Bang bang, my baby got me down

Many new mothers experience baby blues with inexplicable crying bouts, anxiety and mood swings that can last for up to two weeks or more after childbirth.


TheAlternative_New Mother

Last week, the local newspapers were full of stories about a new mom in Bangalore who allegedly killed her seven month-old baby girl. The 23-year-old mother (who also has an older girl child) had been suffering from post partum depression or PPD (also known as post natal depression or PND), police were quoted as saying. The mother also had no support at home—her husband having abandoned her after she gave birth to their second girl child.

The incident prompted a flood of articles about PPD. Experts were quoted, advice dispensed with. What happened subsequently to the mother? Did she get help? Where is the missing husband, and what will happen to the surviving girl child? Such details are not clear.

The hidden illness

But then neither is PPD itself.

PPD, a form of depression that affect new moms, only hits the headlines when such tragedies happen. It rarely comes up in the context of moms and babies. It is not talked about in detail at pre-natal classes or during check-ups at the gynaecologist. It is barely touched upon in the innumerable mom-and-child groups that thrive on social media. And mommy bloggers who do gush about the joys of motherhood generally do not talk so joyfully about this side effects of childbirth. For that matter, PPD is also not something mothers discuss with their expectant daughters. Unsurprisingly, new moms who do experience PPD don’t talk about it either, even if they feeling lost and utterly low.

Because often, moms don’t even know what’s happening to them. As Celestina Cavinder, a certified labour doula (or birth companion) with CAPPA (Childbirth and Postpartum Professional Association), points out, “mothers have no idea or are clueless about what happens after the birth of the baby.” A mother of six herself, Cavinder has been working as a doula in Bangalore for 20 years now. “The period immediately after the birth is so very exciting and joyous for most. But when you hold that miracle of yours in your hand, you also then realise, “I have a baby and now what am I to do?” Yes, reality kicks in,” she said.

Is this the time to be sad? 

What’s more, if a new mom is unhappy, her feelings are often dismissed. That, said Dr Prabha Chandra, Professor of Psychiatry at the National Institute of Mental Health and Neuro Sciences, Bangalore, is because childbirth is considered a time for happiness. “If the mom is unhappy, people wonder why she is upset. It is as if she is not even given permission to talk about what she is going through,” said Dr Chandra, who works in the field of perinatal psychiatry.

According to her, PPD occurs across classes, income groups, urban and rural backgrounds, whether the mom is part of a joint family or a nuclear family. But all mothers do not experience it. “Some are more vulnerable to it —if the mother has had a traumatic delivery, if there is a history of violence in the family (domestic abuse), if she has little or no support, if she is having difficulty in breast feeding (or lactating), so on. Differences between the in-laws about rituals conducted after childbirth, pressure to lose the baby weight, tension between husband and wife, etc, can also exacerbate the situation, and make the new mom more prone to PPD,” explained Dr Chandra.

Cavinder concurs. “PPD has always been there. It’s the lack of awareness and knowledge (of it) that is of more concern”. New motherhood is an exciting, emotional and challenging time, she said. “With the physical and hormonal changes a woman undergoes after giving birth combined with a lack of sleep, is it any wonder that new mothers often feel overwhelmed,” she pointed out. What really matters is how involved the husband is, what kind of support and help the new mother receives on those sleepless nights with her baby,” she said. Cavinder is also an administrator at the Bangalore Birth Network, a forum that seeks to promote safe, mother-and child-friendly care from pregnancy to post partum, for women of all socio-economic backgrounds.

Do doctors know what PPD is?

TheAlternative_Depression

Many new mothers experience what is called the baby blues — inexplicable crying bouts, anxiety, difficulty sleeping, mood swings etc. According to the Mayo Clinic of the US, the blues commonly lasts for upto two weeks or more after childbirth. PPD is a more severe and longer lasting form of depression but it is treatable, if correctly diagnosed. But often, it is mistaken for other conditions. As new mother Anjana Sharma discovered. When she sought help, a top psychiatrist in Chennai diagnosed her as having bipolar disorder and advised immediate hospitalisation. It was only when the young woman, with her husband’s support, sought a second opinion, that her condition was correctly diagnosed as PPD.

