Yes, even a Princess can suffer from postpartum depression. Princess Diana openly admitted she suffered silently with postpartum depression after the birth of her first son, William in the book Diana: Her True Story (Morton, 1992). Diana was a public figure and global icon who inspired the world with her acts of charity and dedication to raising her boys. However internally, Diana was struggling during her pregnancy, stating "Some days I felt terrible. No one told me I would feel like I did" (Morton, 1995, p. 209). Diana's reported healthy lifestyle of regular exercise, no alcohol, and early nights did help, however it simply wasn't enough. Diana's lack of support from her spouse Charles as well as others within the royal system placed the People's Princess at high risk for a perinatal mood and anxiety disorder. As Diana later recalled "The public side of her was very different from the private side. They wanted a fairy princess to come and touch them and turn everything into gold. All their worries would be forgotten. Little did they realize that the individual was crucifying herself inside" (Morton, 1995, p. 211). Diana did however reach out to one female friend during this difficult time - Sarah Ferguson. Diana would reportedly call Sarah when she needed some cheering up or would arrange for Sarah to visit her at Buckingham Palace (Morton, 1995, p. 210).
RISK FACTORS
Princess Diana's lack of support from her partner, her history of bulimia, her significant life transition of becoming a member of the Royal Family and moving to multiple residences within a year of giving birth, and her unresolved trauma related to her parent's divorce when she was a young child placed her at increased risk for a perinatal mood and anxiety disorder. "The tours, new homes, new baby and Diana's illnesses took a heavy toll" (Morton, 1995, p. 226). Diana admitted, "One minute I was nobody, the next minute I was Princess of Wales, mother, media toy, member of this family, you name it, and it was too much for one person at that time" (Morton, 1995, p. 72). Over a period of time Diana was seen by a number of psychotherapists and psychologists who adopted differing approaches to her varied problems. It is apparent to me of how exhausting and overwhelming it must have been for Diana to re-tell her story to the multiple therapists that were involved in her care. This one factor alone can steer women away from reaching out for help due to the possibility of being re-triggered each time they tell their story. I only wish there were certified perinatal mental health professionals back in the 1980's when women like Diana could have received proper help in a timely manner, without any stigma of being seen as 'weak' or a 'problem'. And with Diana's influence worldwide, perhaps she would have raised awareness on maternal mental health if given the chance!
FEELING ISOLATED AND ALONE
Like many new mothers who have not been properly screened for a perinatal mood and anxiety disorder, Diana's isolation and loneliness as a new mother continued through to the birth of her second son. "Then between William and Harry being born it is total darkness. I can't remember much. I've blotted it out, it was such pain" (Morton, 1995, p. 80). When the scan showed she was expecting a boy, Diana decided to keep the gender a secret until Harry was born since Charles always wanted a girl. "Oh God, it's a boy" said Charles, 'and he's even got red hair'. With these dismissive remarks he left for Kensington Palace. The following day he played polo. From that moment, as Diana told friends: 'Something inside me died'. (Morton, 1995, p. 227). My heart broke when I read this. The inner strength Diana must have pulled upon to carry on with a brave face for the remainder of her pregnancy, all the while being burdened with the secret that the gender of her child wasn't what her spouse wanted is mind-boggling to me. Not to mention the realization that soon enough she would have to face the disturbing reality that her spouse would not only reject, but openly criticize during one of the most precious moments in a parent's life - to finally meet their baby is quite frankly, appalling. This one part of Diana's story sheds light on so many women who struggle during pregnancy, not just with themselves but with their relationships with those closest to them.
A CRY FOR HELP
Women experiencing postpartum depression may have feelings of hopelessness, suicidal ideation, and may even go to extreme measures to be heard. In Diana's case, when she was pregnant with William, she desperately threw herself down a set of stairs in an attempt to get her husband's attention. "Charles said I was crying wolf and I said I felt so desperate and I was crying my eyes out and he said: 'I'm not going to listen. You're always doing this to me. I'm going riding now'. So I threw myself down the stairs. I knew I wasn't going to lose the baby; quite bruised around the stomach. Charles went out riding and when he came back, you know, it was just dismissal, total dismissal. He just carried on out of the door" (Morton, 1992, p. 71). Furthermore, when planning William's induction date, they had to find a date that accommodated Prince Charles' polo schedule. When William was born, Diana stated "Came home and then postnatal depression hit me hard and it wasn't so much the baby that had produced it, it was the baby that triggered off all else that was going on in my mind. Boy, I was troubled. If he didn't come home when he said he was coming home I thought something dreadful had happened to him. Tears, panic, all the rest of it. He didn't see the panic because I would sit there quietly" (Morton, 1995, p. 72). Postpartum anxiety is frequently associated with postpartum depression, and in Diana's case, it was yet another condition that unfortunately was left untreated.
FEELING DISMISSED
Princess Diana described the day her son William was baptized and how her being excluded from any decision-making further exacerbated her symptoms. "At William's Christening I was treated like nobody else's business. Nobody asked me when it was suitable for William - 11 o'clock couldn't have been worse. Endless pictures of the Queen, Queen Mother, Charles and William. I was excluded totally that day. I felt desperate, because I had literally just given birth - William was only six weeks old. And it was all decided around me. Everything was out of control, everything. I wasn't very well and I just bubbled my eyes out" (Morton, 1995, p. 72). Diana's story is one of many new mothers who face difficulty with their role transition into motherhood. Diana did not speak up and advocate for herself and her child during a pivotal moment in his life that was meant to be a great celebration. In Diana's case, one can only guess what her state of mind was 6 weeks postpartum - factors such as sleep deprivation, feeding challenges, and a traumatic birth may lead to more than just the baby blues, brain fog, and feeling like you're losing control. Not to mention if your mother-in-law is the Queen of England, you may hesitate to speak up! But using your voice and being unapologetic while doing so is sometimes necessary if it ensures your child's needs will bet met. It can also increase your self-confidence and mom-esteem knowing that you are in fact capable of being assertive and standing up for yourself. My guess is 11 o'clock was William's nap or feeding time, and any mother out there knows first-hand how important it is to stick to the same routine as much as possible. This is a perfect example of a time when it would definitely be appropriate to use your voice and advocate on you and your child's behalf.
Diana's story of her lived experience both as a woman, wife, and mother is achingly human to the core. It is a stark reminder that perinatal mood and anxiety disorders has no boundaries, and affects women of all different socioeconomic backgrounds - even a Princess. You are not alone, and you are not to blame. The transition into motherhood can be complex and challenging, which is why it is important to raise awareness on maternal mental health so that we can continue to support each other through it, no matter how dark it may seem.
If you or someone you know may be at risk for a perinatal mood and anxiety disorder, speak to your primary healthcare provider or a certified perinatal mental health professional at Postpartum Parent Network for further screening and proper assessment. An online directory of worldwide certified perinatal mental health professionals can be found here: https://psidirectory.com/
Because the sooner you get help, the better.
Reference:
Morton, A. (1995). Diana: Her true story. Thorndike Press.