Postpartum Depression

Postpartum depression is a mental health disorder that can affect mothers within the first twelve weeks of childbirth In India, It has been estimated that nearly 20% of mothers suffer from postpartum depression. 

“The symptoms of postpartum depression are similar to depression in general; such as irritability, mood swings, crying, a feeling of being overwhelmed, lack of sleep, and fatigue. What is interesting about postpartum depression is that there is a lot more focus on the newborn child, and doubts tend to creep in about the mother’s own aptitude for mothering. This may manifest as difficulty in bonding with the baby, or guilt about not handling motherhood well,” says Dr Annie Mathew, Psychiatrist 

What is the difference between Postpartum Blues and Postpartum Depression?

According to Dr Mathew, “When you look at the postpartum period, there’s something called baby blues, which occurs very commonly. This is seen in about 25-30% of all women after delivery, and those have more subtle symptoms such as exhaustion, feeling overwhelmed, sleep deprivation and irritability. However, these usually subside, within a couple of weeks if there is family support. What sets it apart from postpartum depression is the duration and intensity. In  postpartum blues, the mother does not have thoughts of worthlessness, death, or harm to self or baby. These symptoms are, however, characteristic of postpartum depression.”

Can Postpartum Depression be debilitating if left unchecked?

“Almost 50% of cases go undiagnosed, and can hence lead to serious complications. If left unchecked, there can be significant risk of harm to the mother or the baby. Additionally, mothers who are depressed will spend less time bonding with the baby. It is often seen that children of mothers who have suffered from untreated postpartum depression may show emotional and development delays. Further, this illness can also predispose the mother to chronic and recurrent depression in the future,” says Dr Annie Mathew.

Why is Postpartum Depression often overlooked?

Dr Annie believes that, “In the Indian context, after delivery, there’s a period of seclusion for the mother. There is often a lack of perceived social support. As soon as the baby is born, everything becomes about the baby, and no one pays much attention to what the mother is going through emotionally. There is a stigma associated with seeking help, as with depression. While seeking help, there is also the additional complication of being labelled as a bad or selfish mother. Furthermore, in the first six weeks, mothers go to their gynaecologist or to the paediatrician, and there is not much importance given to their emotional health. Doctors check for physical symptoms, breastfeeding,  how the baby is growing, and, so symptoms of postpartum depression are often overlooked.”

What are the most effective treatments for Postpartum Depression?

“The kind of treatment depends on the level of severity. For mild to moderate symptoms, I would first recommend psychotherapy. With therapy, the mothers would meet with their therapist weekly. Furthermore, it doesn’t affect breastfeeding, and it is known to be an effective treatment for people with milder symptoms.

For moderate to severe postpartum depression, I would recommend a combination of medication with therapy. The moment we bring up medication, there are concerns about its effects on both the mother and the baby. There are studies which show that certain medications are relatively safe for new mothers to have. Apart from medication, there are also Non Invasive Neuromodulation Techniques, like Repetitive Transcranial Magnetic Stimulation, which is using magnetic or electric fields resulting in an antidepressant effect. It is important to sit down with the mother, and the family, explain the pros and cons of each treatment, and only then take it forward,” says Dr Annie Mathew.

Advice for women who suspect that they suffer from Postpartum Depression

“Please reach out for help. There are a number of reasons why postpartum depression is undiagnosed. There is a stigma associated with women seeking help, that it makes them bad mothers, however, that is not true. Please seek support because that will help you improve your health, which is also beneficial for the baby. You can go to a therapist or a psychiatrist, but it is crucial to get at least the first evaluation done. The mental health professional will then be able to guide you towards the best course of treatment,” is Dr Annie Mathew’s advice for women who believe that they may have postpartum depression.

If you, or anybody you know has been experiencing symptoms of postpartum depression, please contact a mental health professional.

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