Post-natal depression has almost tripled during coronavirus pandemic, study finds

‘The social and physical isolation measures are taking a toll on the mental health of many of us,’ says researcher

Depression among expectant and new mothers has almost tripled during the coronavirus pandemic, new research has found.

The study, which was conducted by the University of Alberta in Canada, showed that the number of women reporting symptoms of maternal depression has increased to 41 per cent compared to 15 per cent before the outbreak began.

In addition, the number of women expediting moderate to high anxiety symptoms has risen from 29 per cent to 72 per cent.

The survey included 900 women, 520 of whom were pregnant and 380 of whom had given birth in the past 12 months, and each participant was asked about their depression and anxiety symptoms before and during the pandemic.

Pregnant women and those who have recently given birth are already at a greater risk of depression and anxiety, with around one in seven struggling with symptoms just after having a baby.

However, the researchers found that the global health crisis has exacerbated those struggles, with the likelihood of maternal depression and anxiety having “substantially increased”.

“The social and physical isolation measures that are critically needed to reduce the spread of the virus are taking a toll on the physical and mental health of many of us,” explains Dr Margie Davenport, co-author of the study.

“We know that experiencing depression and anxiety during pregnancy and the postpartum period can have detrimental effects on the mental and physical health of both mother and baby that can persist for years.”

Dr Davenport added that effects of maternal depression can include premature delivery, reduced mother-baby bonding, and developmental delays in infants.

Annie Belasco, head of charity at the PANDAS Foundation – an organisation that gives support to people coping with pre and postnatal mental illnesses – added that while Covid-19 and lockdown do not “cause” postnatal depression, the circumstances and additional stress resulting from them could certainly contribute.

“We know that parents who have a diagnosis are particularly vulnerable during this time as their 'normal coping mechanisms' day to day are not able to take place,” she told Yahoo.

“Disturbance of routine, anxiety around the political and economical state have also contributed to parents with or without a diagnosis of perinatal mental illness that can create heightened anxiety and stress which can also magnify depression and low mood.”

According to the NHS, postnatal depression can affect women in different ways. It can start at any point in the first year after giving birth and may develop suddenly or gradually.

Some common symptoms include a persistent feeling of sadness and low mood, loss of interest in the world around you, lack of energy, trouble sleeping and feeling that you're unable to look after your baby.

(Source: Independent)

Miscarriage can lead to 'long-term post-traumatic stress'

One in six women who lose a baby in early pregnancy experiences long-term symptoms of post-traumatic stress, a UK study suggests.

Women need more sensitive and specific care after a miscarriage or ectopic pregnancy, researchers say.

Toni Edwards-Beighton, 36, says she felt she was losing her mind after a miscarriage in 2016.

"I felt my grief was wrong because it wasn't a real baby - but I was in complete shock," she says.

Warning: Some readers may find part of this article distressing

Toni with her daughter, Willow

Toni and husband Matt, from Leicester, had been told their baby had no heartbeat at 12 weeks, before she miscarried naturally at home in the bathroom.

But she didn't expect to bleed heavily for eight days and then have to go through painful contractions.

"I thought I was going mad," she says.

"I had no information about what what would happen to me or what I could expect to see."

Panic and anxiety

In the end, something "recognisable and the size of a palm" fell between her legs in the middle of the night.

When she called the hospital the following day, they told her to "bring the pregnancy tissue in and we'll get rid of it".

"It wasn't 'tissue' to me, it was our baby," Toni says.

In the weeks that followed, she started to panic about everything, especially their daughter who was four at the time.

"I worried she was going to die - I could see her falling to the ground."

Months later, Toni's GP diagnosed her with PTSD (post-traumatic stress disorder) and offered her counselling - but she didn't go because by that time she was pregnant again.

"The following nine months were awful - I was convinced I'd lose my baby again," she says.

Toni and Matt now have two daughters, Phoebe who is eight and Willow who is two.

In the study of 650 women, by Imperial College London and KU Leuven in Belgium, 29% showed symptoms of post-traumatic stress one month after pregnancy loss, declining to 18% after nine months.

Most had been through an early miscarriage before 12 weeks - while the rest had had an ectopic pregnancy.

The women, who attended three London hospitals - Queen Charlotte's and Chelsea, St Mary's, and Chelsea and Westminster, completed questionnaires about their feelings over the course of a year.

One month following their loss, 24% had symptoms of anxiety and 11% of depression.

This reduced to 17% and 6% after nine months, the study in the American Journal of Obstetrics and Gynaecology found.

Dr Jessica Farren, specialist registrar and clinical fellow at Imperial College London, said miscarriage could be a very traumatic experience.

"For some women, it's the first time they have experienced anything beyond their control.

"These can be profound events which stay with you."

Even though these losses are at a very early stage, "women are looking for validation for them", Dr Farren says.

Being told it's "only a bag of cells" is not always helpful.

Among a control group of women who had healthy pregnancies, 13% had symptoms of anxiety and 2% of depression one month after giving birth.

'Need for change'

The study recommends that women who have miscarried are screened to find out who is most at risk of psychological problems.

Counselling and support will help many women, but those with symptoms of PTS need specific treatment if they are going to recover, the research says.

This can range from cognitive behavioural therapy (CBT) to medication, and should be given by a qualified professional.

An earlier, smaller study from 2016 found that early pregnancy loss could trigger symptoms of post-traumatic stress.

"For too long, women have not received the care they need following a miscarriage and this research shows the scale of the problem," says Jane Brewin, chief executive of miscarriage and stillbirth charity Tommy's.

"Miscarriage services need to be changed to ensure they are available to everyone and women are followed up to assess their mental wellbeing with support being offered to those who need it, and advice is routinely given to prepare for a subsequent pregnancy."

Facts about early pregnancy loss

• One in four pregnancies ends in miscarriage in the UK - with most happening early before 12 weeks
• There are 250,000 miscarriages every year and 10,000 ectopic pregnancies
• Miscarriage is the loss of a pregnancy during the first 23 weeks
• An ectopic pregnancy is one that develops outside the uterus, or womb

(Source: BBC)

Why is Indian women’s mental health the last priority on everyone’s mind?

Fear of social stigma means that we tend to hide any issues of Indian women’s mental health until it is too late. This May, Mental Health Month, let’s address this.

Indian women are at the verge of a mental health crisis like never before and need respite, care and space.

A news report claims that more than 20,000 housewives took their lives in India in 2014. This was the year when 5,650 farmers killed themselves in the country.

Why women’s mental health issues?
Gender is often a critical determining factor in mental health and mental illness. Patterns of psychological distress and even psychiatric disorders among women vary from those seen among men. Women exhibit a higher tendency of internalizing disorders while men externalize the same more.

