While many regard the birth of a baby as one of the happiest occasions in a couple’s life, the sad reality is that it can be a very dark time for many women who experience postpartum depression (also referred to as peripartum depression or major depressive disorder with peripartum onset). It’s believed that postpartum depression affects one in seven women, yet few speak about due to fear of being judged and misunderstood.
The official term, ‘peripartum depression’ recognizes that signs of depression are often present even before delivery. Women experience hormonal, physical and emotional changes during and shortly after pregnancy. While most women experience the ‘baby blues’ after childbirth (changes in mood due to hormonal changes, inadequate sleep and adjusting to a new baby), this passes in a week or two after delivery. The effects of postpartum depression are more significant and persistent.
Symptoms of peripartum depression:
- depressed mood
- sleep disturbances (insomnia or hypersomnia)
- anhedonia (loss of pleasure in activities previously enjoyed)
- feelings of guilt
- fatigue or loss of energy
- appetite changes (no appetite or comfort eating)
- thoughts of death or suicide (in severe cases)
Postpartum depression is very difficult for women to talk about, for the fear of being judged. Society often tells us what a blessing it is to have a baby and that one should be grateful. While such comments might be true, they often prevent new mums from sharing their struggles for the fear of invalidation. This leads to many new mums suffering in silence. There is sadly still a stigma associated with postpartum depression, leaving many new mums lonely and unsupported.
Some of the risk factors for postpartum depression include a history of depression or anxiety, premenstrual syndrome, high risk or complicated pregnancies, traumatic birthing experience, marital conflict and a lack of psychosocial support.
If you suspect that you may have postpartum depression or are struggling to adjust to the birth of your newborn, speak to your gynaecologist or GP. They will refer you to a psychologist, psychiatrist, or both. If these symptoms occur during pregnancy, see a psychologist immediately so the symptoms may be treated to prevent further stress during the pregnancy.
Treatment options are psychotherapy, specifically cognitive behavioural therapy and supportive psychotherapy, couples therapy (as a supportive partner can greatly help improve symptoms through the support they provide) and in some cases, medication. Many new mums may be resistant to the idea of medication during pregnancy or breastfeeding. In severe cases, where symptoms are impacting on the mum’s daily functioning, a psychiatrist can prescribe medication that is considered to be safe in pregnancy. Mums who are breastfeeding may discuss the pros and cons as well as safe treatment options with a psychiatrist.
Supporting a Loved One
If you’re a partner or family member of someone who is pregnant or has just delivered, educate yourself on the signs and symptoms of postpartum depression, so you can facilitate professional help-seeking. Provide emotional support through regular check-ins about how they are feeling, what they are struggling with the most and how you can support them better. Encourage rest and try to alleviate the new mum of some responsibilities so she has time for little self care activities. Assist with finding a suitable professional and help facilitate an appointment, if necessary. Help by normalizing their experience and assuring them of your support.
The key to effective recovery is seeking help as soon as symptoms are recognized. Effective treatment not only manages the depressive symptoms, but plays a significant role in the mother-infant bond and the development of the baby.
by Rakhi Beekrum, counselling psychologist.