Dealing with depression after pregnancy

We are fond of saying sentimentally that a woman feels really fulfilled only after she has a baby. That only when she holds her bundle of joy in her arms does she understand what it really means to be a woman.

But, emotion aside, pregnancy and childbirth result in a complex mix of physical, hormonal, emotional and behavioral changes taking place in a woman and this whole package can affect her in various ways at different times. During pregnancy, for example, she could sometimes feel excited, full of energy and deliriously happy, but at other times, she could also have headaches and feel overwhelmed, tired and flustered.

Going through labour and successfully giving birth to a child invariably makes a woman feel that she has done something marvelous and she cannot stop smiling. Later, the world intrudes and so does worry at the responsibilities that have now fallen on her shoulders. This worry makes 90 per cent of mothers depressed and fearful but, as they begin to cope with baby-care, this depression disappears. Yet, for about a quarter of the new mothers, the depression persists for some weeks and they need help in both, caring for their babies and in coming to terms with their feelings. This help is usually provided by their families.Postpartum Depression

Negative Feelings

And, occasionally (in about 0.2 per cent of the cases), the mother’s negative feelings are so strong that she feels as if the world around her is all black and that she is drowning in a sea of depression. She feels unable to move and is unwilling to care for her baby because she feels no emotional bond with it.

In some cases, she does not even want to feed or touch the baby. Since this depression occurs after birth (or postpartum), it is called postpartum depression (PPD) or Peripartum depression. Very occasionally, usually in very severe cases, the physical and emotional symptoms of acute depression manifest themselves even before the delivery.

PPD may appear within a few days of giving birth or may manifest itself more slowly, reaching its acute stage months after the woman has given birth. It may last from a few weeks to more than a year.

The mild version is often called “having the baby blues”. The new mother has mood swings — she goes from feeling on top of the world to suddenly beginning to cry. She often feels depressed, is unable to concentrate on anything, loses her appetite and is unable to sleep soundly. These symptoms start a few days after delivery and last about a week.

Many of us women have gone through this without thinking that this is a symptom of some disorder. We just think that we are overwhelmed by the responsibility that is suddenly on us. In fact, having the blues is considered a normal part of early motherhood      and        the         negative feelings that it entails usually go away within a fortnight of delivery. But women suffering not from “baby blues” but real PPD have more symptoms – or symptoms that last longer. For them, the mild sensation of feeling low that “being blue” entails turns into actual depression.

But few people recognize and understand this depression. The woman is told — in a bracing tone — that she should stop pampering herself. She should be grateful that she has such a beautiful baby and she should snap out of her bad mood. In other words, she is made to feel that she is being self-indulgent and selfish and hardly anyone understands that her feelings are out of her control.

What causes PPD? Doctors aren’t sure, but they think that it is probably due to fluctuating hormonal levels. Again, why hormonal fluctuations take place more in some women and less or not at all in others is a question that doctors cannot answer. But they have seen that, once hormonal levels settle down at normal, pre-pregnancy levels, the depression goes away.

This means that PPD can be treated with antidepressants and hormones. But the treatment doesn’t always work well and the real cure is when the body suddenly decides to snap out of it and come back to normal.

Facts about PPD

  • An illness: It is important that women suffering from PPD realize that it is an illness like any other. They are not responsible for their condition in any way. So they should not feel guilty about their emotions and actions.
  • Symptoms: If women suffering from a PPD suffer from loss of appetite, either insomnia or sleeping more than usual, loss of interest in life, lowered energy levels, lack of motivation to work, crying bouts, lowered levels of self-confidence, an overwhelming    sense    of hopelessness, guilt, disinterest in the baby and worry about hurting it, panic attacks, constantly feeling worried, quick and unexplained weight loss or gain and they sometimes feel suicidal.
  • Can start at any time: Though for most victims of PPD, the symptoms begin soon after childbirth, for some others they start some weeks or even months later. Occasionally, they start even before the baby is born.
  • Who is at risk of getting PPD? Though any woman can get it, some are more at risk than others. These include those who do not have happy marriages or family members to whom they are close to whom they can talk freely. Women who suffer from severe premenstrual syndrome (PMS) are also at higher risk because they already have hormonal problems. Women who have suffered from PPD after the birth of earlier children or who have suffered from depression earlier in life are also at higher risk. Stressful events like a divorce, the death of a close relative or friend, etc., also increase risk. More first-time mothers get it than women who have already gone through the ordeal of childbirth.
  • Causes: The exact causes aren’t yet known. But it is thought that the hormonal changes that take place during pregnancy and childbirth produce chemical changes in the brain and that these cause the basic depression that causes all the other symptoms of PPD.
  • Duration: PPD can continue from the period of a week or so to some months and to even more than a year.
  • Treatment: PPD can be treated with therapy or medicines. Just talking to a person who has suffered from the condition can also help. If you are breast- feeding, you should tell the doctor this if she prescribes anti- depressants for you.

