Women in India stay in the hospital for less than 48 hours after giving birth, making it harder for healthcare professionals to talk to them about postpartum depression. If women show symptoms like sleep disturbances, loss of appetite, feelings of guilt and worthlessness, extreme tiredness, restlessness, difficulty in concentration, and these feelings last for about two weeks or more, they may be suffering from postpartum depression and may need professional help.
- What is postpartum depression, why does it happen and how do women know if they have it?
- Symptoms of postpartum depression
- What causes postpartum depression?
- What should you do?
We often hear women talk about the birth of their baby as one of the happiest moments of their lives. But it isn’t so for everyone. For some women, it can be a difficult experience. The intense physical, hormonal, and emotional changes that women experience during this time can lead to conditions like postpartum depression. The World Health Organisation (WHO) says that almost 10% of pregnant women, and 13% of those who have just given birth experience mental health issues, mainly depression. The number is higher in developing countries like India; in these countries, about 16% of women face mental health issues during pregnancy and almost 20% after child birth.
In India specifically, according to a study, as many as 22% women suffer from postpartum depression. The study says some of the risk factors seen in India were: financial difficulties, birth of a girl, lack of family support, marital conflict, history of mental health issues, pregnancy complications and low maternal education.
The study also says that women in India who deliver their child in a hospital stay there for less than 48 hours post delivery, giving healthcare professionals little opportunity to counsel them and their families about the symptoms and treatment of postpartum depression.
“In India, mental health is not taken very seriously; it is only the severe cases that are reported to our clinics. Although, things are changing slowly and young mothers are becoming more aware, but it isn’t enough. Most women are still hesitant to seek help,” says clinical psychologist Dr. Poojashivam Jaitly.
In India specifically, according to a study, as many as 22% women suffer from postpartum depression post child birth.
What is postpartum depression, why does it happen and how do women know if they have it?
A woman goes through major physical, hormonal, and mental changes during and post pregnancy. Experts say that most women have something called the “baby blues” or feelings of sadness or emptiness after giving birth. Women may feel mildly depressed, anxious, emotional, and restless during this time, but it usually goes away in a few days. However, it can be postpartum depression, if it lasts more than two weeks. While it is rare, some women also experience postpartum psychosis, which has serious symptoms like agitation, hurting yourself or their baby, paranoia, restlessness, hallucinations, feeling withdrawn, lack of energy or appetite, and behaving out of character. This is a serious concern, and women undergoing these symptoms must seek professional help.
Experts say that most women have something called the “baby blues” or feelings of sadness or emptiness after giving birth. Women may feel mildly depressed, anxious, emotional, and restless during this time, but it usually goes away in a few days. However, it can be postpartum depression, if it lasts more than two weeks.
Symptoms of postpartum depression
According to studies, symptoms of postpartum depression include: sleep disturbances, panic attacks, feelings of guilt, feeling worthless, lethargy, lack of concentration, extreme tiredness, disturbance in appetite, and psychomotor disturbances.
Women may also experience fatigue, fear, hopelessness, mood swings, anxiety, and insomnia.
What causes postpartum depression?
Some experts believe that hormonal changes which occur immediately after giving birth are to be blamed. Estrogen and progesterone are at their highest levels during pregnancy, but they drop to normal levels after childbirth, leading to mood changes and even depression. Studies also say that social and psychological factors including lack of social support and marital dissatisfaction are to blame for an increased risk of postpartum depression as well.
Tiredness, feeling unattractive, and being overwhelmed by labour and the experience of childbirth, and the pressure to be a good mother can also be triggering.
It is also important to note that women who are younger than 20, those who have lost a baby before, have suffered drug or alcohol abuse, are unable to breastfeed, have an unwanted pregnancy, or a history of mental illness in the family, are at a higher risk of postpartum depression.
“If someone already has a mental health condition or has had one in the past, if they’ve had depression or if they have experienced depressive or anxious states prior to their pregnancy, they are likely to experience postpartum depression. Young mothers are more susceptible as well. It also depends on the kind of support system and the care the mother receives,” says Dr. Jaitly.
What should you do?
Doctors say that getting enough rest and sleep, and seeking help from your partner and family in taking care of the baby can help. Women should also not try and do everything on their own if they can avoid it and exhaust themselves further. Making time to do things apart from taking care of the baby is also recommended. Spending time with your partner alone and talking to them is considered helpful as well.
If the feelings of depression and other symptoms don’t go away in two weeks, or emerge anytime within a year to 18 months of childbirth, you should seek professional help. Doctors can treat postpartum depression using therapy, medication and electroconvulsive therapy (ECT).
It can be particularly hard on working women. Research says that women who return to work a bit later, in about 13-24 weeks, after giving work have better postpartum mental health. Studies also say that women who worked part-time had lesser depressive symptoms compared with unemployed women. While, higher workload was reported to be associated with poorer mental health postpartum.
Read an interview on postpartum depression with clinical psychologist Dr. Poojashivam Jaitly here.
- Maternal mental health. World Health Organisation
- Postpartum depression in India: a systematic review and meta-analysis. Ravi Prakash Upadhyay, Ranadip Chowdhury, Aslyeh Salehi, Kaushik Sarkar, Sunil Kumar Singh, Bireshwar Sinha, Aditya Pawar, Aarya Krishnan Rajalakshmi, Amardeep Kumar.
- The Role of Reproductive Hormones in Postpartum Depression. Dr. Crystal Edler Schiller, Ph.D.,* Dr. Samantha Meltzer-Brody, M.D., M.P.H., and Dr. David R. Rubinow, M.D.
- The relationship between employment status and depression symptomatology among women at risk for postpartum depression. Beth A Lewis, Lauren Billing, Katie Schuver, Dwenda Gjerdingen, Melissa Avery, and Bess H Marcus.
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