Maa Matters Part 2
(A series on Maternal Mental Health by Dr. Khushboo Kansal)
29 year old Ruhi, who had delivered a beautiful daughter four months back was sitting across me in tears “Why does this sadness don’t go away? This feeling is present like a shadow every single minute since last 8 months. Nothing just makes me happy. I feel empty, as if no emotions and no desire whatsoever to do anything, not even getting up from bed. I look at my baby and feel nothing. She smiles at me with all the vigour, but I am unable to respond and then she gets sad. This emptiness is so painful. I feel very guilty about not being able to take care of my baby. I just stare at the clock in my room whole through the night when everyone sleeps. I lost 10 kgs of my pregnancy weight in last two months because I have to force myself to eat even a little bit. I just don’t want to talk to anyone. I don’t think I will be able a good enough mother. I don’t even feel like joining my work back. I talked to my doctor regarding this while I was pregnant. I was reassured that these are hormonal changes and I would come out of it eventually. But in last four months post-delivery things have only worsened.
How many women suffer from perinatal depression?
Perinatal depression is defined as depression during pregnancy, around childbirth or anytime up to one year postpartum. Around 15 to 20 % of the women have a Depressive Episode after delivery. Out of which, 30-35% of the patients start having symptoms during pregnancy itself. Just because pregnancy itself has its own set of symptoms because of physiological changes, the depressive symptoms are largely mistaken for the normal pregnancy symptoms.
Why do some of the women get it while others don’t?
Life stress, major life events, lack of social, family and partner support, chronic medical illness, complicated pregnancies, prior history of psychiatric illness, family history of psychiatry illness, previous pregnancy losses, domestic violence (physical, verbal, financial and emotional abuse) are few of the risk factors which increase the vulnerability of a lady to have perinatal depression. Sometimes depression occurs even when there is no risk factor. These add to the fact that there are significant hormonal changes in peripartum period.
Why it is important?
Children of depressed mothers are more likely to have cognitive and neurological developmental issues. These children are more likely to have emotional dysregulation and psychiatric issues when they grow up.
Untreated psychiatric illness in perinatal period can have poor pregnancy outcomes such as low birth weight and premature delivery. There are long term detrimental effects on mothers too as it increases the severity of the illness as well as the recurrence rates. It leads to disharmony among the family members.
Treatment in perinatal period is a stepwise approach. Early identification and management is most important so as to reduced sufferings and proper management of the illness.
1. Self Help:
2. Professional help:
- Healthy lifestyle: women are requested to follow healthy eating habits, do regular exercise and meditation even before depressive features start.
- Family and partner support: This modifiable risk factor can be reduced to a large extent if the partner is supportive.
- Tune your thoughts: try to become aware about how your negative thoughts and outlook is fuelling your depression. It’s a vicious cycle. Try keep a positive outlook or shift your thoughts from negative to a positive one.
- Psychotherapy: mild to moderate depression can be very effectively dealt with this. It’s basically understanding yourself better and make positive changes with a professionals help.
- Medicines: when the patient is suffering from severe depression and/or emergencies like thoughts of self-harm and harm to baby. Contrary to the popular belief that medicines only harm the baby and mother, there are very effective and safe medicines available.