The much-awaited event has happened! Your baby is here! But wait, why do not feel happy and excited like you should? Why do you feel sad sometimes? Is that how you are supposed to feel?
Becoming a mother comes with a whole set of emotions. While you are overjoyed that you have a little version of yourself (or your husband, if the universe has conspired against you,) you could also start experiencing severe depression. You may also have mood swings that make you feel like you are an emotional yo-yo. If this is the case with you after your delivery, chances are that you are experiencing postpartum depression.
So, what is postpartum depression?
Postpartum depression, usually referred to as PPD, is a common occurrence. The symptoms usually begin a few weeks after childbirth and can persist for a long time, if untreated. It is characterized by
- Frequent mood swings
- Inexplicable urges to cry
- Difficulty bonding with your baby
- Difficulty in decision making
- An overwhelming sense of guilt or ineptitude
If you are a mother of a newborn and are experiencing PPD, do not feel alone or confused. Recent studies have shown that 1 out of 7 women experience varying levels of depression in the first few months since the baby is born. This is different from what we call, ‘baby blues.’ Every woman experiences some level of anxiety and stress after childbirth. But PPD persists for longer than the baby blues. It does not go away on its own like some elders make you believe. Treatment is the best way to ensure that you are not affected badly by it.
Why do many women experience PPD?
During pregnancy, there are many hormonal changes. The levels of the two hormones- estrogen and progesterone, are very high. Soon after childbirth, in less than 24 hours, hormone levels start to drop back to normal. This sudden change from a high level to a pre-pregnancy one can cause many emotional upheavals. This is similar to the hormone changes that women experience before the first days of their menstrual cycle.
Another reason is the level of thyroxine, the thyroid hormone. The thyroxine levels can change drastically soon after childbirth. Hypothyroidism, that is, low levels of thyroxine could lead to depression as well.
There are some other factors as well. The sudden change in your sleep cycles owing to feeding patterns, pressure from family members about the best ways to nurture your offspring, and lack of free time, could contribute to how you feel overwhelmed.
Any woman who goes through pregnancy is at risk for postpartum depression. If there has been any history of depression either for the individual or in the family, a new mother is more likely to get depression after delivery.
How do I know if I have postpartum depression and not baby blues?
The easiest way to identify if you are suffering from postpartum depression is to be aware of how you are feeling. Yes, it is overwhelming to be responsible for a little human being. No matter how many people are willing to help, every mother is plagued by doubts. But you need to stop and ask yourself what you are feeling is an everyday emotion or if it seems more intense. Speak openly with your partner or your parents about how you are feeling. If you feel like you are unable to communicate with your near and dear ones, you can talk to your doctor when you visit for your routine check-up.
Your physician would use one of the following tests or a similar one to determine the severity of your condition.
- Patient health questionnaire– This is usually the first step in the screening process. This generally consists of two questions-
- How often have you noticed a lack of interest in your day-to-day activities?
- How long has it been since you started experiencing these symptoms?
- 9-PH questionnaire– If the first questionnaire shows that you may be experiencing PPD, then the physician would use a longer one to find out the exact symptoms. This one could include questions about
- Appetite changes
- Energy levels
There are various other tests that your doctor or medical practitioner would use to determine the extent of your depression. Once they have determined the problems you face, and how intense your depression is, they will prescribe medication or therapy. Before any medication can be prescribed, your doctor will check your thyroid level to determine if it is a factor.
How do I overcome PPD?
In some cases, postpartum depression does not linger for more than three months. More than 90% of the women who have been diagnosed with postpartum depression have reported that they are cured with treatment.
The treatment, however, depends on the symptoms. These can vary from person to person. There are various forms of treatment. Some people also report that combinations of treatment methods help overcome the symptoms.
A doctor’s consultation would be the best way to determine if you have postpartum depression. In this case, the best way to treat it is to use prescription medicines from a certified physician. Over-the-counter pills are not only hazardous to your health; they could harm your baby as well.
The downside of taking medication is that most doctors prescribe antidepressants. These may result in dependence at a later stage. However, your doctor, who is aware of your case history and symptoms, would know the best course of treatment.
Psychotherapy is a sought-after method of treating depression. Two methods are most commonly used- Cognitive Behavioral Therapy and Interpersonal Therapy. This method is where you meet a counselor and have an informal chat about your feelings. The counselor, in turn, will help you steer your thoughts towards more positive ideas, and also help you change some of your habits so that you can feel better.
Therapists usually help you identify the problem areas and change them. They also help you to communicate better with your partner or your parents so that they can help you in your journey towards a happier you.
Recognizing that there have been changes in your lifestyle because of childbirth is a major step towards bringing about a change. Work with your partner, child’s nanny, your parents, or in-laws to work out a proper feeding and sleep schedule so you are not tired all the time. Take some time away from the baby and other household chores, so you have time to yourself. You can read, write or indulge in some art therapy during this time, so you can connect with your old self the one before your pregnancy.
Since you are breastfeeding as well, it is important to make sure you eat on time. You also should be taking care of the nutrition requirements for both you and your child.
Sometimes, new mothers find themselves in the unenviable position of being far away from their immediate family. Although virtual communication has become the norm these days, nothing beats having someone to talk to face-to-face. Many support groups help new mothers to handle their day-to-day stress, or just lend an ear to hear them out. These support groups could also be found online, in case the mother cannot step out for a long period.
New mothers with postpartum depression may be overwhelmed by the appearance of their bodies. Some women have also reported feeling ugly and undesirable soon after childbirth. Exercise can help deal with this as well as postpartum depression. It helps to lift your spirits while it helps you work towards your pre-pregnancy weight.
However, the focus of the exercise is to help you feel lighter in your mind. Setting unattainable goals with physical fitness could lead you further down the dark lane of self-pity and sorrow.
Again, consult a medical practitioner or a certified nutritionist or fitness expert to chalk out an exercise plan.
Yoga has been a practice since time immemorial for various reasons. Breathing, meditation, and general well-being are the different areas that yoga focuses on. Owing to the nature of the exercises, most people with depression who practice this ancient form, have reported a change in emotions. Since it does not involve vigorous activity like aerobics or dance, new mothers can practice it, after getting the green signal from their ob-gyn. But this is not the only solution, and should only be seen as a supplement to the medication prescribed.
Some practitioners suggest that self-hypnosis and other relaxation techniques such as guided imagery can help those dealing with postpartum depression.
Self-diagnosis can prove extremely dangerous in such cases. As is wont among many Indian families, seeing depression as taboo, and hoping it will go away if ignored, could lead to more complications than it is worth. In some extreme cases, the mother may suffer from post-partum psychosis, which is characterized by hallucinations, delusions, sleep disturbances, and paranoia. If untreated, the mother may end up hurting herself or the baby.