Emma Jane Unsworth on her postnatal depression: "It felt so risky to say I can't cope"

To mark Maternal Mental Health Awareness Week we talk to the novelist and screenwriter about her new memoir, After the Storm. With searingly brutal honesty, Emma unpacks her son's traumatic birth, the PND that almost destroyed everything, and why the myth of women having it all is making us sick

Postnatal depression is not supposed to make you laugh but brutal honesty and dazzling humour are part of Emma Jane Unsworth’s award-winning literary arsenal. Weapons she deploys so brilliantly and to devastating effect in Adults - a social media satire which had me howling and gasping - and likewise in the toxic friendship detailed in Animals (she also wrote the screenplay of the film starring Holliday Grainger and Alia Shawkat). Complicated, hedonistic, messed-up women in all their messy, complicated glory, grief and grittiness is what Emma excels at.

All well and good when you’re writing up these stories as works of fiction, but in her latest book, After The Storm, Emma is the complicated, messed-up star of her own shitshow. Her first foray into non-fiction is a brave and compelling part memoir, part manifesto on the ‘utter weirdness of new motherhood’ charting Emma’s descent into an all-engulfing postnatal depression that almost broke her and her marriage.

“Normally my books are fiction so this felt like a really dangerous step for me,” Emma tells me from her home in Brighton. “I’m implicating real people and that felt terrifying. Especially because one of them was my child. I had to do a lot of thinking around that and convince myself that writing this book was the right thing to do.” Within 140-pages Emma has wrung herself out, taken us to the darkest corners of her mind and made us laugh at the sheer madness of new motherhood. Back in 2016, the now 43-year-old mum of two, realised her rage, anger, fury and dark thoughts were in fact postnatal depression. It was six months after the traumatic birth of her first child, a son, that she finally admitted to her husband, Ian, that she needed help. Fast.

“I’d spent so long pretending everything was fine, even to myself,” says Emma. “I felt like, is this how I should feel? You just don’t know. I was so lost and isolated within myself.”

Over the next 12 months, with Ian’s unflinching support, a brilliant therapist and antidepressants, Emma slowly found her way back to herself. And now she’s crafted a liferaft of literature for others struggling out there in the tumultuous deep end of parenthood.

It’s a love letter to herself, about rediscovering her identity and helping others realise they’re far from going mad when they’re bone tired from only having three hours sleep in three days and harbouring dark fantasies of violence.  According to the NHS, more than 1 in 10 women experience postnatal depression (PND), and it’s thought many more cases go unreported. Quite frankly, After The Storm should be available free on the NHS for other women struggling in silence and maybe too scared, guilt-ridden or ashamed to ask for help. Here Emma talks about her experience and how After The Storm offers solidarity to others…

Emma, was there a primary motivation pushing you to write your brave account?

“Women are so often silent about the reality they’re experiencing in their bodies and their mind, so I just really wanted to crack that silence for other women. I wanted to put something out there that would be useful to others. When I was recovering, I started to figure out what really went wrong for me, but I couldn't find anything from a personal perspective on postnatal depression. This book is about my relationship with motherhood and all the myths surrounding it. It was me vs something I have been pushed in to, that wasn’t a good fit at all.“I didn’t want to be another woman suffering from something so terrible who wasn't allowed to shout about it. I wanted to break that silence and make peace with the implications of that for a real little person in my life.

"After talking to so many experts in the book, I realised that unless you have a brilliant midwife, we are even denied the science to inform ourselves. We are told how big the baby should be, which piece of fruit it should at the scans. We are not told anything about what might happen to us and how it might make us feel. We are not empowered in that way and that’s really shocking and unfair. It sets us on the back foot from the start.”

You tackle the taboo of maternal anger in a number of disturbing episodes, which many will relate to whether they admit it publicly or not. Was it important to you to expose these extremely vulnerable times?

“Oh yes it was so important. And you know, the more people that get in touch about the book, the more I realise how common all that dark stuff is. These are really common feelings and nothing to be ashamed of. I am sure there is a hormonal reason for this, along with the fact that quite often you’re so exhausted. You almost can't cope with the responsibility of this new role and it almost feels something you need to get away from or destroy in some way.”

Your therapist said postnatal depression is a 'reasonable reaction' to the pressures of modern motherhood. Do you agree?

“What other job would you walk in to and think, ‘yes, I can do this, with no training, no skills, no honest appraisal from anyone else,’ it’s a very hard job. It's not magical or mystical. I love my children and there’s so much about them that I find so magical. But as a job and what I have to do every day is hard work. To be a good mum is such hard work. I think it's a real disservice to child care professionals too. It’s a real underestimation of how much we can learn from them and they can teach us about how to do it well. People should not be ashamed of asking for their help.

