Let's talk about post partum depression

Contrary to the picture of a mother looking fondly at the child in her arms, experts stress that many women go through severe anger, insomnia, self-loathing and even suicidal thoughts after giving birth.
Let's talk about postnatal mental health, says Manish Sain/PTI.

First-time mother Annu Mathew went through a gamut of emotions not usually linked with childbirth.

She experienced bouts of anger, irritation, self-doubt and guilt about not being the "perfect" mum to her infant daughter.

Mathew is not the only mother to have felt helpless and depressed for months after a child's birth.

Contrary to the rosy picture of a mother looking fondly at the child in her arms, experts stress that many women actually go through severe anger, insomnia, self-loathing and even suicidal thoughts after giving birth.

"I felt abject helplessness. You are already dealing with a sudden drop in hormones. Top that with little or no sleep, the new responsibility of having to care for a child, post-delivery bleeding, the pain of the stitches... And then there's an immense feeling of guilt because you know that you are not being the perfect mother," Mathew, who works with a media organisation, said.

As India observes National Safe Motherhood Day on April 11, doctors said the issue of postnatal mental health, especially postpartum depression following childbirth, remains largely ignored and under-recognised.

Talking to PTI about postpartum depression, gynaecologist Puneet Bedi said despite the issue being universal and experienced by "100 per cent of the mothers", there is a complete lack of interest towards the mental health of a new mother after she gives birth to a child.

"Doctors in India don't talk about it at all; they don't even know about it. The whole postpartum health issue is neglected in India. Pregnancy management is to forewarn, recognise early symptoms and see if treatment is required," Dr Bedi said.

If the symptoms of postpartum depression are not recognised at an early stage, it could leave "deep scars, and also long-term relationship issues," he added.

Women suffering from postpartum depression usually show the same symptoms associated with other kinds of stress and depression such as a feeling of despair, crying for no apparent reason, being irritable, restless, oversleeping or not sleeping enough, eating too little or too much, and staying aloof from friends and family.

In acute cases it can lead to self harm, or even injuries to the child.

Despite the easily identifiable symptoms, psychiatrist Nimesh Desai said PPD was often not diagnosed.

"We will never know the actual extent of postpartum depression because there have never been any proper studies. The physician, obstetrician, gynaecologist and nurses also miss the symptoms. And since most mothers get better with time perhaps they will never be noticed. The number is far greater than what comes to notice," Dr Desai, director of the Institute of Human Behavior and Allied Sciences, said.

While Mathew was supported by her husband and family, not everybody is as fortunate.

Sunanda Chakravarty, who also suffered from PPD when her daughter was born, said her family did not understand her situation.

"It's very difficult for them (family) to understand what I was going through... I could realise that I was over-reacting and tried to control as much as I could... Maybe if they had supported me that time I would have been stronger and could have come out of it faster," she said.

Even though PPD is mostly caused by a sudden change in hormone levels post-pregnancy, Dr Desai and Dr Bedi said cultural, family, financial and other factors contributed to the condition.

"The cause is basically hormonal. But cultural problems like overfeeding after childbirth and tying down the woman to the house add to the depression," Dr Bedi said.

Another factor that compounds the condition of self-doubt and depression is that a woman is expected to be "elated" about being a mother.

"Not liking your child is a normal thing. It takes some time for the mother to start liking her child. The mother also carries a lot of guilt for that. Every woman is expected to be elated about becoming a mother. But they do feel very sad, especially for someone who has become a mother for the first time," Dr Bedi said.

Support from the family and intervention of counsellors and therapists, if required, can help a new mother get accustomed to the changes and her new role in life, the experts suggested.