According to surveys and studies by mental health professionals in India, it’s more common for women to be abandoned if diagnosed with a mental illness.

According to a 2016 report by the National Commission for Women, families that willingly abandoned their mentally ill women members most often do so because of huge associated social stigma. Other logistic reasons that influence such decisions more adversely in case of women as compared to men are lack of space in households, inability of caregivers or fear for the safety of the suffering women causing harm to themselves or others living with them.

Depression biggest women’s mental health issue
Unipolar depression, predicted to be the second major cause of global disability by 2020, is two times as common in women.

It is a well-known fact that an estimated 80% of people affected by violent conflicts, civil wars, disasters, and displacement are mostly women and children. India is no different and in addition to these socio-economic and natural factors around two-thirds of married women in India were victims of domestic violence. Depressive disorders cause 41.9% of disability among women compared to 29.3% among men. Even among the elderly those suffering from depression and dementia are mostly women.

Symptoms of depression are common in men and women overall, though women manifest them differently. For instance they often slip into “reverse vegetative” symptoms such as increased appetite and weight gain, which further leads to loss of self-esteem and anxiety disorders, the severity of symptoms of which is again higher in women.

Why is this so gendered?
During their entire lifetime, women are faced with various common life stressors like puberty, menstruation, childbirth and maternity, being primary caretakers for the old and unwell of the family.

In conventional societies like India women are comparatively less empowered due to lesser opportunities of education and employment, and general discrimination and taboos against their sexuality and existence. Even the financially secure and upwardly mobile women fear to cross social demarcations, and thus remain constantly vulnerable on the mental health front.

A research paper in the Indian Journal of Psychological Medicine states:

“In the Indian scenario, a man is always treated as an asset wherein families try to accommodate men even though with the difficulties and the wife or parents will act as a source of support to them. However, for the women, the situation is entirely different. The widow is abandoned; the divorced one is consistently blamed; the single one is frequently questioned about the illness; and the married women are always shuttled between the family of origin and the family of procreation.”

Women’s mental health is often the least prioritized subject matter in our families. The gender stereotypes in our feudal and patriarchal Indian society get accentuated by discrimination and several restrictions on women.

The clichés like “Great Indian All-sacrificing Motherhood” and “Good Indian Women” who always put others first further leave very little space for Indian women to negotiate and care for their own mental health, and prevent them from putting themselves first ever.

(Source: Women's Web)

'I would not have kept the baby': Fighting depression in pregnancy

About 450 million people worldwide currently suffer from a mental health condition, making it one of the leading causes of ill health. Could it be that others within their community hold the key to help solve this problem?

People in high-income countries often face a lack of mental health services, but in middle and low-income countries the scale of the problem can be much worse.

Millions with conditions like depression, anxiety and schizophrenia struggle to get treatment due to lack of resources and the stigmatisation of mental health problems.

Pregnant women are a particularly at-risk group.

In Kenya, for example, symptoms of depression such as fatigue and sleep problems are sometimes dismissed as purely symptoms of pregnancy, or even blamed on witchcraft.

This lack of medical attention, combined with high rates of domestic violence contributed to a 0.5% maternal mortality rate in 2015, one of the highest in the world.

Depression in pregnancy is also associated with low birth weight, maltreatment and problems breastfeeding.

Many pregnant women in rural Kenya use the services of a birth attendant

One million people without a psychiatrist
Kenya has only two mental health professionals for every 100,000 people, and they are concentrated in urban areas. This means some rural counties have a population of millions, but no psychiatrists.

An estimated 75% of people with mental health conditions in poorer countries can't access medical treatment. This means many to turn to non-specialist traditional healers, faith healers and community health workers instead.

We discovered that training these groups to screen for mental health conditions could drastically reduce the number of people who can't access treatment.

Building on these findings, traditional birth attendants were trained to screen for depression in more than 1,700 pregnant women in a pilot study by the Africa Mental Health Research and Training Foundation.

The study took place in Makueni County, a largely rural part of south-eastern Kenya. One of the country's poorest counties, it has no resident psychologists.

Makueni is a largely rural part of south-eastern Kenya, with a population of almost one million people

Who are traditional birth attendants?

• Birth attendants are often the first point of contact for pregnant women in rural Africa
• While not medically trained, they perform a similar role to midwives
• Learning through apprenticeships, they usually receive money or payments in kind from the woman's family
• As well as delivering the baby, birth attendants reassure women and help them prepare for becoming a mother, while trying to reduce family conflict.
• The birth attendants used the Edinburgh Postnatal Depression Scale questionnaire and then a WHO mental health intervention guide, both of which are designed for use outside of clinics and hospitals

Domestic violence
The results of the screening were striking.

A quarter of the mothers in the study were found to have mild to moderate depression. Three-quarters had experienced intimate partner violence, whether physical, sexual or emotional abuse, or controlling behaviour. Half are victims of at least two forms of this violence.

Nearly 60% of the mothers diagnosed with depression received treatment from their birth attendant based on a World Health Organization programme designed for use by non-specialists.

One role of a birth attendant is to talk through any problems a pregnant woman might be having

The mothers were 26 years old on average, with almost half aged between 12 and 24.

One young mother involved in the study, Ndanu*, was diagnosed with depression.

She said: "If it were not for this programme and the help of a birth attendant, I would not have kept this baby to term and perhaps not gone for all the antenatal visits.

"The birth attendant counselled me, encouraged me to keep the baby by telling me that it was not my fault and children are a blessing and that I should visit the health centre for antenatal care. She promised to check on me and opened her house for me to talk to her whenever I wanted"

The mental health training was based on a WHO programme for non-specialists

Birth attendants intervened by talking through problems, involving supportive family members, and flagging any signs of mistreatment.

They encouraged depressed mothers to exercise and maintain a regular sleep cycle, rebuild their social networks and resume activities which they'd previously enjoyed. The mothers were also given the opportunity to take part in community activities and join support groups.

Mueni*, a birth attendant taking part in the study, said: "A pregnant mother opens up to us and we try to understand the reasons for her depression, we solve the issues through guidance and counselling. If the issue is rooted on her parents or her spouse, we engage them and we reach an agreement."

Mothers who received the treatment saw their depressive symptoms fall by 55% at the end of three months, compared to 26% of those who didn't have a specific intervention.

Discreet mental health services
These early findings suggest training birth attendants in mental healthcare could improve the wellbeing of mothers and their children, not just in Kenya but in any countries where similar community health workers operate.

Birth attendants are usually accessible and have a good relationship with their patients, meaning they are well placed to offer low-cost, discreet mental health services.

Training up more psychiatrists would be helpful, but this takes a lot of time and funding.

Birth attendants could bridge the gap by offering an accessible, acceptable level of basic mental health care in under-resourced areas, while still providing a link between healthcare professionals and pregnant mothers.

