‘It’s ridiculous to tell a new mom to snap out of postpartum depression’
'Eight in 10 women will experience baby blues. One or more in 10 could face postpartum depression. And in rare cases, they could have postpartum psychosis.'
“Joy isn’t the only thing a new mom experiences after her baby is born,” said Dr Archana Nirula, a senior gynaecologist associated with myUpchar. “Eight in 10 women will experience baby blues. One or more in 10 could face postpartum depression. And in very rare cases, they could have postpartum psychosis. It’s ridiculous to tell the new mom to get a hold of her self or snap out of it. Just ridiculous.”
Dr Nirula has 25 years of experience as a gynaecologist, and for 10 of these years, she has also served as the India Coordinator of Postpartum Depression International, an organisation dedicated to raising awareness and developing resources to help new moms cope with the flurry of hormonal changes that can bring on depression in 15% cases.
“So many women blame themselves when they can’t connect with their newborn,” said Dr Nirula. “All that self-blame is so unnecessary, it makes me angry,” she added.
We asked Dr Nirula to tell us all about postpartum depression, and how to recognise the signs of it so more new moms can get the loving care and attention they need.
To begin, could you tell us the difference between baby blues, postpartum depression and postpartum psychosis?
Baby blues is a feeling of sadness that can take hold of new moms soon after their baby is born. The reason is that as soon as a woman gives birth, the level of progesterone and estrogen hormones in her body start plummeting. Think of it like a cartoon falling off a cliff. Pfft.
This hormonal storm can take a toll on her mood. The best thing to do in this situation is for the new mom to talk about her emotions. Sad, angry, sleepy, annoyed, whatever it is. New moms can also help themselves by asking for assistance with all kinds of things, from changing the baby’s diapers to getting someone to watch the baby while she goes out for fresh air.
Usually, baby blues don’t need any treatment - they go away on their own in about two weeks. If they don’t go away, then women shouldn’t even think twice about reaching out to their doctors. Their body has been through enough already, wouldn’t you agree?
So what’s postpartum depression, and how’s it different from baby blues?
The key differences are the intensity of symptoms and how quickly they come and go.
Baby blues set in a few hours or days after delivery.
Postpartum depression usually sets in two or more weeks after the birth of the baby. If the new mom’s feeling tired or depressed all the time, or if she bursts into tears but she doesn’t know why, or if she’s feeling lacklustre about the activities that used to bring her joy before, or if she’s having trouble sleeping, then she may be exhibiting early signs of postpartum depression.
Unlike baby blues, postpartum doesn’t usually go away on its own. It’s a mood disorder - a medical condition that has a proper diagnosis and a cure.
The worst thing new parents can do - for their own health as well as the baby’s - is to ignore these signs and try to power through.
And what about psychosis?
Postpartum psychosis is quite rare, but it requires immediate medical attention. Women with postpartum psychosis may have hallucinations and feel very, very anxious. It’s really not a good place to be in.
So what are the symptoms for each of these conditions?
With baby blues, it’s often fatigue and sadness. Women can also feel teary, restless, anxious or be irritable. They could have trouble focusing and sleeping. The reasons are obvious: you have just delivered a baby. Your hormones are all over the place. On top of that, you don’t get enough sleep because your baby needs two-hourly feeds and anyway your hormones won’t let you sleep. Who wouldn’t be irritable?
Postpartum depression is more serious. It can have a whole host of symptoms from feeling sad or overwhelmed to being overly anxious, moody, irritable, or restless. The new mom can feel uninterested in things that used to excite her earlier. She can feel low and lose all interest in sex. A deviation from regular behaviours can also be a sign. For example, if you’re used to sleeping eight hours a night but suddenly you can’t get a restful couple hours. Or if you are a good eater but suddenly you can’t eat half as much or half as regularly. These are things to watch out for.
Women who experience postpartum depression don’t always know why they are feeling so teary, angry or withdrawn. Sometimes, women can have physical symptoms like headaches, stomach aches and muscle pain. Often, women have trouble forming a connection with their baby. In fact, if the new mom stops caring for the baby, it’s one of the surer signs of postpartum depression.
Postpartum depression can also be very confusing for the new mom, who can develop doubts about her ability to take care of her baby.
If they don’t get treatment, women can sometimes think about harming themselves or their babies. I cannot stress this point enough: postpartum depression needs to be addressed. There have been cases where women have tried to put a brave face on it, and years later they’ve harmed themselves or their babies. Depression is a mental health condition. You can’t just shake it off. It can fester.
And what about postpartum psychosis?
This is unequivocally a medical illness in which women can experience huge mood swings, hallucinate and feel overly suspicious of the people and things around them. If a new mom starts behaving out of character like if she suddenly becomes too chatty or too withdrawn, or can’t eat or sleep, this should raise some alarm.
How common is postpartum psychosis?
It’s quite rare.
I recently had a 24-year-old patient who was on antidepressants even before she gave birth. After her child was born, she became withdrawn. Her husband was concerned because she used to get very angry and scream and shout at times. She was waking up in the middle of the night, screaming. This was a few months after the delivery. But even this is an extreme case.
What’s the treatment?
Baby blues usually go away on their own. For postpartum depression, your doctor may prescribe antidepressants, counselling or both.
I have to add that though postpartum depression can happen to anyone, some women are more prone to it. People with a previous history of depression, a family history of mental illness and those who have a traumatic experience during pregnancy could be at risk.
What is your advice for new moms, then?
Talk to people. Even if you don’t feel like it initially, tell your doctor or your partner or a friend you trust about how you’re feeling. Even if you sometimes feel detached from your baby, remember you are not alone. Don’t bottle up your feelings. Remember the saying, it takes a village to raise a child? It’s true. Let your spouse, family, friends, colleagues, medical caregivers support you. Focus on your own wellness, too. You’ve done brilliantly so far.
I also have something to say to the new dad and the new family.
To the new dad, I want to say that I know that everything’s new for you too. But if you remember that postpartum is just the hormones going crazy and that it’s completely fixable, you can really help your partner. Watch out for any signs that they’re depressed, withdrawn, overwhelmed or otherwise different. You spend the most amount of time with the new mom, try to gauge how she’s feeling. Be extra mindful for just a little while longer. You’ve done brilliantly so far, too.
One more thing; new dads can experience paternal postpartum depression, too. Their reasons may be somewhat different (repressing their feelings and societal pressure to be strong for their young family), but their feelings of sadness and being overwhelmed are the same. So look out for yourself, too.
New family: stop shaming the new mom. It’s okay if she wants to rest, go out, talk, not talk, be moody, be silly, ask for help, eat something else, do something else. You had no trouble pampering her when she was expecting, and that was when the hormone levels in her body were rising. Now they’re crashing and she needs your help. Be patient. Be loving. And keep the snark to yourself. She does not need you to tell her how much weight she’s put on.
Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on Depression.
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