I was scrolling down my facebook newsfeed the other day when I saw a friend shared a news of a woman trying to kill her newborn baby. The thing more horrible than the news itself were the comments by people who were abusing the woman and wishing cruel treatment and even death upon her. Without even read half of the comments, it was made clear to me that there is no awareness about postpartum depression in Pakistan. Therefore, I am writing this blog in hope to create some awareness around this topic.
What is Postpartum Depression?
The news of pregnancy and the idea of having a baby triggers a lot of emotions from excitement and happiness to fear and anxiety in a woman. Majority of new mothers experience a feeling of moodiness called “baby blues” after childbirth. Baby blues include mood changes, feeling anxious and overwhelmed. Mothers experiencing baby blues also experience crying spells and they face trouble sleeping. Baby blues begin within the first few days after delivery, and occur for a few minutes up to a few hours each day. This feeling can last for up to a couple of weeks. Baby blues is normal but in some cases, new mothers experience a more severe and long-lasting form of depression called postpartum depression. And in some rare cases, the most extreme mood disorder may also develop which is called postpartum psychosis. Like any other mental health disorder, postpartum depression is a serious mental health condition and it should be viewed as such. Postpartum depression affects around 10 to 20 percent of new mothers. It is a mental health condition that makes the mother depressed to the point that she becomes unable to bond with and care for her own baby.
Postpartum Depression in Pakistani Women:
According to studies, postpartum depression is more common in underdeveloped countries which can be linked to limited resources and lack of awareness. A study revealed that the prevalence rate of postpartum depression ranges from 28% to 63% among Pakistani women which is highest in Asia. It is believed that culture, environment and society plays a vital role in contributing to the development of postpartum depression in Pakistani women. Our cultural and traditional postpartum rituals and practices like Chilla (a time period of 40 days after child-birth where women are relieved of their household chores) are supposed to help the new mothers but there’s mixed evidence of it having an adverse effect.
Causes of Postpartum Depression:
There is no single cause of postpartum depression. Change in hormones during pregnancy and after childbirth, social, physical, emotional and other factors also play a role. Women’s bodies go through major hormonal changes during pregnancy and childbirth. Just after giving birth, women experience a dramatic drop in estrogen and progesterone in their body which may contribute to postpartum depression. Women may also experience postpartum thyroiditis which ultimately results in hypothyroidism – a drop in their thyroid gland secretions – which leaves them feeling tired, sluggish and depressed.
Some other factors like unplanned or unwanted pregnancy, miscarriage or stillbirth, sleep deprivation, history of clinical depression, bipolar disorder, weak support system, a child with special needs or colicky baby, financial pressure, and physical and emotional issues like illness or losing a job can also cause postpartum depression.
Symptoms of postpartum depression:
Postpartum depression can be confused with baby blues because of the similar signs and symptoms. Here’s the difference: Baby blues last only for a few days and they include mood swings, anxiety, feeling overwhelmed, crying spells, and trouble sleeping. Whereas, the symptoms of postpartum depression, though similar, are extreme and they last longer. These symptoms include severe mood swings, social withdrawal, anger, change in sleep and appetite, indecisiveness, fatigue, restlessness, crying spells, problem bonding with your baby, feeling worthless, hopeless, guilty, and shame, having suicidal thoughts, and having thoughts of inflicting harm on your baby.
In extreme and cases and if left untreated, postpartum depression may even progress or lead to postpartum psychosis which will cause paranoia, hallucinations and delusions as well. Postpartum psychosis leads to life-threatening thoughts and behaviors and the mother might need to be hospitalized. Postpartum depression should be treated as soon as one suspects that they might be suffering from it. Even if it doesn’t progress to postpartum psychosis, leaving it untreated can interfere with mother-child bonding and can have serious consequences for both the mother and the child.
There’s no medical test to accurately diagnose postpartum depression. Therefore, it is important that women with a history of depression should discuss this with their doctor if they are planning a baby or as soon as they find out they are pregnant. This will help their doctor monitor them closely for signs and symptoms of depression. Mild depression can usually be managed with counseling and psychotherapies and if the symptoms are severe, the doctor may also prescribe antidepressants.
Creating and spreading awareness about postpartum depression as a psychological disorder is important because in our society, it is viewed as a character flaw and consequently, instead of getting the help that they need, the victims are blamed and shamed. Treatment options for postpartum depression include psychotherapy, anti-depressants, and support groups.
Note: The stats and facts from studies mentioned in the blog were taken from NCBI, Mayo Clinic, and SAMHSA.