*Names have been changed

(Source: BBC)

Stress in pregnancy 'makes child personality disorder more likely'

The children of women who experience severe stress when pregnant are nearly 10 times more likely to develop a personality disorder by the age of 30, a study suggests.

Even moderate prolonged stress may have an impact on child development and continue after a baby's birth, it said.

More than 3,600 pregnant women in Finland were asked about their stress levels, and their children followed up.

Psychiatrists say mums-to-be must have access to mental health support.

Other important factors, such as how children are brought up, the family's financial situation and trauma experienced during childhood, are known to contribute to the development of personality disorders and could have played a role.

What is a personality disorder?
It means that certain aspects of someone's personality make life difficult for them and for other people.

They can be overly anxious or emotionally unstable, for example, or paranoid or anti-social - there are a wide range of types.

Personality disorders are thought to affect about one in 20 people.

They are more likely to have other mental health problems, such as depression, or drug and alcohol problems.

Like other mental disorders, upbringing, brain problems and genes can play a part in their development.

What did the study do?
Every month during pregnancy, the study - in the British Journal of Psychiatry - asked women to answer questions about their mental stress levels.

They had to say if they had notable stress, some stress or no stress.

The women lived around Helsinki, Finland, and their babies were born between 1975 and 1976.

When those children turned 30, any diagnoses of personality disorder were noted - there were 40 in total, which were all severe cases involving admission to hospital.

What did it find out about stress?
The study found prolonged, high levels of stress during pregnancy could have a potentially long-lasting effect on children.

Children exposed to severe maternal stress were 9.53 times more likely to develop a personality disorder than those whose mothers experienced no stress.

Those exposed to moderate stress had four times the chances.

This could be stress related to relationship problems, social factors or psychological problems, for example.

Why is stress damaging?
It's not known how stress in pregnant women could increase the risk of personality disorders - it could be down to changes caused in the brain or the result of inherited genes, or a number of other factors in the children's upbringing.

The researchers tried to tease out the effects of stress alone, by controlling for other factors such as the psychiatric history of the pregnant women, whether they smoked during pregnancy or had depression.

Previous research has found links between stress in pregnancy and the development of depression, anxiety and schizophrenia.

What can be done?
Dr Trudi Seneviratne, who chairs the perinatal faculty at Royal College of Psychiatrists, said pregnancy could be a stressful time and mums-to-be needed support.

"If stress isn't tackled, there is a high chance it will spill into the post-natal period," she said.

"It's a really sensitive thing to talk about.

"We don't want parents to think they are damaging their children - but high levels of stress do affect us."

She said NHS England had dramatically improved perinatal mental health services in recent times.

How can stress be reduced during pregnancy?
Women should be supported at home and work during pregnancy and given coping strategies for when they were stressed, Dr Seneviratne said.

"They need to learn to rest, to ask for support and talk to someone about how they are feeling."

Eating a balanced diet, stopping smoking and getting regular sleep is also advised.

More advice is available from the Royal College of Psychiatrists' website and NHS UK.

And after the birth?
Lead study author Ross Brannigan, from the Royal College of Surgeons in Ireland, said: "This study highlights the importance of providing mental health and stress support to both pregnant women and families during the antenatal and postnatal period."

Your midwife or health visitor should ask if you have ever had problems with your mental health in the past and whether you have feelings of hopelessness after your baby is born.

You should be offered support from health professionals to help you manage your feelings.

(Source: BBC)

Motherhood hid my depression

There was a time, in my early twenties, when I was so full of energy and pep that people often asked if I used to be a cheerleader in high school. I surely was not . . . not because I dislike cheerleaders—I’m just not what you would call graceful.

I was full of spunk and excited about life. I had two great jobs, had just finished my first Bachelor’s degree, started my second, and was preparing to marry the love of my life.

In 2012, I married that man, graduated a second time, and we started to plan our lives together.  Everything seemed like it was as good as it would ever be.

Then came time for us to start a little family together. Even though it took a little longer than I would have liked, we welcomed a beautiful baby girl in 2014. The next year was a whirlwind of staying up all night, sleeping most of the day, and sludging my way through being a homemaker. At that time, I can honestly say the thought of postpartum depression never even crossed my mind. I had limited resources and just assumed every new mom felt like this. I was overwhelmed, under stimulated, and totally out of sorts. I figured things would settle at some point and I would get back to feeling normal (not that I knew or know now what being normal even means).

In 2016, a sweet, chunky baby boy joined our brood and I was sure it was what I needed to feel complete. This would make me feel full and I would finally be content with my life.

For a long time—too long—I let myself and everyone around me believe I was fine.  I told friends I was just tired, and that my babies were hard work, but I was coping well.

Spoiler alert: I wasn’t.

One day, when my son was about five months old, my mom, who lives hours away, pointed out to me that I hadn’t sent her any pictures of the kids for almost a week. This didn’t seem right, as I always send her pictures, so I looked at my phone and realized I hadn’t even taken a picture of either of my kids in a week.

Talk about a slap in the face.

My two babies had been growing and changing and learning right in front of my face and I hadn’t even been noticing it.

That was when I realized maybe I wasn’t OK. That day, I made an appointment with my midwife, went to her office, and cried. I honestly couldn’t believe I had missed ALL the signs, after months of preparation and reading for this baby.

This has more than a year-long battle of trying to find a medication that works, dealing with the side effects, feeling terrible, and fighting debilitating migraines. I would love to say I am further along in my journey than I was when I started, but the truth is sometimes I feel like I get so caught up in worrying about my family that I move backward instead of forward.

During this year, I lost a friend to the terrible battle that depression creates. I realized so many things because of this loss, the most important being that suffering in silence is dangerous.

My depression, anxiety, and whatever else is happening in my brain is real. Even though I know it affects me the most, I have come to realize just how much it affects everyone invested in my life.

It took me a long time to come to terms with the fact that my brain just acts a little bit funny sometimes, but that mental illness is something that is happening TO me and not BECAUSE of me.

My brain betrayed me, but I will not let it define me.

So if you are somewhere in between struggling to get out of bed and giving up, please remember: you are not alone. There is always some who feels the way you do, or is at least willing to listen to you bare your soul.

I have found amazing people who have been willing to dive in headfirst and hold my hand as I walk through the jungle that is my mind; I hope you can too.

(Source: Her View From Home)

Postpartum psychosis claimed Molly Roth. Her husband hopes to save others

Molly Roth wanted three children, just like her mother had.

Getting to two, however, proved harder than she and her husband, Jamison Roth of Norwalk, had imagined. There would be four years and oneectopic pregnancy between the births of her children, Jaxon and Gracelyn.

