The birth of a baby can bring a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect – anxiety, depression, psychosis. The mental health of a mother is a public health priority due to its impact on both maternal and child health. Most women feel vulnerable and anxious during the pregnancy phase which is a common problem. Some may also develop signs of mental health disorder without any reason.
According to WHO’s report, 10% of the pregnant women and 13% of women who have just given birth worldwide experience a mental disorder, primarily depression. The percentage in the developing countries is even higher – 15.6% during pregnancy and 19.8% after childbirth.
In more severe cases, the suffering might even force them to take extreme steps. This may have a negative impact on the growth and development of children. However, maternal mental disorders are treatable and effective interventions can be delivered by well-trained specialist health care providers.
Evidence indicates that treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhea and malnutrition among them.
Dr. Shradha Shejekar Revankar, Psychiatrist and Counsellor Childbirth Education (online), Bangalore, spoke to HealthWire about mental health care in pregnancy and said, In a country like India many women are not given required care during the time of pregnancy and beyond, and the focus is mostly on the newborn. The mother thus has a risk of postpartum mental health disorder which the family fails to understand and ignores it either because of the taboo associated with it or because of lack of knowledge. The patient is often taken to the psychiatrist much later when they have failed to treat the problem with all sorts of home remedies or faith healers, unfortunately having caused emotional and at times physical damage to the patient and family”
“Postpartum blues are commonly seen in the first few days after the mother delivers the child and may last upto 2 weeks. It can worsen due to lack of sleep, anxiety about feeding the baby, surgical wounds, body aches and pains associated with the process of delivering the child, self-doubt and body image worries due to the bodily changes associated with Pregnancy etc. This might even compel the mother to think why she even planned a baby. It can get compounded if there are other issues like domestic violence, extreme stress or lack of family support, substance use, any co-morbid health issues and a history of psychiatric illness in the family,” Dr Revankar added.
What is Postpartum psychosis?
Dr. Revankar said, “Simply speaking Postpartum psychosis includes a loss of touch with the reality and is characterized by delusions, hallucinations, getting paranoid about people, being aggressive and agitated easily, fatigue and sleep disturbances. It needs to be brought to the attention of a Psychiatrist at the earliest.”
“Some mothers might experience a more severe, long-lasting form of low mood known as postpartum depression in which the mother reports feeling low, having crying spells, not being interested in self/baby or surroundings, feeling helpless, hopeless and may have sleep and appetite disturbances” she adds.
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But postpartum depression isn’t a character flaw or a weakness. Many a time, it’s simply a complication of giving birth. If you undergo postpartum depression, quick treatment can help in managing the symptoms and will help you bond with your baby.
Who is at risk?
Nearly all women can develop mental disorders during pregnancy, that may last up to one year after the delivery. Conditions like, poverty, migration, extreme stress, exposure to domestic violence including sexual and gender-based violence, situations of emergency and conflicts, any natural disaster and low social support are the major risks for mental disorders in mothers.
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What are the symptoms of postpartum depression?
Postpartum depression signs and symptoms may include:
- Depressed mood or severe mood swings
- Excessive crying
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Loss of appetite or eating much more than usual
- Inability to sleep (insomnia) or sleeping too much
- Overwhelming fatigue or loss of energy
- Reduced interest and pleasure in activities you used to enjoy
- Intense irritability and anger
- Fear that you’re not a good mother
- Feelings of worthlessness, shame, guilt, or inadequacy
- Diminished ability to think clearly, concentrate or make decisions
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Recurrent thoughts of death or suicide
When to see a doctor?
“It is common to get depressed after the delivery of the baby and most mother may feel embarrassed to admit it”, says Dr. Revankar. But they must be assured that they are not committing a sin by having such involuntary thoughts disturbing them and it is always better to call a Doctor, schedule an appointment whenever you experience any symptom of mental health issues.
You should schedule a doctor’s appointment when you see these signs:
- When you feel depressed for most of the time or throughout the day continuously.
- You Are getting worse
- It is hard for you to care for your baby
- it is hard to complete everyday tasks
- Include thoughts of harming yourself or your baby
- You feel paranoid about people
- You are losing weight, suffering from sleep issues, unable to concentrate on your work.
And if at any point in time, you have suicidal thoughts or you want to harm your baby, it is always advisable to immediately seek help. Talk to your loved ones, your partner or friends, or any of the family members. You can even call the national suicide prevention hotline number to seek help.
What are the treatments available?
Postpartum depression can be a part of bipolar disorder as well. The treatments and recovery time may vary depending on the condition and the individual needs. The most common ways of help are :
Medications: Depending on the severity of the condition, the doctor will choose the medication best suitable for you. Depending on the diagnosis, the duration of treatment can range from few days to months.
Psychotherapy- Psychotherapy in combination with medications is known to help in better response to treatment. Talking to a psychiatrist, psychologist or other mental health professionals about your health problem helps a lot. Therapy may help to find better ways to cope with your feelings, helps to manage your problems, establishes a positive mindset, and helps you set realistic goals.
Family support and care– sometimes the family or relationship therapy helps a lot. Proper care and support from your husband and family help reduce the depression of the mother.
Healthy lifestyle: Maintaining a proper lifestyle including proper food habits, avoiding cigarettes, alcohol and such substances, exercises as simple as brisk walking and yoga, proper 7-9 hours of sleep, indulging in music, painting, DIYs etc. can help mothers tremendously.