World Mental Health Day 2019: Why we need to talk about postnatal depressionhttps://indianexpress.com/article/lifestyle/health/world-mental-health-2019-giving-a-voice-to-postnatal-mental-health-6062003/

World Mental Health Day 2019: Why we need to talk about postnatal depression

In the Indian community, while it's said that “a baby is not born to a couple but to the neighbourhood and the extended family”, we still see an increasing number of women in India succumbing to postpartum depression.

World Mental health 2019, postnatal mental health, mental health, pregnancy depression
On World Mental Health Day this year, WHO has emphasised on the theme ‘Suicide is preventable’. (Source: Getty/Thinkstock Images)

Bollywood actor Neha Dhupia, in an interview with indianexpress.com, had shared how postpartum depression is a real thing, and how the guilt of a mother follows her as she leaves behind her six-year-old to go to work. “The guilt is the hardest part of being a new mom. It’s always the guilt that kills you. When I am standing at the door and my little one waves me bye-bye, it breaks my heart. Be vocal and talk to everyone about what you are feeling. I have always said it out aloud that postpartum depression is a real thing,” she said.

Postpartum blues, postnatal depression or postpartum psychosis can be worrisome as the mother can potentially harm herself or the baby. Although support from the spouse and family is important, they cannot take the place of counsellors. Professional emotional and mental health support is prescribed, especially as a woman may feel an incomprehensible feeling of disconnect from her newborn child, which could breed feelings of guilt and self-blame.

Post-partum blues can extend up till two weeks, after which it usually subsides on its own. Depressive symptoms like increase in irritability, frequent crying spells, restlessness, difficulty in sleeping, feeling of exhaustion, etc are common signs.

“The social stigma attached to mental health conditions makes it unlikely for a new mother to seek support, as they can be labelled lazy and ill-equipped to manage maternal responsibility. Also, women in Indian cities, who deliver at a health facility, often stay for less than 48 hours after delivery at the hospital/nursing home. There is no time opportunity for the health provider to determine or counsel the new parents and family members on the signs and symptoms of postpartum depression and when to seek care,” remarks gynaecologist Nupur Gupta, Department of Obstetrics and Gynaecology, Fortis Memorial Research Institute.

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India may be a country with a strong family system, yet the number of women undergoing various degrees of postpartum depression has seen an upward trend in the last five years, according to Bulletin of the World Health Organization (WHO) 2017.

The narrative around postnatal depression

Postpartum blues, postnatal depression or postpartum psychosis can be worrisome as the mother can harm self or baby.

Much like Dhupia, TV host and actor Mandira Bedi also went on record about undergoing postpartum depression for a month after she gave birth to son Vir. “I didn’t know what had hit me although my mother was with me, helping me out. My husband has been most wonderful during this tough phase when I was waking and sleeping at the baby’s whim. One day I just burst into tears and told my husband that I couldn’t cope with all this. Oh, that was a tough phase indeed! But then, I had been reading a lot about it, and I knew that it was perfectly normal and a lot of women faced it before me,” she said to Times of India.

It is estimated that approximately one in five Indian mothers are likely to experience symptoms of post-partum depression as opposed to three to six per cent globally, informs Dr Kedar Tilwe, Psychiatrist and Sexologist, SL Raheja Hospital, Mahim.

While the birth of a child is universally a happy occasion, there is often a complete lack of awareness about the mental health concerns during pregnancy and motherhood. In addition to the numerous extra responsibilities that come with being a parent, while dealing with physiological changes, often the new mother is also required to resume work responsibilities.

Srishti Saha, Consultant Clinical Psychologist, Fortis Hospital Anandapur, believes certain factors, such as prolonged and untreated stress, conflicts, and low social support may enhance the risk. “Post-natal mental illnesses are becoming more and more common. In the clinic, we see around 10 such cases in a month, and unfortunately, most come to us, when the symptoms have already become severe enough to be called a disorder,” she said to indianexpress.com.

“We usually start by recommending counselling, yoga, exercise, meditation, home remedies and lifestyle modification. About one per cent of patients need pharmacological treatment. The reason for rising post-natal depression in India could be the trend of nuclear families and lack of support, gender inequality in the family, lack of financial stability and understanding from the partner, besides other health issues,” stated Dr Ranjeeta Gupta, Obs & Gynae, Fertility Specialist, Reproductive Medicine and IVF at Medicheck Group of Hospitals.

A role of the partner is considered equally important.

Postnatal depression and partner’s contribution

Post-natal depression is a clearly recognised medical condition, for which professional help is critical. It cannot be explained away as “laziness” or “being a bad mother”. It requires adequate and timely intervention, including psychiatric medication and counselling.

The role of the partner is considered equally important. “Taking over some tasks of child-rearing can considerably decrease the burden on the wife and enable her to get some much-needed rest. A gentle word of encouragement and appreciation will also increase her self-confidence and self-esteem greatly, as well as enrich the relationship. The husband is also one of the persons most likely to identify the earliest signs of post-partum depression and should make themselves aware of the symptoms,” suggests Tilwe, psychiatrist and sexologist.

Try and stay involved in the activities that you used to gain pleasure from and enjoy before and during your pregnancy.

Here are questions that a newbie mother can ask herself to evaluate her state of mind:

1. How am I feeling overall in the scale of 1-10, 1 being awful and 10 being amazing?

2. Am I getting enough sleep?

3. Do I eat well and enjoy my meals?

4. Am I able to manage domestic chores or professional responsibilities and baby’s needs?

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Samir Parikh, Director-Department of Mental Health and Behavioral Sciences of Fortis National Mental Health Program, shared some helpful tips: “Get involved in activities that you enjoyed before and during your pregnancy. It is important to pay attention to your own health even post-delivery. During the pregnancy and after having a baby, it is necessary for parents to not cut themselves from their social circle. Despite being eager to do the best for your child, don’t try to be a ‘supermom’. Set limits, and don’t let yourself get fatigued or burnt out,” he advised.