But two weeks after Gracelyn arrived Jan. 5, Molly encountered her biggest hurdle. A nurse practitioner called it the “baby blues,” a benign term for a sometimes monumental change that affects about one in five new mothers. Normally a whirlwind of energy, the 32-year-old Molly, who used to make sure everyone else was OK, now had to drag herself through the motions of daily life. She would cry uncontrollably and say she had made a mistake.

About a month in, she was diagnosed with postpartum depression and put on a handful of medicines, Jamison says. By then she was struggling just to bathe: "I had to show her the simple steps of turning on the water and getting a towel." She talked of suicide. What she was suffering from, according to Jamison, was actually a rarer, more dangerous perinatal mood disorder called postpartum psychosis, compounding her existing anxieties.

For Jamison, 35, it was as if a stranger had taken up residence in his wife’s body. The fun-loving mom and wife, the extraordinary organizer, the smartest person he knew, had been replaced by a shell.

Molly Roth with her baby Gracelynn, born Jan. 5 

Molly spent time in Lutheran Hospital’s mental-health unit but came out and overdosed on ibuprofen. She then spent 10 days in Mercy’s mental health wing. Both times her husband says she was with serious substance abusers, though she wasn't one.

Things improved for two weeks. She started a new job. “She was back to her old self, joking around and being happy,” says her husband. Now he thinks it was probably the drugs finally kicking in. It didn't last. The Wednesday after Easter, he came home to find his wife had hanged herself.

Jamison's mother has moved in to help care for the kids, but Jamison says he lost half of himself.  Their 4-year-old son sings a song: “Mom, I miss you. Please come back.” Jamison forces himself to stay upbeat but struggles to understand: How is so little known about postpartum illness when even heart disease has treatments? Hospitals have wings for new babies to rest, but why not for new mothers?

"They should treat them like queens, not mental (cases). They haven’t done anything but have a baby. They did everything they were supposed to,” he said.

Postpartum depression is said to result from some combination of fatigue, hormonal imbalance and depression. Postpartum psychosis, which affects one or two in 1,000 new mothers, may be accompanied by hallucinations and fantasies of dying or killing one's baby.

Many of us learned of it after Heidi Anfinson’s two-week old son vanished in 1998 and turned up under a pile of rocks in Saylorville Lake. Anfinson spent 12 years in prison for killing him before a parole release in 2012. She said she left  him unattended in a bathtub during what she and supporters said was postpartum psychosis.

Jaxon Roth, 4, imitates his mother Molly rubbing her pregnant belly. 

After one hung jury, then a conviction and 50-year sentence, Iowa’s Supreme Court ordered a new trial in 2009 because her attorney had presented no evidence of mental illness.

In the documentary, “When the Bough Breaks,” one women describes “a sheet of glass” separating her from her infant. A psychiatrist says people with a history of depression, obsessive-compulsive disorder or bipolar disorder are most at risk for postpartum problems.

The Roths were each other’s yang and yin, says Jamison: “I was the one who calmed our family down and she was the one who pumped our family up.” But Molly was sensitive and her feelings were hurt easily and there had been disruptions in their lives during her pregnancy.

A few months before Gracelyn was born in January, Molly lost her hotel job in what she believed was pregnancy-related discrimination. In December, Jamison’s job as product manager for a medical supply company was eliminated. They lost health insurance. Friends helped support them through a GoFundMe account, and both found new jobs. His started in late February and hers in early March. She thrived in it those first few weeks, he said.

When her spirits improved, Molly wrote down some advice for others experiencing what she had. “You are not alone,” she wrote. “There IS help and it WILL get better.” She urged getting professional therapy and checking yes to a question on depression on a form given to new mothers in the hospital. It would help them connect with resources later, if necessary, she wrote.

How could she know so much yet be unable to save herself? Hanna Engel-Brower, her general practitioner, says, "She did everything she could and her family did everything they could," but Molly's symptoms were too severe for even the aggressive medications she got.

In Britain, postpartum depression and psychosis are recognized to the extent that women aren't prosecuted for killing their babies in the first year. In the U.S., we've made great strides in demystifying the childbirth process and decreasing reliance on unnecessary medications and C-sections. Yet childbirth and new parenthood can be mentally and physically traumatic and socially isolating. And neither our workplaces, our healthcare system, nor our nuclear family units are always equipped to handle it.

New mothers are out of the hospital in two days and expected back at work in six weeks. They aren't universally screened for depression. Engel-Brower adds to that a severe shortage of mental health care and coverage in Iowa. She recommends all women be told of possible postpartum problems before they ever get pregnant. She thinks stigma and shame prevent many from getting help.

Women have been relied on to perpetuate the human race, yet too little attention has been paid to their emotional well-being in the process. Jamison Roth hopes his family's tragedy can help change that. He is partnering with the National Alliance on Mental Illness to educate people on postpartum depression. They're holding a public celebratory event July 22 from 11 a.m. to 4 p.m. at Fort Des Moines Park, with food, a raffle and information.

(Source: Desmoinesregister)

Having kids lowers women’s self-esteem for at least three years

Becoming a parent is full of contradictions: It’s a time in life when love and meaning and joy crash headlong into worry and exhaustion, so much so that some new parents struggle to maintain their own identity. A new study out of the Netherlands suggests that this is especially true for mothers.
Led by researchers at the University of Tilburg, psychologists analyzed survey data collected from more than 84,000 Norwegian women between 1999 and 2008. Women completed surveys at two points during their first pregnancies, and at three points after the birth of their children, with the last being 36 months after birth. Some of the women also completed the same surveys before and after the birth of second, third, and fourth children.

The researchers found a consistent pattern: Women experienced declines in self-esteem during their pregnancies, and then increases in the six months afterwards. But then their self-esteem declined once again, and continued falling. By three years into their child’s life, it was still lower than their original “baseline.” Because they didn’t keep collecting data, researchers don’t know if the dip lasted even longer, but they do know it wasn’t permanent: Women who completed the survey again for a subsequent child had returned to their baseline by the time the process began anew.

The researchers noted several possible reasons for a decline in self-esteem during pregnancy, including physical changes to the body, rampant hormones, stress over the baby’s development, and concerns about the future.

After birth the picture gets more complex, and another clue might lie in the study’s other major finding. At the same key intervals, researchers also asked women to evaluate their relationships. They found that women’s estimation of their romantic partners remained fairly steady during pregnancy, but fell dramatically right after the baby was born. The same effect was also noticeable, to a lesser extent, after subsequent children were born.

Of course, not all women experienced either loss of self-esteem or adverse relationship effects, and this allowed the researchers to identify a correlation: Women who reported lower self-worth also tended to report relationship declines. It’s impossible to say whether one caused the other, but it’s clear that having a troubled relationship and feeling worse about oneself are related experiences, both of which tend to be exacerbated by having kids.

