It’s never an easy thing to say out loud, so good on Keira Knightley for speaking out this week about her experience of postnatal depression (PND) after the birth of her first child, Edie (now ten).

Being interviewed by Giovanna Fletcher on her podcast Happy Mum Happy Baby, the actress and mother of two described the “hormone crash’’ she experienced soon after the birth, which she believes led to postnatal depression.

Knightley’s daughter was born rapidly — just 45 minutes after she was induced — causing her to tear, which she couldn’t entirely feel. “It’s a really weird one that, when you’ve taken the drugs,” she told Fletcher. “I mean, thank you for the drugs, but I think the recovery, because you haven’t felt [the birth], is incredibly confusing. So the battered nature of my body afterwards … It didn’t make sense. There was a crash down, and then I think it was postnatal depression.”

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The too-fast delivery, the ensuing chaos, the bodily injury leading to a psychological detachment — Knightley’s account was all too relatable. I suffered postnatal depression in 2016 after the birth of my first child.

My son came out in under an hour and I tore badly. The epidural didn’t work, so unlike Knightley I felt everything. Then I was badly stitched up by an inexperienced midwife, and had to go back later to have the stitching corrected and a huge knot cut off. I joked at the time that if men birthed babies through their penises, there would be a Nobel prize for penis repair; a vagina seemed less important. I was cracking jokes, but I wasn’t fine.

The visceral memories of the months that followed haunt me still. I didn’t know what was wrong with me, and I felt upside down, completely bombarded and broken. I felt detached from my baby. Breastfeeding was agony; my nipples bled and scabbed, and I started to hate my son’s crying mouth —the wide, gaping need of him.

I felt resentful about sharing my body, when all it was bringing me was pain. While he was feeding I often let out a silent, agonised scream at the ceiling. I felt bitterly, horribly alone and abused. All of it felt so wrong.

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The trouble was — it didn’t seem like depression. I wasn’t sitting around crying all the time. My PND manifested as rage: I was so angry I couldn’t see straight. I had a blind, mad fury that made me hate my husband and avoid my friends, not to mention going nuclear at random people who I perceived to be offending me or getting in my way. I see now that I was behaving like a cornered animal, lashing out in self-defence because I was so frightened underneath.

One day I was supposed to have afternoon tea with friends at a posh hotel. I arrived in the foyer and saw them waiting for me in that serene room, cups and saucers laid out, fancy waiters circling; I turned and left.

I had no idea how to get a buggy through the gaps between the chairs, and I couldn’t bring myself to rupture the scene with my barely held-together presentation of a woman in control. I texted my friends that I had forgotten a doctor’s appointment, and instead I went home and breastfed, crying.

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Knightley described her sleep deprivation, which she believes contributed to her poor mental state. It’s no surprise. Sleep is key to healing, and month after month of being denied such a basic need — there’s a reason it’s used as torture.

Knightley described feeling as though she “could hear the trees’’, like she was living in a “whirlwind, a wind tunnel of experience and emotion”. I felt wired as well as angry, and hypersensitive to the simplest of things, as though all my nerve endings had been snipped off.

I used to walk down to the sea near my home in Brighton and stare at the waves crashing. I thought I could just let myself fall in, and that might help. I wasn’t consciously thinking of suicide, but wasn’t death just like a really long sleep? If I were dead, at least I could rest.

But even though I was on fire inside, from the outside it was pretty much business as usual. The baby was fed and clean. We were both dressed. I was working, doing freelance writing jobs. I was careful to display functionality and success to my friends and wider family.

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I was so scared to look like I was failing at motherhood, so really no one apart from my husband (and the odd stranger who got it in the neck) would have known there was anything wrong. It was my husband’s first experience of parenthood too — he didn’t know what the new version of our normal should be.

It took me months to work out that I was ill. It was over a full breakdown in the Brighton Marina branch of Five Guys, where I sobbed into a bottle of beer, that my husband and I finally, finally realised it might be time to seek some sort of help.

If only we knew more about the hormones involved in childbirth, and how and when they might take effect, we could have been better prepared. I wrote a book about my experience, years later, for which I interviewed neuroscientists and psychologists, trying to get some insight into exactly what goes on in women’s brains during pregnancy and new motherhood.

It is an area that is very underresearched, but there are surges of certain hormones that occur at various points in each trimester (for example, a cortisol surge around week 26 of pregnancy, to enable foetal lung development), resulting in very real feelings for women. Imagine if we were better informed and knew what to expect.

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As soon as I sought help, things started to get better. I started on antidepressants and, like Knightley, I had therapy. My therapist said something transformative to me — something I tell all mums I encounter who feel like they are freaks or monsters for not breezing through.

She said: “What we call ‘postnatal depression’ is actually a very reasonable response to the pressures of motherhood in the western world.” We are told we can work, and mother, while bossing our social lives, exercising regularly, baking, reading books, performing wellbeing rituals and all the rest. In reality we’re lucky if we manage to keep a few of these things afloat while going through the chaos of that period of intensive change and recalibration.

PND can happen to anyone — not even a famous actress is immune. The official statistics say that it affects 1 in 10 new mothers, but I think that is conservative. Too often we maintain the “I’m fine” dance while we suffer.

There is a loss in any big life change, even the ones we choose — even the ones we are grateful for — and having a baby can sometimes be joyous, seismic, life-affirming and catastrophic all at once. I’m grateful to Knightley, and to every woman who acknowledges the many multitudes that new motherhood can bring.
After the Storm: Postnatal Depression and the Utter Weirdness of New Motherhood by Emma Jane Unsworth is published by Profile Books