Global Issues

Postpartum Depression In Women

Postpartum depression
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Having a child may be the most joyous experience in a woman life. Her entire life changes as she gets promoted to a higher status of motherhood. And then when we come across new like “A 27-year-old mother tried to kill her newborn baby and then herself because she was suffering from postpartum depression” we wonder what kind of a mother she must be, such a woman who doesn’t deserve to be called a good woman let alone should be a mother. But, have we ever consider that there can be more to it maybe that mother was going through more than just depression that made her take such a step. No, because, in our society, a mother is not allowed to feel anything less than joyous after having a child. 

The Un-Spoken Fear

Aaliyah a new mom sharing her experience said:

I would watch my 2 weeks baby sleep in her crib, worrying that at any second she would die.”

Over the next three weeks of sleep deprivation started to destroy me. I shuffled through the days and nights of nonstop nursing, burping, and changing, but attempting and failing to nap and feed myself.

I told my husband, “I’m so tired it hurts.”

“Of course you’re tired,” he said with a smile. “You’re a new mom.”

But I was feeling more than tired. I wanted to die.”

Was Aaliya just exhausted from the responsibilities of a new mother? No. Aaliya was also suffering from postpartum depression. According to Dr. Sue Varma, a New York City-based psychiatrist, about 45% of new moms experience postpartum depression.

“It often goes unnoticed. Women are told they are just anxious about having a baby — they will get over it the minute they meet their new baby,” she said.

The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. When this condition is left unattended more rarely — in about 1 or 2 per 1,000 births — postpartum depression turns into what’s called postpartum psychosis, characterized by delusions, paranoia, rapid mood swings, and hallucinations. Sometimes, mothers having the urge to harm themselves or their babies.

The Reality of Postpartum Depression

Pregnancy, labour, and birth are perhaps the most significant life experiences that a woman and her partner will encounter. It is a time of extreme physical and emotional transition with intense hormonal, psychological, and biological changes, all of which can affect the central nervous system. The puerperium may be a time of high vulnerability for women, coupled with feelings of loss of control. Tremendous changes occur in the mother’s interpersonal and familial world.

The birth of a new baby is expected to be a joyful milestone in a woman’s life, but that is not always the case. Some women experience minor adjustment issues, and others experience a grave and debilitating mood disorder, known as postpartum depression. This condition is often overlooked by health-care providers, which cause anxiety and confusion in the woman. More than half of the women with PPD go undetected and undiagnosed because the new mother may be unwilling to reveal how she is feeling to her provider or close family members, including her spouse. She may be embarrassed by her symptoms, or afraid that, if revealed, she will be institutionalized and separated from her baby.

Postpartum depression

Postpartum Mood Disorders And Symptoms

Bennett and Indman (2003) classify postpartum mood disorders into five categories: 

(1) Postpartum depression and/or anxiety; 

(2) Postpartum obsessive-compulsive disorder; 

(3) Postpartum panic disorder; 

(4) Postpartum psychosis; and 

(5) Postpartum posttraumatic stress disorder. 

Each disorder presents a range of mood changes and physical complaints. Bennett and Indman also note that postpartum “blues” is not considered a disorder; it is regarded as part of the normal postpartum adjustment.

Postpartum “Blues”

Normal postpartum adjustment and the “blues” represent normal biological and psychosocial adjustments to giving birth and do not impair the daily functioning of the mother or impinge on the maternal-newborn bonding experience. So, approximately 80% of postpartum women experience the “blues,” which are mild hormonal changes that take place within the first 48 hours after giving birth. These symptoms may last up to 6 weeks. Symptoms of the “blues” include mood instability, weepiness, sadness, anxiety, lack of concentration, and feelings of dependency. If symptoms last longer than 6 weeks or worsen during the 6-week interval, a woman meets the criteria for being diagnosed with PPD.

Postpartum Depression and/or Anxiety

Symptoms of PPD and anxiety are presented in several ways. They may include excessive worry or anxiety; along with, irritability or short temper; feelings of being overwhelmed; feeling very sad, guilty or phobic; hopelessness; Furthermore, it causes sleep disturbances (either too much or too little sleep); excessive physical complaints; loss of focus or concentration (frequently missing appointments); also loss of interest pleasure in anything; lack of libido; and changes in appetite (weight loss or gain) 

Postpartum Obsessive-Compulsive Disorder

The postpartum obsessive-compulsive disorder presents in 3% to 5% of new mothers. The primary symptom consists of repetitive and unrelenting thoughts, fears, or images. The thoughts appear spontaneously and may or may not involve harming the baby either intentionally or accidentally.