The research is forthcoming in the Journal of Personality and Social Psychology. Previous studies found that, in general, self-esteem has a trajectory over life: High in childhood, declining in adolescence, rising through adulthood and dropping again in old age. The new study adds nuance. Though it doesn’t account for fathers’ experiences, parenting emerges as one of the big challenges when it comes to valuing yourself.

(Source: Quartz)

Postpartum depression: Deromanticizing motherhood

Motherhood is one of the most romanticized experiences, with mothers being seen as the ideal women. Facts that run contrary to the myth of the perfect experience, are brushed apart. One such experience is postpartum depression (PPD) – a form of depression women may get after childbirth, anytime during the baby’s first year but particularly during the first three weeks after birth. It is not limited to first-time mothers. Some of the common symptoms include feeling sad, hopeless and guilty about not wanting to care for the baby in ways you are expected to.

For this piece, I spoke to women who had experienced PPD and wanted to share their experiences anonymously. When asked about the level of awareness among medical professionals, family and friends about the reality of PPD, the response was consistent: typically the doctors only followed-up on the physical aspects of the post-pregnancy experience. While as medical professionals they were theoretically aware of PPD as a reality, there was little to no actual discussion about the issue or linking it to the women in front of the doctors. One respondent mentioned that her obstetrician said: “Yes, some women suffer it. It gets better”, while she was right there. Naturally, this made her feel that her pain was unseen and the doctor was not willing to have a true conversation with her.

SOCIETY HAS UNREALISTIC EXPECTATIONS OF HOW MOTHERS AND MOTHERHOOD SHOULD BE.

While families and friends may also be aware of the condition, there is a lot of stigma around discussing what it means and seeking help. Several women mentioned how the 40-day confinement period (when women are not supposed to move out of the house for the mother and baby’s health) worsened their feelings of sadness and hopelessness, since they were constrained to their house (whether they were at their natal home or otherwise). As depicted in various forms of media, society has unrealistic expectations of how mothers and motherhood should be – enamoured by their babies, to feel only happiness at being a mother, being completely focused on their babies, living in the ‘glow of motherhood’. Being depressed is simply not seen as an acceptable response and as with other forms of depression, considered something women can snap out of if they tried hard enough – as if you are lazy, if you experience depression.

Some of the women mentioned that having supportive husbands made the experience a little better, especially when they were limited to home and had a constant stream of visitors asking intrusive questions about everything from breastfeeding to the mother’s diet. The confinement and constant visitors were not the choices they would make but in this scenario, respondents mentioned ways in which they tried to make the best of this situation.

THEY WERE SEEN AS MOTHERS, NOT AS INDIVIDUALS IN THEIR OWN RIGHT.

When asked how they knew they had PPD (or as one respondent mentioned, a milder case of blues), respondents mentioned periods when they only wanted to cry and be left alone, or when they felt inadequate as a parent or mother. Others diagnosed themselves at first, using the Internet, and then followed it up with a visit to the doctor. Getting formal help came with its own stigma and not everyone chose to do it, despite knowing they would benefit from seeing a doctor. One respondent gave the example of taking up a time-consuming project at home to distract herself. While family did support new mothers with taking care of the baby, but they were disinclined to acknowledge PPD and brushed it off.

I asked the respondents what they wished they had known before their babies were born, responses were varied. One respondent mentioned she wished she knew how all barriers between her body, her parenting style, and society would be broken. Another spoke about wishing she and her spouse had discussed their roles after the baby’s birth with more clarity. Others felt that their feelings and suffering were minimized, if not ignored completely. They were seen as mothers only, not as individuals in their own right.

There are some online support groups but they are not enough and are not always free of judgment. Friends and family do have the potential to play a more supportive role but are limited by their own and societal prejudices and ignorance. Medical professionals in India are a long way away from acknowledging and setting aside their own biases about women’s lives and experiences. For now, women who are going to be mothers, are perhaps best served by building their own plan to deal with PPD – whether this mean finding the right doctor or educating their family and friends. None of this is easy and to be honest, none of this should be necessary. But until mental healthcare in India evolves to be a space where women (and people across the gender spectrum) can be seen without a biased lens, the burden of this work is left on individuals.

(Source: Feminism in India)

What happens to a woman's brain when she becomes a mother

Mapping the maternal brain is also, many scientists believe, the key to understanding why so many new mothers experience serious anxiety and depression. An estimated one in six women suffers from postpartum depression, and many more develop behaviors like compulsively washing hands and obsessively checking whether the baby is breathing. Here's an article on the topic in the Atlantic:

The artist Sarah Walker once told me that becoming a mother is like discovering the existence of a strange new room in the house where you already live. I always liked Walker's description because it’s more precise than the shorthand most people use for life with a newborn: Everything changes.

Because a lot of things do change, of course, but for new mothers, some of the starkest differences are also the most intimate ones—the emotional changes. Which, it turns out, are also largely neurological.

Even before a woman gives birth, pregnancy tinkers with the very structure of her brain, several neurologists told me. After centuries of observing behavioral changes in new mothers, scientists are only recently beginning to definitively link the way a woman acts with what's happening in her prefrontal cortex, midbrain, parietal lobes, and elsewhere. Gray matter becomes more concentrated. Activity increases in regions that control empathy, anxiety, and social interaction. On the most basic level, these changes, prompted by a flood of hormones during pregnancy and in the postpartum period, help attract a new mother to her baby. In other words, those maternal feelings of overwhelming love, fierce protectiveness, and constant worry begin with reactions in the brain.

Mapping the maternal brain is also, many scientists believe, the key to understanding why so many new mothers experience serious anxiety and depression. An estimated one in six women suffers from postpartum depression, and many more develop behaviors like compulsively washing hands and obsessively checking whether the baby is breathing.

“This is what we call an aspect of almost the obsessive compulsive behaviors during the very first few months after the baby’s arrival,” maternal brain researcher Pilyoung Kim told me. "Mothers actually report very high levels of patterns of thinking about things that they cannot control. They're constantly thinking about baby. Is baby healthy? Sick? Full?"

Scientists tracked differences in brain activity among

women looking at photos of their own babies versus

unfamiliar babies.

"In new moms, there are changes in many of the brain areas," Kim continued. "Growth in brain regions involved in emotion regulation, empathy-related regions, but also what we call maternal motivation—and I think this region could be largely related to obsessive-compulsive behaviors. In animals and humans during the postpartum period, there's an enormous desire to take care of their own child."

There are several interconnected brain regions that help drive mothering behaviors and mood.

