Postpartum depression is quite common in Indian women; but awareness and support for new mothers is still very low.
When actress Brooke Shields went through clinical postpartum depression after having her daughter Rowan, she channeled her experiences into Down Came the Rain, a book every woman suffering from postpartum depression (PPD) needs to read. She discusses the illness in the context of her life, including her struggle to get pregnant, the high expectations she had for herself and that others placed on her as a new mom, and the role of her husband, friends, and family as she struggled to attain her maternal footing in the midst of a disabling depression.
Ultimately, she shares how she found a way out through talk therapy, medication, and time. In India, most women are still not aware of postpartum depression, and even if they are, find it difficult to ask for help.
Says Dr. Rajeev Punjabi, Partner Gynaecologist & Obstetrician, Tulip Women’s Healthcare Centre, Mumbai, “We believe that almost 20 to 30 per cent of women experience some form of PPD or blues post delivery. These are in varying degrees from just feeling blue and a sense of vacuum to outright depression with suicidal tendency or hate towards the child / family. Luckily, the severe forms are rare but in India largely go undiagnosed.”
According to Wikipedia, “Postpartum depression (PPD), also called postnatal depression, is a form of clinical depression which can affect women, and less frequently men, after childbirth. Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual prevalence rate unclear… Postpartum depression occurs in women after they have carried a child, usually in the first few months, and may last up to several months or even a year.”
Dr. Punjabi says, “Symptoms of PPD to watch out for are a lack of interest in celebrations by the family, listlessness, fatigue, exceptional quietness, disinterest in breastfeeding and of course crying and unexplained depressive moods.” Apart from these, anxiety, suicidal thoughts, aggression, insomnia and irritability may also occur.
Symptoms of PPD to watch out for are a lack of interest in celebrations by the family, listlessness, fatigue, exceptional quietness, disinterest in breastfeeding and of course crying and unexplained depressive moods.
The intensity of symptoms varies from one case to another; for some women, PPD might be relatively mild, and go away without medical counseling or intervention. Says Sunayana Roy, 28, Copywriter with an advertising agency, “I had some kind of depression, most likely PPD for a long time afterwards, but I didn’t get it diagnosed and what with all the other stresses, I’m not sure when it ended. It made me very violent… I’m short-tempered but not usually violent.”
Sleep deprivation, hormonal changes in a woman’s body after childbirth, the high expectations from mothers to suddenly assume total charge of another human being – all these can act as triggers for PPD. If left unattended, depression could become a long-term problem.
Blogger Cee Kay, 40, (that is her blog pseudonym), narrates her traumatic experience; “I had it, though I never got it clinically diagnosed. It started right after I had my daughter and it went on for five years. I believe it would have been shorter if I had sought help. But at that time I didn’t know who I could turn to for help. My daughter’s paediatrician had a doubt, but never went beyond one or two questions. My OBGYN could have helped but she never called me for any follow up visits.”
Her issues were compounded by the shabby treatment she received from her in laws, as she was living in a joint family set up then. She says, “I was so deeply unhappy during those five years. My husband and I fought a lot. I cried almost all the time. Surprisingly, I took very good care of my daughter even through this. But I ate uncontrollably, piled on pounds and even had suicidal thoughts.” They eventually moved out into their own home, abroad, which helped in the next pregnancy.
The second time round, Cee Kay kept her past experience with PPD in mind. “I had told my OBGYN at the beginning of my pregnancy that I was afraid I’d get PPD again. He kept a close eye on me and even sent the director of the local women’s support group to ‘assess’ me. I knew I had help available so I felt in control. This time, we decided not to have our parents come over for the delivery and spent the first two months alone with the baby and the big sister. That gave us a chance to get things under control and avoid the situations where I could get depressed again. This time around I am a happier parent.”
Sadly, the key people who can look out for symptoms of PPD amongst new mothers – paediatricians and obstetricians/ gynaecologists – often don’t inform women or their spouses about PPD symptoms. Says Dr Punjabi, “Personally, I am very aware and on the lookout and also prepare my patients for it in advance during my Antenatal Classes… the more well informed, to the less extent women suffer. Also, the husband is brought on board with what to expect. But in general, awareness even amongst gynaecologists in India is not that great and Indian society is not aware enough.”
Some tips to cope with PPD include:
-Getting support in the day to day routine, even if only for a few hours, where the new mother can have some respite from the demanding needs of a newborn and sleep undisturbed, or eat, bathe and relax without being at the beck and call of the baby
-Exercising (when permitted by the doctor) and eating well
-Having someone to talk to about how demanding and overwhelming the experience of giving birth is.
For the entire pregnancy, the focus of attention is on the mother to be, and once the baby is out, the attention shifts to the baby, leaving the new mother feeling ignored and unwanted. Family members should be sensitive to this.
For the entire pregnancy, the focus of attention is on the mother to be, and once the baby is out, the attention shifts to the baby, leaving the new mother feeling ignored and unwanted. Family members should be sensitive to this. Be attentive to the mother as well and offer to help, but in areas where she wants your help. Cee Kay believes that these were among the triggers for her PPD. She says, “…everyone would come to my room to ‘talk’ to the baby but wouldn’t say even a word to me or ask me how I was doing. I felt helpless and isolated. Moreover, my in-laws wanted me to take a step back and allow them to raise my child. I wasn’t ready for that. This resulted in huge fights.”
If talking to your spouse or close friends does not seem to be enough and the PPD feels unbearable, do not hesitate to seek medical help. Cee Kay says, “There is nothing shameful about it. It isn’t your fault. The most important thing to remember is – Get Help. Seek Help. Don’t isolate yourself or ignore the issue. Don’t blame yourself. I was fortunate that I didn’t harm my child due to my depression. I could easily have. That thought still sends a chill down my spine.”
If someone you know seems to be going through a tough time after childbirth, do suggest that they speak to a trusted confidante or a medical professional about PPD. If you are about to become a mother, be aware of the possibility of PPD and seek help – as soon as you need it.
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