn’t do affects not only him or herself but everyone else in the family as well. In assessing both its strengths and weaknesses, family therapy enables all members of the family to understand and develop ways of assisting and supporting each other. It helps the family focus less on a particular member but rather on the family as a whole. It helps to identify conflicts and anxieties and helps the family develop strategies to resolve them. Learning respect, tolerance and attentive listening, especially during conflict, lays the basis for a healthy family emotional system which forms a strong foundation to work from when difficult circumstances arise.
Divorce is one of the most stressful events a person can experience in his/her lifetime. Where children are involved, this stress is compounded and the psychological well-being of the child is brought under the spotlight. When parents decide to divorce, they end their personal relationship as partners, but continue their relationship as parents. Most former spouses are able to establish a relatively conflict-free parenting relationship for the benefit of their children. However, many have difficulty in establishing a workable parenting relationship. Co-parent counselling (or individual counselling as the case may be) allows parents an opportunity to talk about the best interests of their children in a neutral environment and, when appropriate, to get input and advice. The focus in treatment is on the difficulties between the separated parents only as they relate to co-parenting. The goals are to help parents unburden their children by learning to manage their own emotions and anxieties. Parents learn to free themselves from dysfunctional, emotionally-charged communication and instead adopt a more clearly-defined, respectful, and dispassionate approach to problem-solving as it relates to parenting.