Of particular interest to researchers is the almond-shaped set of neurons known as the amygdala, which helps process memory and drives emotional reactions like fear, anxiety, and aggression. In a normal brain, activity in the amygdala grows in the weeks and months after giving birth. This growth, researchers believe, is correlated with how a new mother behaves—an enhanced amygdala makes her hypersensitive to her baby's needs—while a cocktail of hormones, which find more receptors in a larger amygdala, help create a positive feedback loop to motivate mothering behaviors. Just by staring at her baby, the reward centers of a mother's brain will light up, scientists have found in several studies. This maternal brain circuitry influences the syrupy way a mother speaks to her baby, how attentive she is, even the affection she feels for her baby. It's not surprising, then, that damage to the amygdala is associated with higher levels of depression in mothers.

Amygdala damage in babies could affect the mother-child bond as well. In a 2004 Journal of Neuroscience study, infant monkeys who had amygdala lesions were less likely to vocalize their distress, or pick their own mothers over other adults. A newborn's ability to distinguish between his mother and anybody else is linked to the amygdala.

Activity in the amygdala is also associated with a mother's strong feelings about her own baby versus babies in general. In a 2011 study of amygdala response in new mothers, women reported feeling more positive about photos depicting their own smiling babies compared with photos of unfamiliar smiling babies, and their brain activity reflected that discrepancy. Scientists recorded bolder brain response—in the amygdala, thalamus, and elsewhere—among mothers as they looked at photos of their own babies.

Greater amygdala response when viewing their own children was tied to lower maternal anxiety and fewer symptoms of depression, researchers found. In other words, a new mother's brain changes help motivate her to care for her baby but they may also help buffer her own emotional state. From the study:

Thus, the greater amygdala response to one’s own infant face observed in our study likely reflects more positive and pro-social aspects of maternal responsiveness, feelings, and experience. Mothers experiencing higher levels of anxiety and lower mood demonstrated less amygdala response to their own infant and reported more stressful and more negatively valenced parenting attitudes and experiences.
Much of what happens in a new mother's amygdala has to do with the hormones flowing to it. The region has a high concentration of receptors for hormones like oxytocin, which surge during pregnancy.

"We see changes at both the hormonal and brain levels," brain researcher Ruth Feldman told me in an email. "Maternal oxytocin levels—the system responsible for maternal-infant bonding across all mammalian species—dramatically increase during pregnancy and the postpartum [period] and the more mother is involved in childcare, the greater the increase in oxytocin."

Becoming a parent looks—at least in the brain—a lot like falling in love.
Oxytocin also increases as women look at their babies, or hear their babies' coos and cries, or snuggle with their babies. An increase in oxytocin during breastfeeding may help explain why researchers have found that breastfeeding mothers are more sensitive to the sound of their babies' cries than non-breastfeeding mothers. "Breastfeeding mothers show a greater level of [brain] responses to baby's cry compared with formula-feeding mothers in the first month postpartum," Kim said. "It's just really interesting. We don't know if it's the act of breastfeeding or the oxytocin or any other factor."

What scientists do know, Feldman says, is that becoming a parent looks—at least in the brain—a lot like falling in love. Which helps explain how many new parents describe feeling when they meet their newborns. At the brain level, the networks that become especially sensitized are those that involve vigilance and social salience—the amygdala—as well as dopamine networks that incentivize prioritizing the infant. "In our research, we find that periods of social bonding involve change in the same 'affiliative' circuits," Feldman said. "We showed that during the first months of 'falling in love' some similar changes occur between romantic partners." Incidentally, that same circuitry is what makes babies smell so good to their mothers, researchers found in a 2013 study.

The neural correlates of maternal and romantic love, 2003 (University College London)

The greatest brain changes occur with a mother's first child, though it's not clear whether a mother's brain ever goes back to what it was like before childbirth, several neurologists told me. And yet brain changes aren't limited to new moms.

Men show similar brain changes when they're deeply involved in caregiving. Oxytocin does not seem to drive nurturing behavior in men the way it does in women, Feldman and other researchers found in a study last year. Instead, a man's parental brain is supported by a socio-cognitive network that develops in the brain of both sexes later in life, whereas women appear to have evolved to have a "brain-hormone-behavior constellation" that's automatically primed for mothering. Another way to look at it: the blueprint for mothering behavior exists in the brain even before a woman has children.

Perhaps, then, motherhood really is like secret space in a woman's brain, waiting to be discovered. "Although only mothers experience pregnancy, birth, and lactation, and these provide powerful primers for the expression of maternal care via amygdala sensitization," researchers wrote, "evolution created other pathways for adaptation to the parental role in human fathers, and these alternative pathways come with practice, attunement, and day-by-day caregiving."

In other words, the act of simply caring for one's baby forges new neural pathways—undiscovered rooms in the parental brain.

I didn’t know being a mother would be this hard

Becoming mother is not difficult, but managing it the whole life is difficult. Though many of us dream of becoming moms, looking after babies, we forget the fact that how our personal world becomes topsy-turvy. I have personally gone through it and always feel that being a mom is not that easy. The havoc pregnancy plays on our body and mental state is not measurable. The kind of exhaustion we feel each day cannot be explained. Here's a lovely article on HuffPo by a mom who feels the same:

For as long as I could remember I have wanted to be a mother. I dreamed about my pregnancies, I dreamed about what it would feel like to experience labor and delivery, and I longed for the days when I would be at home with my little tribe of beings. We’d play, I’d make amazing nutritious lunches, the TV would rarely be on and my children would certainly never use a tablet much less a smartphone. They’d ask me to read to them and we’d have afternoons where I’d spend hours reading and creating memories. The house, of course, would be totally easy to maintain. It didn’t take long for me to realize how flawed my dreams of motherhood was when I actually became a mother.

I didn’t know being a mother would be this hard.

I didn’t know the havoc pregnancy would wreak on my body and mental state.

I didn’t know how long and how hard I would have to work to get my body recovered from pregnancy.

I didn’t know the pure exhaustion I would feel at the end of each day.

I didn’t expect for my heart, who for so long desired to be a mother, to feel constantly divided into two pieces. One piece devoted to my children and the kind of mother I want to be; the other part constantly wanting to find that woman that I was before I became “mom.”

I didn’t know that there would be times when I would long to turn on that TV.

I didn’t know that the “Paw Patrol” theme song would become the sweetest sound to my ears. Why? Because for at least 21 minutes I can enjoy the sound of silence. Oh no, not silence in the way I was expecting but in the absence of 5 million questions about what we’re going to do today, tomorrow, and the day after that.

I didn’t know that there would be times when my husband and I would feel like two ships passing in the night because we can’t get a word in from the minute he sets foot in the door and I can’t seem to stay awake past 10 p.m.

I didn’t know that me, being the extrovert that I am, would crave alone time and silence.

