SOMYA had just delivered a baby boy. Her delivery was in every sense a culmination of all the anticipation, excitement, mystery and joy that she had been experiencing during the past nine months. This was the moment she had been longing for - to give life to another human being.
But after about a week, the exhilaration and excitement began to fade away and then began a phase of disillusionment and harsh reality. The ever-so-wanted baby was a little bundle of joy, no doubt, but at the same time it was weepy and troublesome too. Besides, it was demanding and no matter how much Somya tried, her efforts were always falling short.
The delivery that should have ushered in a period of happiness also brought along with it bouts of depression for Somya. She would feel lonely, listless, disinterested and guilty. She would find it difficult to carry out even the most mundane of jobs.
The baby she had yearned for and waited for, for nine long months suddenly ceased to be the cynosure of her life and she started losing focus. She wanted to break away from it all…run away to a far away place… and be alone.
Somya could not understand her mental state, she was becoming more of an enigma to her husband, who was supportive and very loving but failed to understand why she was behaving so abnormally.
Then they decided to consult their gynaecologist, who told them that Somya was suffering from postpartum depression - a state that 70 per cent of new moms go through after delivery and the good news is that in most of the cases the problem can be sorted out with support and care from the family.
Postpartum depression is a common problem and Somya's case is not a very rare one. In fact, most new moms have it in some form or the other after delivery. Some suffer from a mild form that surfaces about ten days after delivery. The woman feels weepy, frightened, touchy and very sensitive. This state -- also termed as baby blues -- occurs due to hormonal changes in the body and may last from a few days to a several months.
Baby blues is a self-resolving problem and lasts as long as the hormone levels in the body are undergoing a change and once the hormones are settled, the blues disappear. The woman feels like her old self again.
But baby blues may get aggravated and take the form of acute depression, if not dealt with properly. Sometimes due to a hormonal imbalance, the blues may persist longer and turn into a more serious disorder or postpartum depression.
According to Dr Raymond Hamden, clinical psychologist at the Comprehensive Medical Centre, Dubai, "95 per cent of mothers suffer from fear and depression after their delivery. Out of these, one-third have recurring depression, which can be treated with mild therapy and two out of a thousand suffer from psychosis which may need hospitalisation as it has acute disabling effects."
In case of a mild depression, the woman feels lonely and tired and is unable to work. She may be more sensitive, irritable and agitated and feel unloved. She may also feel insecure and frightened at times, worrying excessively for the well-being of the child. Eating and sleep disorders are common in this state.
Mild depression may last for anything between several days to several weeks. The patient requires a proper support system during this period and the spouse and family play a significant role in getting rid of this kind of depression. The woman should be helped and made to understand that she is not the only one suffering from such a state and there are many others like her. It also very important to make her aware of the fact that she is not at fault but that, it is something that she has no control over because the cause is physiological and not just mental.
Mild depression disappears with emotional support from the family and a little help from a psychologist, if needed. Psychologists advise that new mothers should take some time off for themselves and take a break from just being over-indulgent mums. Motherhood is very demanding but women should not be overwhelmed with the new role and lose their individuality. It is a good idea to pursue a hobby just to divert you from routine. Reading or going out for a walk are good for a change in such a situation.
In some cases, the problem does not end even after a number of months and the condition of the woman continues to deteriorate. She continues to feel down and depressed and at this stage it is better to seek an expert's help for this may be chronic depression. Chronic depression lasts for several months and the woman suffers from anxiety and a lack of interest in everything. It is a vicious cycle in which the woman finds it impossible to take care of the baby and do other household chores due to certain physical limitations. Being unable to do these things makes her feel guilty, sad and depressed. In such cases, the woman may need therapy and a psychologist's help.
The treatment requires both the psychologist and the mid-wife or gynaecologist who is familiar with the medical history of the patient to be present. Doctors prescribe anti-depressants in certain cases but medication is very carefully selected taking into account the physiological state of the patient. Family support plays a crucial role here. The spouse should bear with the wife and give her emotional support. Spending some time with the wife to talk or probably reading out to her are some of the ways by which husbands can help.
Dr Sarita Kapoor, a specialist gynaecologist in Dubai says, "I counsel the spouses of women who suffer from postpartum depression. They should know how to deal with it. Sometimes a lack of understanding on the part of the spouse may result in making matters worse for the couple."
According to psychologists, first time moms are more prone to postpartum depression due to their anxiety to cope with their new-found identity but there is no definite pattern.
Dr Hamden explains, "There is a greater likelihood of postpartum depression in the case of first time moms. Sometimes even geographical changes like shifting the house or city may contribute to the state."
Dr Sarita Kapoor has observed a greater tendency among expat women from the Subcontinent to suffer from a mild depression due to the cultural gap. Most of the couples back home lived in extended families and are used to a lot of family support. The birth of a baby in the family means a lot of festivity and celebration, which keeps the new mom preoccupied. But living in the UAE, one misses out on this kind of family support. Therefore, the role of the husband becomes all the more important.
"During the first few days after delivery, the woman undergoes a lot of emotional upheaval and she needs someone by her side. I advise all new fathers to take some days off from work and spend time with the wife. I think paternity leave is a great idea!" explains Dr Kapoor.
A more severe form of postpartum depression is postpartum psychosis, which occurs in very rare cases -- about two in a thousand women may suffer from this. Postpartum psychosis lasts for months and has severe debilitating effects. It is extremely disabling and may need hospitalisation. Some women may also have suicidal tendencies in such cases and a psychiatrist's intervention is needed. Studies reveal that women who have a past history of depression are more likely to suffer from postpartum psychosis. Even the most severe cases are absolutely curable and one can lead a normal life after recovery. But therapy has to be followed for several months and sometimes for a year or two.
Postpartum depression is an extremely under-diagnosed problem. Accepting a diagnosis of depression can be difficult for new mothers, and many women even avoid seeking treatment because they think they have failed if they can't handle their depression or having a new baby. But doctors say that postpartum depression should be recognised as a bio-medical problem and proper support and therapy help put a spring back into a patient's life.
