An In-depth Understanding of Postpartum Depression

“I was ‘supposed’ to be happy, having given birth, but here I was thinking only negatively. Your body has gone through changes and how! Loose tummy, stretch marks, stitches haven’t healed down there, you smell of milk, your sleep schedule has gone for a toss; all of this affects you”, shares Sunaina, a 30-year old mother.

Sunaina experienced postpartum depression like many other mothers do. Childbirth is a complex and tedious process which leads to numerous physical and emotional changes in a person. There occurs a disruption in one’s daily functioning due to feelings of extreme sadness and anxiety.

Postpartum Depression is a mood disorder that can affect women after childbirth and is the result of a set of many contributing factors and does not have a single cause. Estrogen and Progesterone are hormones present in the mother whose levels undergo a sudden drop post child birth.

Sunaina goes on to say, “I would curse myself for acting out and breaking down and had no explanation for this sort of behavior.”

Drastic changes in mood are a product of such chemical variations. Disturbed sleep patterns are common after childbirth in new mothers, and also cause mood swings due to physical discomfort and exhaustion. Risk factors include depression or anxiety during pregnancy, stressful life events, traumatic childbirth experiences, preterm delivery, lack of social support, previous history of depression, unplanned pregnancy, child with birth defects or other medical problems, family history of psychiatric problems, low socioeconomic status or financial instability, domestic violence etc..

It is important to note that the above stated risk factors do not ensure that a mother is bound to suffer from postpartum depression either. Certain mothers are more vulnerable to PDD while others are not. However, postpartum depression can affect any woman regardless of age, race, ethnicity, or economic status.

Gomathy, another 30 year old mum, from Chennai, says, “I felt extremely lonely and had no one to talk to except my husband post delivery. I hardly got any sleep (less than four hours at a stretch) in the first eighteen months and it was a lot to juggle with all of a sudden, given that my child needed constant attention.”

Symptoms of postpartum depression include feeling down or depressed for most of the day for several weeks or more, feeling distant and withdrawn from family and friends, a loss of interest in activities, changes in eating and sleeping habits, feeling tired most of the day, feeling angry or irritable and having feelings of anxiety, worry, panic attacks or racing thoughts.

“Some of my early signs were irritability. I could not hold it in and screamt “what the hell do you want?!” to my then one month old baby around 4 AM in the wee hours after staying up all night and feeding every 30 minutes.”, shares Gomathy.

Women with postpartum depression are frequently diagnosed with comorbid disorders. Almost two-thirds of women have comorbid anxiety disorders, 68.5% have comorbid unipolar depressive disorders, and 22.6% have bipolar disorders.

Postpartum Psychosis is a rare condition which may develop within the first week after delivery and must be followed up with immediate treatment as it can prove to be dangerous to the mother as well as the child. Symptoms include confusion and disorientation, obsessive thoughts, hallucinations and delusions, sleep disturbances, paranoia, attempts to harm oneself or the baby among others.

Postpartum Anxiety is the persistence of intense panic that interferes with routine and activities. 8.5 percent of postpartum moms have clinical anxiety. Fears usually revolve around constantly worrying about Sudden Infant Death Syndrome (SIDS), receiving criticism about one’s parenting, body image issues post childbirth and fear of losing or having their baby taken away from them.

Mom Guilt?

“Now when I look back, I know that I was not emotionally connected to my baby. I did not cherish those first few months and dreaded each day. It is something I cannot wipe off from my memories and I still feel bad for not being there when my kid only cried for me to hold her. If I do this all over again I will slack, I will not insist on cooking and cleaning everyday and would rather spend more time with the baby and Netflix a lot”, Gomathy elaborates on this intense consequence of postpartum depression.

Media’s portrayal of motherhood is quite exaggerated and distorted. Women gather from such depictions that they must be just as cheerful and grateful for bringing life into this world. When there is a discrepancy between their real life experience and what they had imagined motherhood to be all along, there is a lasting impact on their mental and emotional well-being.

Women begin to feel regret over not being the ‘perfect’ mother. This is because there exists a notion of appropriate and clearly defined ways of celebrating the birth of her child. If she does not meet these expectations, the situation ultimately implies that she is less of a mother than she should be. Postpartum depression should be not be spoken about in a hushed manner. If years ago, there was even the little awareness there is now, maybe mothers like Gomathy and Sunaina would have had a joyous and less stressful transition from pregnancy to motherhood. Fortunately, there are multiple effective treatment alternatives available for Postpartum Depression. Some of them include:

Psychotherapy:

Cognitive Behavioral Therapy (CBT) is frequently used as a form of treatment for PPD as its goal is to change patterns of thinking or behavior that are behind people’s difficulties, subsequently changing the way they feel. Interpersonal Therapy (IPT) helps people develop more effective skills and work through problematic personal relationships.

Medication:

Antidepressants help greatly with postpartum depression but any medication consumed will ultimately affect breastfeeding though the intensity may vary. Hence, it is imperative to consult a good health care professional before taking them.

Self-care and Support:

Apart from the above, self-care is extremely important. This includes eating and sleeping well, having the mother’s basic needs met, asking for help from friends and family or seeking an expert opinion, joining a support group or mother’s group which can be cathartic, exercising regularly or taking walks to cope with stressors and getting enough rest throughout the day to beat the exhaustion coming with caring for a newborn.

Most of the times, with the above treatments (taken either together or alone), postpartum depression is treated within a span of six months but at times it can turn into chronic depression that can severely affect the lives of the mother as well as the baby. Hence, postpartum depression should be given immediate attention if a mother thinks she is at risk. Partners and family members should especially step in and take over.

As Sunaina rightly explains, “People often forget to look after the mother and only focus on the baby. Making the mother comfortable and happy should be of utmost priority too.”

Shruti Venkatesh is the Program Director, Queer Resource Centre at One Future Collective.

Featured image source: PNGIO