Rural isolation is a unique problem in a number of areas in New Zealand.
Many rural people live large distances away from their nearest town and families can often be quite isolated from one another. There are additional problems when there is a lack of support services nearby. GPs are often quite a distance away and can be busy and overworked. Psychologists and psychiatrists may not be available locally, so support services for women with mental health problems may be quite limited. Extra childcare may not be available.
This geographic and social isolation can lead to anxiety and stress even in women who are well. Rural women with PND and anxiety disorders often find that the isolation and lack of local supports cause addition problems. It can be hard to ask for help in a small community where everybody knows everybody else.
The internet is becoming a valuable tool for assisting these women. There are programmes trialling online counselling treatment programmes. Isolated women may find these advances a help.
Jackie lives on a farm in an isolated rural area on the West Coast with her husband. She had PND and anxiety and suddenly became unwell two weeks after her daughter was born.
“It suddenly hit me like a ton of bricks. I felt as though I couldn’t bond with my daughter. I asked for help. Initially I was told that I had “first mother syndrome” and that I was fine. I wasn’t. I tried breastfeeding but my daughter was not gaining weight. I felt a failure as a mother and hopeless at breastfeeding. I changed to bottle-feeding. Then I worried that I wasn’t cleaning the bottles well enough and that she would get sick.
I suddenly stopped sleeping and was sent to a psychiatrist 50 km away. I told him that I felt as though I hadn’t had my daughter. What I meant by this was that I couldn’t bond with her. He put me on a strong antipsychotic medication, which made me feel like a zombie. I couldn’t do anything, not even shower myself. I stopped taking this but stayed on an antidepressant medication, which worked well for me and slowly I improved.
During this time I felt very isolated where we lived. There were no younger women around me who had recently had babies. I felt awful and lonely. The closest town was 30km away and there were no supports here for me.
I had my second child a year ago. I developed problems with anxiety and depression again but this time I was much more aware and got onto medications quickly. I still worried about my baby’s feeding and his weight gains. I stopped breastfeeding at ten days and this time I felt great about stopping. I didn’t need the pressure of trying to breastfeed on top of my depression and anxiety. There was pressure from Plunket to continue breastfeeding but this time I knew what was best for me and my son.
My family was great, but again, there wasn’t much outside support for me. Plunket could only come and visit me at home twice other than that I had to go to the clinic which was 30km away.
My midwife came and visited me once a week for six weeks after my son was born. There were no other support services available. There are now younger women living in my area which helps. Rural women can be very isolated and need more support for mental health problems. It is very hard to admit to having PND and women should not be embarrassed about it.”
Where to get help
The internet can be a valuable tool for assisting people. There are programmes offering online counselling treatment programmes. People who are isolated may find these advances a help.
Beating the Blues is the most widely used and evidence-based online CBT treatment program for anxiety and depression. Login to your ManageMyHealth account to access Beating the Blues.
SPARX is a computerised, self-help tool for young people aged 12-19 with mild to moderate depression.
The Mental Health Foundation of New Zealand | Mauri Tū Mauri Ora have a guided self help workbook; The Mindful Way Workbook is an eight-week mindfulness-based cognitive therapy (MBCT) programme for depression and emotional distress.
There are support services available to people within each District Health Board region. For details of services in your area visit our Support Services page.