“Doctor, I dont understand. I was trying for this baby for 2 years. I have everything now, a good family, a healthy baby, everything! It was supposed to be the happiest time of my life. After nine months of anticipation, I finally held my precious baby in my arms. But instead of pure joy, I was consumed by an overwhelming darkness.
The simplest tasks felt like insurmountable challenges. My once-vibrant personality was now replaced by a hollow shell. I plastered a smile on my face for others, but inside, I was crumbling. I couldn't comprehend why I wasn't feeling the overwhelming love and joy that I thought I was supposed to feel as a new mother. I didnt enjoy taking care of the child, nor did I enjoy the celebrations, the “Namakaran Vidhi” or visits by those near and dear to me! There were times, when I couldnt even look at my child, and.. sometimes when I did, I didnt want to hold him, love him, feed him! I felt like the worst.”
She was recanting the experience she had a week after the birth of her first child. At first, she dismissed her symptoms as mere exhaustion from sleepless nights and hormonal fluctuations. Not to mention, it was normalised and trivialised by those around her initially as “part of the game”.
But soon, the weight of it all became too much to bear. She was drowning in a sea of emotions that she couldn't understand or control. She struggled to connect with the baby, and was plagued by constant feelings of guilt and inadequacy. After a while, her symptoms were seen as “fad” or “laziness” by those around her, which lead to unwarranted advise, lecture and sermons on the duties of a mother. Luckily, this was noted by their watchful obstetrician during a follow up visit, who readily referred them to us.
This story is not the first, and definitely not the last. This was postpartum depression (PPD). Often, it is wrongly called postpartum blues, which is a very milder and self-remitting form of PPD.
Readers may wonder, whether this is for real? Why would any woman be sad after being a mother? Is it that common? Well the answer may surprise you, as the pooled estimated prevalence of PPD in India is 22%, which means, 1 in every 5 women will experience PPD at one point in their lifetime. Some women experience it during the first childbirth, some during subsequent pregnancies.
Who can get PPD?
Technically, there are no defining risk factors for PPD, however, the following risk factors have been identified in research in Indian context:
Financial difficulties
Domestic violence
Psychiatric illness in mother
Marital conflict
Lack of support
Female child
Is PPD treatable?
PPD is treatable. The most important step of the treatment is, detection and acceptance. As shared by the client, symptoms of PPD most often either are undetected, or on detection, ignored. PPD is treated in early stages with psychotherapy, counselling, CBT and in severe cases medications. Family members and obstetricians should involve mental health professionals, such as psychiatrists, psychologists, counsellors for diagnostic workup and treatment planning.
What other care is needed in PPD?
One of the distressing symptom of PPD is loss of interest, or affection towards the child and childcare. It often leads to avoidance, and sometimes neglect. Therefore, first and foremost, the child either needs to be kept under strict supervision of a truster caretaker till the mother starts recovering from postpartum depression.
Can the child be breast-fed while on treatment?
Yes. Studies show that, antidepressants are not secreted in any significant quantum in breast milk and are considerably safe. There is no need to stop or suppress breastfeeding, however during early stages of postpartum depression, breastfeeding needs to be supervised as well.
What to look for? Warning signs?
Family members and obstetricians particularly should be wary of following changes in behaviour:
1) Persistently sad mood and loss of interest in childcare.
2) Lack of attachment to the child.
3) Neglect in childcare.
4) Irritability, poor sleep and apetite (not linked to night awakenings for childcare).
5) Talk of self harm, suicide and extremely negative thoughts and ideas.
Postpartum depression is completely treatable. The key to preventing it and successfully treating it is early detection, which is the biggest challenge. Mothers may not attribute their symptoms to depression, and even when they do, may not chose seeking help. Encouraging women, family members and obstetricians to look out for postpartum depression is the way ahead in preventing women from suffering.
For more details or help contact:
Manthan Neuropsychiatry Clinic
UG-6, Krystal Plaza, Besides Gold Gym, Circuit House Road Opp. Yellow Chilli Restaurant, Tarabai Park, Kolhapur. Maharashtra. 416003. India.
Contact: +91-9930790433. email: drsnehagore@gmail.com
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