If you find yourself suffering from PPD: If tell yourself that you are not the first and will not be the last to suffer in this fashion. You do not hate your baby and you are not going mad. So do not keep quiet because you feel guilty. Talk to someone you trust about your feelings and symptoms. If yours is a severe case, you need to see a doctor or psychiatrist immediately. If yours is not a severe case, you still mustn’t take it too lightly.

Explain the situation to your husband and ask him to help you with the housework and baby till you regain your energy. Get yourself domestic help/nanny or ask a relative to come and help you for a while. Take your mind off your problems by reading, exercising, going for walks, meditating,   etc.   Above   all,   tell yourself repeatedly that you are going through something that is quite normal for a woman. You’re, after all, trying to come to terms with something overwhelming – being totally responsible for another human being. And, if your body doesn’t cooperate with you, things can become a little too much to cope with for a while.

An interesting tidbit of information: Recent research has shown that after becoming fathers men too have a tendency to suffer from depression and symptoms similar to those which a woman with PPD suffers from. This is usually caused by the pressures of increased responsibility,  increased expectations, decreased sleep, worry, confusion about what being a father means, the upheaval that a baby brings about in a home and an increased burden of work if the mother suffers from PPD.

There are no hormonal and chemical changes involved here, but the depression and other symptoms bear witness to the fact that men too are vulnerable at this time. So, perhaps, it makes sense that a man too should be given “paternity leave” after his wife gives birth to a child!

 

We are fond of saying sentimentally that a woman feels really fulfilled only after she has a baby. That only when she holds her bundle of joy in her arms does          she understand                what it really means to be a woman.

But, emotion aside, pregnancy and childbirth result in a complex mix of physical, hormonal, emotional and behavioral changes taking place in a woman and this whole package can affect her in various ways at different times. During pregnancy, for example, she could sometimes feel excited, full of energy and deliriously happy, but at other times, she could also have headaches and feel overwhelmed, tired and flustered.

Going through labour and successfully giving birth to a child invariably makes a woman feel that she has done something marvelous and she cannot stop smiling. Later, the world intrudes and so does worry at the responsibilities that have now fallen on her shoulders. This worry makes 90 per cent of mothers depressed and fearful but, as they begin to cope with baby-care, this depression disappears. Yet, for about a quarter of the new mothers, the depression persists for some weeks and they need help in both, caring for their babies and in coming to terms with their feelings. This help is usually provided by their families.

Negative Feelings

And, occasionally (in about 0.2 per cent of the cases), the mother’s negative feelings are so strong that she feels as if the world around her is all black and that she is drowning in a sea of depression. She feels unable to move and is unwilling to care for her baby because she feels no emotional bond with it.

In some cases, she does not even want to feed or touch the baby. Since this depression occurs after birth (or postpartum), it is called postpartum depression (PPD) or Peripartum depression. Very occasionally, usually in very severe cases, the physical and emotional symptoms of acute          depression manifest themselves even before the delivery.

PPD may appear within a few days of giving birth or may manifest itself more slowly, reaching its acute stage months after the woman has given birth. It may last from a few weeks to more than a year.

The mild version is often called “having the baby blues”. The new mother has mood swings — she goes from feeling on top of the world to suddenly beginning to cry. She often feels depressed, is unable to concentrate on anything, loses her appetite and is unable to sleep soundly. These symptoms start a few days after delivery and last about a week.