“Women can have careers, and we can wait a bit till we have babies, but we don’t have an economic system that properly supports women looking after a baby. We are told as modern women, we can have it all. But you can’t do it all with a baby. You can’t get your career back on track, you can’t be yourself physically and mentally whilst looking after a tiny infant.

“It’s that performative success that I was definitely even doing at a personal level, not just online, but with my friends, I was ‘I’m fine, I’m fine, look I’m coping, everything is fine. I am being a great mother.’ I was doing all of that in front of the health visitor too and faking things which I never do. I was over-compensating for how not fine I really was. We are given this task to do which I think is completely beyond us to do on our own. They say it takes a village to raise a child and I think it really does. You can’t even do it with just two of you, you need three people to help look after a tiny baby. You need one person on the job, one person resting and recovering and then one person to be prepping everything that is needed next.”

Is your son's traumatic birth tied up with your PND? [Emma’s first baby arrived within three hours after a sweep]

“Yes. I really think so. I had a midwife who gave such a rough examination that was the beginning of the first layer of trauma. Then a midwife didn’t believe the pain I was in after the gas and air ran out, and when the pain relief ran out. I ripped badly and the stitching up was just a horrible experience. That was the trauma cherry on top of the trauma cake really. A midwife was between my legs saying, ‘Oh, I can’t see where to put the stitches because there is so much blood.’ I thought, are you for real? Are you kidding me? This is my body and my identity. “This is a country where we are supposed to have decent medicine and decent services for women but when it comes to maternity care it just falls so short, it really does. Probably because it’s women’s bodies at stake and they ultimately don’t really care. We don’t put enough pressure on. One of the psychiatrists I interviewed for the book said she encourages pregnant women to be difficult on their delivery date. No one wants to be a diva, but at the same time, don’t be fearful. As women, we worry so much about what people think of us, about being pleasant and likeable. That's why I ended up in this horrible situation where I wasn’t being assertive enough and my body got trashed and nobody looked after me. It makes me so angry now, that I wasn’t being difficult and I didn’t say, hang on a minute what do you think you’re doing, can someone more experienced come and do the stitching then please."

Do you view postnatal depression as on a spectrum?

“I honestly do, as I feel I’m not sure where that point is where it tips over into something clinical. There is definitely a spectrum of experience that women have that are just wild. There is no way you can predict how you will feel when your baby arrives. Partly, because it is yours and partly because the hormones are surging round you. Also, because nothing in your previous experience prepares you for the exhaustion. All of your normal reference points and all of your senses to what is normal are turned upside down. Everything falls away and you don’t know what is normal to feel. Everything is so blindsiding for women.

“The best description of postnatal depression, and something you need to pay attention to, is if you are just feeling low all the time or low more than you’re feeling good. If you are more often feeling bad than you are feeling good, then that’s when you need to talk to people about it. Your friends, family, or doctors, you need to be talking about it, because that is what I didn’t do. That’s why it got worse and worse and worse for me for a long time.“I think the main thing that we get wrong is that there is not enough support for new mothers. There’s not enough of a space to feel safe for them to ask for help, or for them to say I can’t do this, I can’t cope. It just feels so risky to say that. That you can’t possibly admit it.”

Your daughter was born by elective C-section last year, were you worried about PND returning?

“I’m still on antidepressants because I didn’t want to rock the boat. I’m staying on them until I am out of the danger zone with the baby - probably wind down when she’s about 9 months old. When I am hoping sleep is much, much better. Lack of sleep was such a huge factor in my PND, so I saved up and for the first couple of months I had a brilliant maternity nurse. Because lo and behold, I got another bad sleeper.

"I’m not seeing a therapist at the moment, but my husband and I did go to couple’s therapy over Zoom when we found out I was pregnant again. We just wanted to go over what happened last time in a neutral space, which was a bit weird on Zoom but it was fine. I wanted to check we would be just as strong a team as we could be going into it again. There is always that fear that PND is going to come back, but I am happy to say that it hasn’t come back this time.

“I feel really fearlessly protective of my mental health now and fearlessly protective of my sleep, and I wasn’t going to allow anything to mess that up. Because if you haven’t got your mental health, everything else falls away beneath that. Our family nearly fell apart the first time round, so I’m doing everything to make that safe this time, everything I possibly can."

Emma need never worry again about whether writing After The Storm was the right thing to do. Every year thousands of women have this 'reasonable reaction' to modern motherhood and millions of complicated and messed-up women will be indebted to her for tackling the biggest taboos around motherhood and mental health. For telling the truth and helping others to take the first step to being seen and rewriting their story.

* After The Storm: Postnatal Depression and the Utter Weirdness of New Motherhood by Emma Jane Unsworth (Profile £12.99) is on sale now

* For advice and support on maternal health, go to PANDAs, the Maternal Mental Health Alliance or Make Birth Better