Elsa Angel Rose
Motherhood does not always come naturally to a woman; for a few, it takes days, weeks, months, and even years to get adjusted to the new role. Fortunately for BABY BLUES OR POST-PARTUM DEPRESSION? “25-50% women develop psychological symptoms in the Puerperal period (during or relating to the period of about six weeks after childbirth, during which the mother’s reproductive organs return to their original non-pregnant condition),” said psychiatrist Dr Veena Kantak. A woman might experience less intense symptoms, which are often regarded as ‘baby blues’, or a more severe one, post partum depression, a mood disorder that requires professional assistance. “Baby blues involve mild mood swings, tearfulness, anxiety, and irritability starting 2-3 days after birth, peaking around day 5 a few, motherhood comes as innately as possible. Rather than having unrealistic expectations of a woman, being aware of why women experience trouble and helping her out is essential for the bright future of the mother, child and of course the family and society. and resolving within 1-2 weeks without treatment,” explained Dr Kinjal Avdhut Kothari, an Obstetrics and Gynaecology consultant at Manipal Hospital. About 75% of moms tend to experience this. Post partum depression (PPD), on the other hand, shows “intense symptoms which persist for a longer time, prevent women from performing their everyday activities, and looking after their children until they reach two weeks, which makes them seek professional assistance through therapy and medication,” said Dr Kinjal.
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DOES PPD AFFECT THE CHILD AND THE FATHER? PPD visibly and immediately presents itself, affecting the mother, but the disorder has an enormous impact on the baby as well. “Maternal PPD, which remains untreated, will decrease a mother’s emotional bond with her child, which leads to delays in the child’s social, language, cognitive and motor development during the first year,” advised Dr Kinjal. Early treatment is what leads to better results for both the mother and child. Treatment, to a large extent, can prevent the baby from facing risks of developmental problems, insecure attachment, feeding challenges, and excessive crying. Paternal postpartum depression affects 1 in 10 dads, a rate comparable to that seen in new mothers, according to research. Dr Manasa G V, another gynaecologist at Manipal, shared, “Studies suggest that hormonal factors, such as decreased testosterone levels and increased levels of estrogen, vasopressin, cortisol, and prolactin, along with social factors including increased caregiving responsibilities and psychosocial stress, are observed in new fathers during the transition to paternal parenting and may trigger mood disturbances.”
UNDERSTAND THE MAJOR CAUSES AND SYMPTOMS “Postpartum depression is defined as the development of a mood disorder in a woman within 1 year of childbirth. According to DSM-5 TR, postpartum depression is observed under the term perinatal depression, a major depressive disorder that begins during pregnancy or within 4weeks after Delivery,” Dr Manasa explained. The major causal factors for this depression include hormonal changes during post partum, which refers to a quick decline in estrogen and progesterone (Female reproductive hormones) levels resulting brain chemical imbalances, thyroid disorders, previous history of depression or anxiety, sleep deficiency, high cortisol levels from stress of caring for a newborn, pregnancy or delivery complications and social and environmental factors including relationship troubles, financial challenges. Dr Kinjal explained the symptoms to keep an eye for: “The symptoms include ongoing sadness, which is accompanied by intense mood fluctuations and excessive crying, irritability, anxiety, feelings of hopelessness or worthlessness, complete sleep difficulties, decreased appetite or excessive eating, total energy loss, and the inability to create a bond with their child.” The symptoms begin to emerge within two weeks after delivery. The gynec added, “However, they can continue to develop until one year later, and they will persist for weeks to months without receiving treatment.”
TREATMENT AND EARLY PREVENTION OF PPD Postpartum depression cannot be totally prevented, as some risk factors are non-modifiable. “For instance, a previous history of depression or bipolar disorder, endocrine disturbances, and other similiars. While some factors are modifiable, like psychosocial conflict, awareness, supportive care, and socio-economic stressors,” said Dr Veena. Prior mental health conditions, especially diagnosed schizophrenia, bipolar disorder, or depression, carry a high chance of relapse in the postpartum period. The psychiatrist added, “Many times, the first episode occurs during the postpartum period (as it is the most vulnerable time for destabilisation) and may later develop into psychiatric problems.” The only route towards prevention is better awareness, education, early detection and treatment. Dr Manasa explained, “PPD can be effectively managed by counselling, cognitive behavioural therapy, interpersonal therapy and pharmacological therapy- use of anti depressants, mood stabilisers and in severe cases, may have to take the aid of ECT (Electroconvulsive therapy) / TMS (Transcranial Magnetic Stimulation) for better management.” Even after treatment, chances of recurrence are still present, especially during subsequent childbirth.
THE CRUCIAL ROLE OF PARTNER AND FAMILY SUPPORT Partner and family involvement is most important, as it reduces risks, helps in early detection and intervention, ensure better care of both the baby and the mother. It allows shared responsibility, improves adherence to medication and treatment strategies, and leads to better recovery. Psychiatrist Dr Veena shared, “The most important areas include awareness, communication, planning ahead, active connection (liaison) between the gynaecologist and psychiatrist/ psychologist, and a supportive environment and care.” Awareness is especially needed, as postpartum mental health concerns are often brushed away as normal due to the stressful period. Dr Veena added, “Openly talking about feelings of being overwhelmed, irritated, frustrated, is socially and culturally considered unacceptable, as motherhood is viewed as a virtuous, ‘godly’ role in which love, care, and affection are expected to come naturally to the woman. Such misconceptions and myths have to be taken as they are supposed to be, with a pinch of salt. More emphasis has to be placed on speaking openly about the issue, breaking unrealistic expectations, and offering as much support as needed for mothers.