I didn’t know that along with this beautiful job of being a mother would I have more experiences of being puked on, peed on, pulling juicy boogers out of my child’s nose and that all of those acts would be utterly and completely normal to me.

I didn’t know how much help I would need in caring for these little animals and this building we call our home.

I didn’t know how challenging it would be to ask for help much less accept it from those around me.

I didn’t know how much my heart would break when my child struggles; whether it’s something small like a skinned knee or something major like a developmental delay that is just not right.

I didn’t know that letting my child take those steps of independence would make me feel so lost at who I am.

I didn’t know that my home life would not be quiet, subdued or filled with flowery fields reading books all afternoon.

I didn’t know that I would have to manage and juggle between dance lessons, swim lessons, early childhood classes, music lessons and every lesson under the sun.

I didn’t know how lonely I would feel with a sleeping babe in my arms.

I didn’t understand that the friends I had who became parents long before I did weren’t being rude when they interrupted me 10 times during our phone conversation to tell little Susie to “knock it off and get off of the table.”

I couldn’t comprehend how sad I would feel sending my first baby off to Kindergarten or how I would mourn the loss of his infancy.

I had absolutely no idea how angry my own children could make me feel.

Every single day I experience joy and frustration, accomplishment and defeat. Every day I wake up with a “to-do” list and every day I go to bed having only crossed off two or three things on my list. Every week my husband comes home at least once to a complete war zone. He looks at me with this look of question in his eyes that says, “What did you do today?” All I can say is, “Life. I did life today.” I didn’t expect that despite all of these frustrations, unplanned scenarios and bumps that motherhood has thrown into the middle of my life I would look at my child at the end of each day and say, “I love you; you are the best thing that has ever happened to me.”

I was the mom who served leftovers for meals

I gave birth to my baby at my parents' place and when the baby was 3-months-old, I joined my hubby in Qatar. I was left all alone to look after the tiny one with no help or guidance in the country. But somehow, I have managed to take care of him and now he's a grown up boy. My parents are proud of me, while some others envy because I did manage all alone.

In India people have help when it comes to looking after babies, whether it's parents, in-laws or any others. But when we live abroad, we can't even dream of help, let alone have any other choice. There are times when we feel guilty about how we look after our children. But at the end of the day, what matters most is how best we are doing with what we have.

Motherhood is very personal. It's not some competition. And husbands should help as much as they can, especially if they are abroad. Unfortunately, Indian parenting doesn't teach men to help, all they know is bossing over women. In-laws teach and preach and ask sons to stop helping wives, because they think it's an insult to the man!

But with the talks, I have changed that scene and my hubby helps me in looking after the baby. And I would inculcate the same values in my son, because my parents have inculcated those values in my brother as well!

Kalyani Pardeshi shares her experience on ToI and says how she feels guilty about serving leftover meals to the kids and the family and how she overcame that guilt:

Hi,

I am Kalyani. I am a regular next-door type of a middle class Indian mother. From what I have seen, we don't talk about our shortcomings openly. I have been told never to reveal how I truly feel because people will make fun of me. But sharing my story has helped many so I will continue to share it.

Here is my story...

I was the mom who was surrounded by so many other mothers who seemed to have it all together while I battled to stay afloat, I felt like I was suffocating almost all of the time, barely making it through the day while feeling a deep, intense feeling of loneliness. No one understood how I felt and there was no one I could talk to.

I was the mom who served leftovers for meals because it was easier and quicker than making a wholesome meal while trying to soothe a cranky, teething baby. Yes I felt that guilt more so because of the judgemental comments I got from "others."

I was the mom who would take an extra 5 minutes in the washroom just to have 5 minutes of peace, 5 minutes to myself which left me feeling guilty.

I was the mom who hid in the pantry and stuffed her face with chocolates, chips and cookies because it was easier to stuff down my emotions than it was to deal with those emotions. And yes, I felt guilty after that.

I was the mom who tried to squeeze into her pre-pregnancy clothes every week because all I really wanted was to feel good about myself. I felt guilty for wanting to feel good, it made me feel selfish.
I was the cranky mom who constantly barked at her kids for the most inconsequential incidents and then felt like the worst mom in the world.

I was the mom who was called the worst wife and worst mother in the world by so-called relatives which really made me question myself - was I really that bad?

I was the mom who was silently battling postpartum depression

How did I change all of this? What did I do to put an end to this? The depression broke the wrong parts of me, depression broke my wings but depression forgot that I had claws.

It started with a simple belief.

That I was doing the best I can, all things considered. Even if it was leftovers, the kids were being fed and most important of all, they were happy.

That I was the best mother for my children, that is why I was chosen to be their mother and not anyone else. That is why I always see love in their eyes for me.

I stopped seeking validation from others and started with introspection and words of affirmation, reminding myself that I am valuable, I am a good mother, I matter, I am worthwhile, I am the best that I can be for those who matter to me. This brought about a quiet reassurance within me which enabled me to transform myself and my life to something magically beautiful.

If no one else has said this to you today, let me say it to you - you are an individual who deserves love, respect, recognition, value, dignity, appreciation, honour, adoration: not from anyone else but from yourself to yourself.

Treasure yourself, love yourself, respect yourself - it all starts with you, the rest will fall into place.

The ‘dark sides of motherhood and pregnancy’

In an encouraging and honest post on Instagram, a mom of two has shared how she’s learned to love her body again and what she wants other moms to know about the many different changes that come with motherhood.

Alexandra, a mom to two sons who are 18 months old and 5-and-a-half months old, posted a photo on Instagram on Jan. 12 of the “tiger stripes” on her stomach. In her caption, she wrote that it took her 18 months “to finally feel beautiful” in her own skin. She also noted that no one prepared her for the mental, physical and emotional changes she experienced after having kids. With her post, Alexandra reminded moms with similar feelings that they’re not alone.

“I want other moms to know that postpartum depression and these physical changes can happen to anyone,” she told The Huffington Post. “I want other moms to know that this is where I am at now, but this isn’t where I started. Don’t lose hope.”

Alexandra encouraged other moms to be vocal about how they feel after kids and talk comfortably about the changes they’ve experienced, physically and mentally. Before she welcomed her two boys she wishes she would have heard more mothers talk about all the emotions they felt with motherhood, not just the positive feelings.

“I wish that I would have known that there is more than just feeling in love when you have your baby, there are a lot of other feelings when you enter motherhood,” she said. “When I had my babies I felt so guilty for feeling other feelings besides love. I wish I would have known that all the feelings I was feeling were valid, they were okay!”

Alexandra told HuffPost she is still working on loving her body every day. She admitted looking in the mirror sometimes brought her to tears for a long time until she reminded herself she “brought two miracles into our world.” Alexandra is proud of the “tiger stripes” on her stomach and thinks other moms should be, too. When asked if she had anything else to say to fellow mothers, she said she wants them to know she’s got their backs.