Many of us women have gone through this without thinking that this is a symptom of some disorder. We just think that we are overwhelmed by the responsibility that is suddenly on us. In fact, having the blues is considered a normal part of early motherhood      and        the         negative feelings that it entails usually go away within a fortnight of delivery. But women suffering not from “baby blues” but real PPD have more symptoms – or symptoms that last longer. For them, the mild sensation of feeling low that “being blue” entails turns into actual depression.

But few people recognize and understand this depression. The woman is told — in a bracing tone — that she should stop pampering herself. She should be grateful that she has such a beautiful baby and she should snap out of her bad mood. In other words, she is made to feel that she is being self-indulgent and selfish and hardly anyone understands that her feelings are out of her control.

What causes PPD? Doctors aren’t sure, but they think that it is probably due to fluctuating hormonal levels. Again, why hormonal fluctuations take place more in some women and less or not at all in others is a question that doctors cannot answer. But they have seen that, once hormonal levels settle down at normal, pre-pregnancy levels, the depression goes away.

This means that PPD can be treated with antidepressants and hormones. But the treatment doesn’t always work well and the real cure is when the body suddenly decides to snap out of it and come back to normal.

Facts about PPD

·         An illness: It is important that women suffering from PPD realize that it is an illness like any other. They are not responsible for their condition in any way. So they should not feel guilty about their emotions and actions.

·         Symptoms: If women suffering from a PPD suffer from loss of appetite, either insomnia or sleeping more than usual, loss of interest in life, lowered energy levels, lack of motivation to work, crying bouts, lowered levels of self-confidence, an overwhelming    sense    of hopelessness, guilt, disinterest in the baby and worry about hurting it, panic attacks, constantly feeling worried, quick and unexplained weight loss or gain and they sometimes feel suicidal.

·         Can start at any time: Though for most victims of PPD, the symptoms begin soon after childbirth, for some others they start some weeks or even months later. Occasionally, they start even before the baby is born.

·         Who is at risk of getting PPD? Though any woman can get it, some are more at risk than others. These include those who do not have happy marriages or family members to whom they are close to whom they can talk freely. Women who suffer from severe premenstrual syndrome (PMS) are also at higher risk because they already have hormonal problems. Women who have suffered from PPD after the birth of earlier children or who have suffered from depression earlier in life are also at higher risk. Stressful events like a divorce, the death of a close relative or friend, etc., also increase risk. More first-time mothers get it than women who have already gone through the ordeal of childbirth.

·         Causes: The exact causes aren’t yet known. But it is thought that the hormonal changes that take place during pregnancy and childbirth produce chemical changes in the brain and that these cause the basic depression that causes all the other symptoms of PPD.

·         Duration: PPD can continue from the period of a week or so to some months and to even more than a year.

·         Treatment: PPD can be treated with therapy or medicines. Just talking to a person who has suffered from the condition can also help. If you are breast- feeding, you should tell the doctor this if she prescribes anti- depressants for you.

If you find yourself suffering from PPD: If tell yourself that you are not the first and will not be the last to suffer in this fashion. You do not hate your baby and you are not going mad. So do not keep quiet because you feel guilty. Talk to someone you trust about your feelings and symptoms. If yours is a severe case, you need to see a doctor or psychiatrist immediately. If yours is not a severe case, you still mustn’t take it too lightly.

Explain the situation to your husband and ask him to help you with the housework and baby till you regain your energy. Get yourself domestic help/nanny or ask a relative to come and help you for a while. Take your mind off your problems by reading, exercising, going for walks, meditating,   etc.   Above   all,   tell yourself repeatedly that you are going through something that is quite normal for a woman. You’re, after all, trying to come to terms with something overwhelming – being totally responsible for another human being. And, if your body doesn’t cooperate with you, things can become a little too much to cope with for a while.

An interesting tidbit of information: Recent research has shown that after becoming fathers men too have a tendency to suffer from depression and symptoms similar to those which a woman with PPD suffers from. This is usually caused by the pressures of increased responsibility,  increased expectations, decreased sleep, worry, confusion about what being a father means, the upheaval that a baby brings about in a home and an increased burden of work if the mother suffers from PPD.

There are no hormonal and chemical changes involved here, but the depression and other symptoms bear witness to the fact that men too are vulnerable at this time. So, perhaps, it makes sense that a man too should be given “paternity leave” after his wife gives birth to a child!

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