Why am I struggling with these troubling urges to run away and abandon my healthy two-months old baby, my husband, and our two-year old daughter? They mean the world to me, but sometimes I just feel so weighed down and unable to cope with even minor tasks. Is this just baby blues?
No, this is more than baby blues. The mood swings and crying bouts of “baby blues” that many mothers experience (due to hormonal changes within the body) usually starts and resolves within a week or two after giving birth without any need for medical treatment. Similar emotional problems in a mother several weeks after childbirth suggests that a more serious problem (likely postpartum depression) is going on, and medical help should be sought promptly.
Depression after childbirth (also known as postpartum depression) typically starts within 4 weeks to one year after giving birth. It manifests in many ways including unexplainable sadness and mood swings, change in appetite, crying spells, sleep problems, irrational urges, alternating feelings of overwhelm and self-doubt. In severe cases, some mothers may struggle with alarming thoughts of intentional harm to self and/or to others, including their babies. Postpartum depression can have a devastating effect on maternal confidence, family stability, and well-being of the baby if the problem is neglected as the illness can drag on for years.
Depression after childbirth is a form of major depression, and the suffering is worse when affected mothers feel pressured to struggle in silence because they perceive that their illness is considered shameful by people who matter to them. Naturally, no woman wants to be socially discredited as mentally unstable or uncaring towards her baby. So, the illness is usually not discussed openly, leading to wrong and stigmatizing perceptions that depression after childbirth is an uncommon, mysterious affliction caused by something inappropriate that the mother did, or something beneficial that she neglected to do.
Actually, depression after childbirth is not rare, and may be expected to occur in about one in every seven women who put to bed (including “veteran” moms with normal delivery of a healthy baby and no history of emotional disorder). Even though the full picture of why postpartum depression happens in some moms and not in others is not yet apparent, it is clear that this condition is not due to any maternal fault.
Women who are helped to embrace medical facts about depression after childbirth tend to be less distressed and less secretive when they encounter the manifestations in themselves or in other mothers. Openness to talk things over freely with supportive and well-informed persons is crucial, and is sometimes the hardest step for mothers to take towards accessing medical care. Social media apps which help mothers to discuss their health challenges anonymously in online support groups and mom chat rooms such as Babymigo.com are creating safe spaces for mothers to break the silence and help one another around this health condition.
Even though talk therapy is a key component of treatment for depression after childbirth, mothers with severe illness will need more than counselling, and may need to be prescribed medication(s), especially if they have risk factors such as:
- depression following previous childbirth
- depression prior to becoming pregnant
- depression in a blood relative
- ongoing stressful marital relationship
- living alone
- recent exposure to an adverse life event.
It is advisable for women to gather personal information ahead of time about these risk factors, and discuss them as early as possible with their healthcare providers during pregnancy. Such awareness helps all involved to plan ahead appropriately. It is also helpful to avoid making stressful life changes around the period of childbirth.
The medical check-up that all mothers undergo about six weeks after delivery (also called postnatal clinic visit) is an ideal opportunity for mothers to express to healthcare providers any health issues that they may be struggling with. This discussion should always include mental health. If suspicions of depression arise in later months after childbirth, mothers can still get an easy linkage to medical attention by confiding in an attending nurse during any of the clinic visits for infant vaccination. Mothers can also seek help in between these scheduled appointments if necessary.
Encouraging embattled moms to speak up and break the code of silent suffering is a public health responsibility. Fathers should also be educated about the symptoms of postpartum depression (as they may be the first to notice them), and they should be empowered to initiate the discussion that may pave the way for appropriate treatment and support.
The good news is that postpartum depression is treatable (with psychotherapy and/or antidepressant medications) without any need for hospitalisation or interruption of breastfeeding. When treatment is augmented by lifestyle improvements (regular sleep, nourishing meals, and enjoyable exercise) most mothers can hope to recover fully within several months.
Contributed by a CH writer.