“I am right here with you,” she said. “I have felt a lot of the same feelings as you, my tummy might look just like yours! We are in this together.”

(Source: Huffpo)

Why my wife committed suicide: Post-Partum Depression and what it does to women

Most films and popular culture fill our minds with images of blissful motherhood but nobody talks about the darkness that sometimes accompanies it.

- Geetika Mantri

Kochi-based Abhilash K had been married to Anu for 7 years in 2012. The couple was based out of Dubai then and Anu was pregnant for the second time. They were overjoyed.

Soon after the pregnancy was confirmed, Anu moved to Kochi, closer to her in-laws, so that she could have help and care at hand. Abhilash was to join them after he fulfilled his work commitments in Dubai. The couple would speak every morning before Abhilash left for work.

But tragedy struck before the family could be reunited.

When their daughter was only 87 days old, Anu committed suicide.

“My mother found Anu hanging in our first-floor house. Anu wasn’t responding to her calls and my mother could hear the baby crying from the ground floor. So, she had to go up and get people to knock the door down,” Abhilash recounts.

Abhilash was told that Anu had been in an accident and that he should rush back. When he found out about the suicide, he was left completely dumbfounded. “We spoke around 7 in the morning that day before I left for office. It was just like a regular conversation. She even went downstairs to visit my mother," he says.

In order to understand what led his otherwise cheerful and outgoing wife to take her life, Abhilash spoke to people close to her and to those from the medical fraternity. While there was nothing outright different about her behaviour, one of her colleagues, a paediatrician, told him that she seemed depressed two weeks before the ill-fated day.

Through the course of these conversations, Abhilash became aware of the term Post-Partum Depression. “I had no idea that there was something like this. There could be no other reason why a person like her, who was always smiling, would do something like this,” he insists.

Abhilash has now started a Facebook page to raise awareness about the issue and insists that it must be mandatory for gynaecologists to give a brief to expecting parents about PPD.

What is PPD?
Most films and popular culture fill our minds with images of blissful motherhood, where the woman appears radiant and fulfilled when she holds her child in her arms. These images conveniently glaze over tougher physical and psychological effects that follow delivery.

Post-Partum Depression (PPD), also known as post-natal depression is one such condition, which while common, is rarely talked of.

Chennai-based gynaecologist V Madhini says that while most women go through post-partum blues, characterised by doubts about child-rearing and nurturing capability, and being emotional and overwhelmed, PPD is rarer.

Dr Jayanthini, a psychiatrist in Chennai, says that in cases where women suffer from PPD, it is likely that they have a family or personal history of depression or other mental illnesses.

However, Dr GK Kannan, a child and adolescent psychiatrist says that while having depression earlier in one's life can increase the risk of going through PPD, it is more important to recognise the groups that are vulnerable to the disorder.

"Those who have low social support, had difficulties in their pregnancy, had marital issues or if the child has medical or developmental problems, fall in the more vulnerable groups," he states.

As per American Psychiatric Association, PPD requires medical intervention and unlike blues, does not go away on its own. It is characterised by loss of interest in things you used to like, drastic change in appetite, anxiety (all or most of the time), feelings of guilt and worthlessness, fear of not being a good mother or disinterest in the baby, sadness, uncontrollable crying, inability to fall asleep or sleeping too much, among others.

PPD can even appear a few months after the delivery and can go on for weeks and months if left untreated.

How does it affect new mothers?
Sarita was 29 when she had Ankita in 2013. She decided to take a break from working as a Chartered Accountant and stay home for a while to take care of the baby. But her newly-attained motherhood was not defined by contentment or happiness. Instead, Sarita was weighed down by a feeling of worthlessness, which she believes came from not working.

Then, Ankita stopped breastfeeding at three months, when Sarita had wanted to breastfeed her for a year at least. Overwhelming feelings of guilt and inefficiency took hold of Sarita. It didn’t help that her in-laws, who lived separately from her husband and she, said in passing that they could now take Ankita to their place for a while because she wasn’t feeding.

Looking back now, she thinks this is when PPD really took hold of her. “I slept and woke up with scary, suicidal thoughts every day. My friends told me to consider therapy but I was too disinterested in my own well-being to care,” Sarita says. It was after two years that she finally went to a therapist and started taking anti-depressants in March this year.

For Ranjana*, who first gave birth in 1993, PPD was triggered by a complicated delivery where she incurred heavy blood loss. Too weak to move, she began having episodes of uncontrollable crying when she was still in the hospital after childbirth.

Once she was discharged, the feeling of worthlessness and hopelessness increased. “I’d cry for everything: being unable to take care of the baby, the housework, even when the child was unable to sleep,” she recounts.

She was diagnosed with PPD a few days later and seemed to have recovered, but it returned when the baby turned three months old. Her husband, while supportive, did not recognise it for what it was. Fortunately, Ranjana went to a doctor for a calcium deficiency and was told that she was suffering from mild depression. Ranjana recovered in a few weeks.

What can be done?
While PPD is treatable, Dr Jayanthini warns that caregivers must ensure that medication is properly administered. Because women suffering from PPD may have suicidal thoughts, the medication must be kept securely so that it is not misused by them to self-harm. Caregivers must also ensure that she takes the medication and does not hoard it.

“Moreover, families need to be educated that this is something biological. It is not in their control. Telling them to not create a fuss or that they’re worrying about nothing will only reinforce the stigma around mental illness, and prevent them from seeking the right help,” Dr Jayanthini warns.

She adds that while self-harming tendencies and neglect to the child are short-term effects, the long-term effects of PPD affect children in the long run.

Sarita for instance, admits that once Ankita was a toddler, Sarita’s frustration and anger would often come out on her in the form of yelling. “I knew she could understand what I was saying, yet she would not listen. I would yell at her a lot. I know it is wrong, but I just wasn’t strong enough,” she says.

Dr Kannan says that a child needs more than just nutritional support from the mother and that PPD can hamper his/her well-rounded growth: “If the mother doesn't give attention or affection to the child, he/she may also show high levels of irritability. In some cases, if the child’s health is neglected, he/she may also suffer from malnutrition. Depression can also lead to marital discord between the spouses which in turn will negatively affect the child. It's a vicious cycle.”

So, how must one know when to seek medical help? Dr Kannan outlines the signs and period:

“If the mother is increasingly crying, showing signs of high irritability, has thoughts of harming herself, shows a lack of interest in the baby but also feels guilty about it and if such symptoms persist for over two weeks, then it is time to see a professional.”

(The names of the women quoted in the story have been changed on request.)

(Source: The News Minute)