Postpartum Panic Disorder

Postpartum panic disorder occurs in about 10% of postpartum women. Feelings come on suddenly, and the woman experiences extreme anxiety. An episode includes physical symptoms such as shortness of breath, chest pain, and sensations of choking, dizziness, derealization, hot or cold flashes, trembling, restlessness, palpitations, numbness, or tingling.

Postpartum Psychosis

Postpartum psychosis is the most extreme of all the postpartum mood disorders. It is rare, occurring in 1 to 3 mothers per 1,000 births. Onset is within the first 24 to 72 hours after giving birth. Also, Postpartum psychosis has a 5% suicide and a 4% infanticide rate. Afflicted women have an abnormal thought process and lose touch with reality. Considerable confusion, poor judgment, delusions, and hallucinations are noted, usually with a religious quality. Postpartum psychosis can be life-threatening to both the mother and the baby.

Postpartum Posttraumatic Stress Disorder

According to Bennett and Indman (2003), postpartum posttraumatic stress disorder is usually connected to a specific trauma relating to the birth of the baby or an event from the woman’s past. So, a new mother who is reminded of this past trauma can often suffer from panic attacks. Symptoms may include recurrent nightmares, extreme anxiety, or reliving past traumatic events, including sexual trauma, physical or emotional trauma, and childbirth.

A COMPLEX HEALTH PROBLEM

The occurrence of PPD is rapidly being recognized as a major public health problem. Although PPD mimics a traditional clinical depression, there are major symptomatic differences between the two disorders. Women who suffer from PPD usually manifest symptoms that are much more severe than women who suffer from a major depressive disorder that is unrelated to the postpartum period. Women with PPD perceive themselves and those around them with trepidation. These women assume a passive attitude, and they will often isolate themselves from others due to fear and a lack of understanding of their illness. Women with PPD would rather separate themselves from friends and loved ones than reveal what they are experiencing, especially when it goes against social and cultural standards and expectations. Their fear of being labelled as a non-perfect mother creates the silence that makes their illness difficult to endure and their recovery complex.

What Are the Risk Factors for Getting Postpartum Depression?

A number of factors can increase the risk of postpartum depression, including:

  • a history of depression prior to becoming pregnant, or during pregnancy
  • age at the time of pregnancy — the younger you are, the higher the risk
  • more number of children
  • limited social support
  • living alone
  • marital conflict

Signs, Symptoms, And Behavioural Changes In Women With Postpartum Depression

A variety of symptoms of PPD contribute to the silence in sufferers. The experience from one woman to the next varies tremendously, which confuses the woman who tries to distinguish and understand what she is experiencing. Some women may feel that they do not have PPD because they do not feel “depressed.” Instead, they may be experiencing severe anxiety, disrupted sleep, loss of appetite, and obsessive thoughts about their newborn. Some women feel as if they are “going crazy” because their symptoms do not match what they read or hear about, and they are afraid to reveal the things that are going on inside their heads. These symptoms can lead to feelings of worthlessness and of being a bad mother, no interest in previously enjoyable activities, and little interest in her newborn and obsessive worry over the baby’s health. If left untreated, a new mother can begin to experience repeated thoughts of death or suicide, which can occur in any major depressive illness.

Expectations of the Society

In our society when a girl grows into womanhood, she is expected to become a selfless individual. Attachment or bonding is fundamental in the development of a loving and trusting relationship between a mother and her newborn baby. What new mothers do not realize is that bonding with their infant can take some time and effort. A new mother’s expectation of an immediate bonding can cause her to feel incompetent.

A combination of physical, psychological, and biopsychosocial factors can cause this bonding experience to go awry. Also, the social stigma of a lack of bonding or the possibility of a new mother not feeling complete bliss over the birth of her child causes the woman to remain silent. Also, the woman with PPD may feel a loss of relationship with her newborn, spouse, friends, and even her mother. Women have described feeling alone, unaware that they may be causing their own isolation.

Treatment:

Postpartum depression is treated differently depending on the type and severity of a woman’s symptoms. Treatment options include anti-anxiety or antidepressant medications, psychotherapy, and participation in a support group for emotional support and education. Moreover, childbirth educators can offer anticipatory guidance and instruction by increasing awareness of possible mental health changes in the postpartum period. According to results in a study, postpartum women are unprepared for the feelings of stress, loneliness, and seclusion that they experience. However, couples who attended a subsequent class on emotional issues felt prepared for the demands of bringing home a newborn, as well as the possibility of mood disorders, and were told to alert their spouses for help if symptoms of mood disorders became apparent. It is also important that we as a society consider new mothers to be a human and not some superhuman

Postpartum depression

I hope this post helps all the new mothers who are either suffering from PPD or are noticing such symptoms. You all are doing great and there is nothing wrong in asking for help.

For more such articles visit our website Fajar Magazine

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