But before correct diagnosis, the mother’s condition has to set off warning bells in others. And sometimes, the husband and family included, don’t know what to do. Neither Anjana’s mother, nor her husband, had a clue as to what was going on. “If those around her notice that the new mother is still crying, feeling awful, is unable to care for the baby, and so on, they must bring it to the doctor’s attention, they have to get the mother help,” stressed Dr Vijaya Krishnan, co-founder of Healthy Mother Sanctum, a midwifery-based natural birth centre in Hyderabad.

Also, it is necessary to have a strong support system, a network of people who can counsel and advice the mother or a good peer group where she can share what she is feeling. “In a midwifery model of care, such as ours, we prepare the mom-to-be for the challenges of motherhood, we touch upon all aspects, pre and postpartum. And after delivery, we make frequent visits to see how mom and baby are doing. We tell her it is okay not to be perfect, that even if she cannot sleep when the baby is sleeping, she must listen to her body and take care of herself,” Dr Krishnan added.

The mom also matters

Baby Blues. flickr cc elisasizzle.

Baby Blues. flickr cc elisasizzle.

The problem is, during pregnancy, the mothers-to-be get pampered. But after delivery, often, all the attention is solely on the baby. The mother, then feels that no one cares about her. Anjana Sharma knows just how terrible that can be. “After I had my daughter, everyone brought gifts for the baby, cooed over her. No one ever asked me how I felt. One friend though, came with a gift for my baby and she got me my favourite aromatic bath salts, my favourite shade of nail polish and my favourite butter cookies. After she left, I cried all evening. Because nobody else had bothered about me till then. Now, when I go visiting new moms, I make sure I get something for the mom and the baby. Trust me, it makes a lot of difference,” Sharma said.

As Dr Chandra pointed out, sometimes it also helps to simply ask the new mother how she is doing, how she is coping. It is important to talk. “Because it is important to break the silence around PPD,” she added.

Baby blues-which last only a few days to a week or two after your baby is born. Signs and symptoms may include:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Crying
  • Reduced concentration
  • Appetite problems
  • Trouble sleeping

Postpartum depression symptoms

Here, the signs and symptoms are more intense and last longer, eventually interfering with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin later—up to six months after birth.

  • 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

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

A rare condition that typically develops within the first week after delivery. Here,  the signs and symptoms are even more severe. Signs and symptoms may include:

  • Confusion and disorientation
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Paranoia
  • Attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors, harmful to both mom and baby and requires immediate treatment.

 

Perinatal Psychiatry Clinic
First Floor New OPD Block
(Above NIMHANS Staff Clinic)
Bangalore
Friday Mornings -9 AM to 2 PM
Phone – 080 – 26995547
For prior appointments, please call- 080 26995272/5251/5279
Email: perinatalnimhans@gmail.com

Bangalore Birth Network–http://bangalorebirth.org can be contacted at bangalorebirth@gmail.com or through their Facebook page.

To know more about Healthy Mother Sanctum, log onto http://healthy-mother.com or check their Facebook page.

For doulas, log onto http://doulaindia.com

Source: http://www.mayoclinic.org

 

 

lll-logo#SpeakYourMind is a special series on mental health by The Alternative in partnership with  The Live Love Laugh Foundation. Starting Mental Health Day, Oct 10th, the series will feature voices and expert views on issues like depression and anxiety disorders and how sensitivity and timely support can help people overcome them. If you have a personal story around mental health to share, please write in to editor@thealternative.in, and we will publish it in the strictest confidence.

 

 


  ABOUT THE AUTHOR
Divya Sreedharan is a journalist and author in Bangalore. She writes on gender, health, lifestyle and ageing-related issues for various publications and has a blog titled Connected Lives on Citizen Matters. more

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  ABOUT THE AUTHOR
Divya Sreedharan is a journalist and author in Bangalore. She writes on gender, health, lifestyle and ageing-related issues for various publications and has a blog titled Connected Lives on Citizen Matters. more

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