Are babies always bundles of joy? : Postpartum Depression

     ⮚She exhibits a depressed mood most of the day—her sense of being sunk in an ocean of sadness.

        ⮚She seems uninterested in everyday activities from which she earlier derived pleasure.

     ⮚She eats too much or too little—her appetite has gone haywire.

     ⮚She sleeps too much or too little—her good night’s sleep has become a distant dream.

     ⮚She moves around lethargically, almost dragging herself to get things done…or conversely, she is agitated in all that she does.

     ⮚She feels worthless. She feels guilty.

     ⮚She can’t get herself to concentrate or decide on the tasks she is passively performing.

        ⮚She maybe thinks, maybe plans, maybe attempts committing suicide.

     ⮚She doesn’t use any substances. She can’t place a finger on any medical condition that is causing her such distress and impairment of functioning.

Yet, here she is with her baby in her hands. The beautiful baby she’s been awaiting. Or, at least she should be awaiting the baby? She doesn’t feel any motherly feelings that she should be feeling. Or, should she be feeling them automatically at all?

The answer varies. Some of us gloriously bask in the post pregnancy glow despite hours of painful labor and impending sleepless nights. Some of us don’t. For those who do, KUDOS! However, for those who don’t react this way; let’s not make them feel ‘sidelined, abnormal and stigmatized’.

The Diagnostic and Statistical Manual of mental disorders (DSM-5) is published by the American Psychiatric Association (APA) for the purpose of helping mental health professionals around the world diagnose and treat persons with mental health issues. Although popularly referred to as Postpartum Depression (PPD), in the scientific terminology used by DSM-5 the above mentioned pointers are symptoms of a condition called Major Depressive Episode with Peripartum Onset. The same checklist of symptoms is also used to detect the presence of Clinical Depression. However, the signifier of Peripartum Onset is used when the individual starts showing at least 5 of the given symptoms(including at least one of the first two) anytime between the 9 months of pregnancy to 4 weeks from delivery of their infant. This means that the symptoms exist primarily due to the presence of a newborn child and the kind of life changes this entails.

Risk Factors contributing to PPD

Motherhood is universal and so are the problems accompanying it. This is to say, any woman can suffer from Postpartum Depression.

If we were to reinterpret all the symptoms from the perspective of a newborn mother, we could say that the pervasive sadness primarily emerges from the sudden drop to normalcy of hormones like progesterone and estrogen that phenomenally rise during the pregnancy period. While this is often responsible for what we call "baby blues" i.e. a shorter, less intense period of depressed mood found in a majority of new mothers; why it leads to PPD in some women and not others is a little unclear. Further, looking after a helplessly dependent baby is a demanding job in itself because of which the mummy often overlooks the nutritional requirements of her tummy. Having a fussy baby that is difficult to put to sleep negatively impacts the mother’s sleeping cycle. And mind it; sleep deprivation can be a serious physiological contributor to PPD.

The needs of the baby start having an upper hand over needs of the self. There is a huge curtailment in the kind of freedom young parents enjoy before childbirth. A lot of responsibility is now placed on their shoulders. The kind of reorganization in life and roles that the entry of a child brings in is unfathomable, even if the pregnancy was a planned one. So imagine; when the pregnancy is unplanned or imposes the requirement of upbringing the child singlehandedly due to divorce/separation/ death of spouse, wouldn’t the struggles multiply manifold? Also, experiencing birth complications in the present pregnancy, miscarriages in the earlier ones or PPD following previous childbirths may heighten the risk of developing this disorder. Over and over again, it is also said that a prior history of depressive disorders experienced firsthand or by a family member can predispose individuals to PPD.

Naturally, suffering from postpartum depression takes away the ability of a parent to provide fully for the child. The mothers in such a predicament often fail to feel ‘motherly enough’ —i.e. they can’t establish an instant connect with the tiny human that they so preciously created. This leaves them feeling confused, worthless and guilty because they see themselves as being a ‘bad mother’ who doesn’t fit the conventional image of a nurturing primary care giver.

An important point to note down here is that PPD majorly affects women but it doesn’t spare men in some cases either. Motherhood is difficult and so is fatherhood. Men are socialized to not give in to emotional pressures but a life altering event such as having a baby can crush their emotional fences down. Sometimes the father may be an alone sufferer of PPD for reasons that are similar to those mentioned above while many other times, the combined demands of a babbling baby and a seemingly unsupportive partner suffering from PPD can push men over the edge.

What PPD is not

Many women willingly stay away or are forcefully made to stay away from their children if they openly express their depressive thoughts because they are by default seen as being dangerous to their own child. This error in judgment is a result of misinformed media reports regarding ‘women who killed their children while experiencing a bout of postpartum depression.’ However, women who commit such deeds are plagued by postpartum psychosis which is a different and rare disorder wherein individuals experience distorted reality and come to be guided by their delusions that might precipitate them to commit infanticide.

What can you do?

One thing that is clear by now is that postpartum depression is not something that individuals call 

upon themselves by choice. So,

          1. Break the stigma: It’s time to stop constructing a socially validated image of a flawless mother which we knowingly or unknowingly force women to pit themselves against. Let every woman be ‘her kind of mother’.

       

      2. Accept: It’s time to embrace the idea that men have emotional insecurities surrounding childbirth too.

      3. Let’s talk: It’s time to provide an open and safe space where parents can express their frightening PPD-related thoughts. And let this space not only be a therapist’s room but also any and every place of social meeting: homes, playgrounds, workplaces, train bogeys. Let this be a topic as natural to talk about as child birth is.

      4. Be equals: It’s time to start supporting your PPD-affected partner and take equal work load for all the chores related to home, work and the baby. Don’t underestimate the power of a good night’s sleep. Make sure each of you get at least one block of uninterrupted sleep that helps you wake up fresh.

     5. Seek professional help: It’s time for us to realize that unlike baby blues, postpartum depression isn’t soothed only by comforting words. It will require a combination of medications and psychotherapy for social support to show its full impact.

     

     It’s time to help PPD struck parents unleash their bundle of joy.