Postpartum Depression: Beyond the baby blues
August 19th, 2021 at 8:52 am
A birth of a child is often considered to be a blissful moment; yet, it can also trigger a sense of overwhelming emotions in new parents. According to the Royal College of Obstetricians and Gynaecologists, what is commonly referred to as the ‘baby blues’ is normal and would pass within the first two weeks postpartum. However, this condition could progress into an episode of major depression known as postpartum depression (PPD), which can in return affect the mother’s ability to care for the newborn.
Although an estimated 1 in 7 women globally is said to experience PPD, a review revealed that the incidents of maternal PPD in Malaysia was at 6.8%-27.3%. Even with the recent increase in prevalence of PPD, the number of women seeking help in Malaysia for PPD is said to be far less.
The stigma of mental health issues is universal, but it is particularly prevalent in Asian countries. This causes PPD to be even more taboo and prevents women from seeking help for their struggles with depression. Mothers are pressured to be perfect, even new mothers, so the shame and embarrassment of admitting to what society sees as “weakness” forces them to suffer in silence. On top of that, mothers may feel guilty for experiencing negative feelings during what should be a joyous occasion, and downplay their own emotions.
What is Postpartum Depression?
PPD is a depressive illness that presents symptoms similar to depression in new mothers, including a low mood that lasts for more than two weeks. Based on the severity, the mother will struggle to look after herself and her baby. At times the person experiencing PPD will even find it difficult to manage simple tasks.
According to experts, symptoms of PPD generally develop after the first two weeks of childbirth and can last up to six months or even a year, while in some cases symptoms could also develop in the weeks prior to childbirth. PPD symptoms may differ from person to person, and the common symptoms can surface as a combination of emotions: anger and irritability, fatigue, excessive crying, finding it difficult to bond with the new-born, and being anxious.
While the heightened emotions of the mother can be attributed to the sudden shift in hormonal levels, experts also attribute that sleep deprivation plays a large role in causing PPD. As the mother adjusts with her new responsibilities to care for the baby, they tend to not get enough sleep, which impacts the way they function, how they feel and how mentally stable they could be.
Types of Postpartum Depression
Depending on the severity of symptoms, there are several types of PPD:
- Postpartum Blues: Affecting approximately 30%-80% of new mothers, this condition will only have a milder or short-term form of the disorder, where the symptoms displayed would range from sadness, crying, tiredness, insomnia and anxiety.
- Postpartum Anxiety: The mother would show symptoms of intense and chronic anxiety, where they would feel nervous and constantly worry that something bad would happen to the baby. These symptoms could last from weeks to months.
- Postpartum Obsessive-Compulsive Disorder (OCD): Can occur during the prenatal period of the second trimester or one month after postpartum, where the mother would experience disturbing thoughts, imagine that the baby is in danger or would be extremely afraid to be left alone with the baby.
- Postpartum Panic Disorder: Postpartum anxiety that includes physical symptoms, such as a racing heart, tightening chest, hyperventilation, dizziness, weakness, and other extreme symptoms.
- Postpartum Post-Traumatic Stress Disorder (PTSD): This disorder can be triggered due to a traumatic incident the mother faced during childbirth or afterwards. The incident could range from emergency C-section, the baby being sent to the Neonatal Intensive Care Unit (NICU), complications experienced during childbirth or lack of support during delivery.
- Postpartum Psychosis: Although a rare and severe disorder, the symptoms of the person could drastically change from agitation to anxiety, which could lead to memory loss and confusion, causing hallucinations and the mother showing disinterest about the baby.
PPD left untreated could interfere with the mother and child bonding, and can also lead to family problems. It could also place a strain on the relationship with the baby and the partner. Moreover, PPD can also impact the development and behaviour of the child, which can have a long-term effect.
While any new mother could experience PPD, it is imperative to know who is more vulnerable to develop symptoms. It is advisable to seek assistance from a psychological counsellor if the mother has: a history of depression during or prior to pregnancy or is receiving treatment for depression; experienced PPD during a previous pregnancy; baby has health issues or other special needs; experienced strenuous events during the past year such as pregnancy complications, illness or job loss; have family members who had depression or mental disorders; experiencing problems in their relationships with the spouse or partner; experiencing financial difficulties; or the pregnancy was unplanned or unwanted.
The doctor could thereafter monitor the mother closely for signs and symptoms of depression and get the mother to respond to a depression-screening questionnaire during the pregnancy and after the delivery. The doctor might refer the parents to support groups, counselling sessions/ therapies, and if required, prescribe suitable antidepressants.
PPD is a serious mental health condition, but the lack of education, prevention and treatment has caused it be unrecognisable. According to a recent study, suicide is among the leading causes of deaths among new mothers, making it crucial for them to voice their concerns and seek help, as well as share their experiences and normalise the conversation. If you or anyone you know is having suicidal thoughts, please contact the Befrienders at 03-76272929.
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