It just manages to creep deep inside your system without your awareness, at the time, when you are actually waiting eagerly to see your new born baby, to cuddle, to express your happiness, to convey through your touch that you are there and you are there to protect and love him/her unconditionally. You can’t wait to meet your baby!!. My experience was not as I expected or wished it to be. Today I want to share my experience with postpartum depression. Like every mother to be, I was also quite thrilled when I found out that I was going to have a baby. I was excited! Thought of having a baby filled me with immense happiness and feeling of contentment, but my excitement was short lived. My experience was not as I expected or wished it to be. Today I want to share my experience with postpartum depression. After three months of pregnancy, I was diagnosed with gestational diabetes. It meant that I shouldn’t eat anything I craved for, it meant to go through injections and check-up every week to keep track of sugar level. Diabetes took away all the delight of eating whatever I would feel like, during pregnancy .I had to stick to regular chapati, dal, spinach, bitter gourd, vegetables and curd. I was always on check! Situation kept on becoming difficult for me, as a result, I had to undergo C-section almost one month before the due date. Finally, I was blessed with a baby boy. I became a parent! For god sake, smile!!What the hell is wrong with you? I was supposed to be happy, right? Being happy at that moment was an expected reaction! But I was surprised at myself. How hard I tried, I was unable to express myself. I was blank(I was battling with an uninvited guest: postpartum depression but at the moment, I didn’t realize what was happening to me).I couldn’t relate to the baby lying next to me, waiting for me to hold him. I used to just keep staring at him, with uncontrollable tears flowing through my eyes. My heart couldn’t say what I was going through but my tears said that something was not right. Why I’m grieving at the time when I was expected to be happy? I was supposed to hold him, feed him but how could I!! I was unable to eat anything. Even one morsel of food was difficult to swallow. As a result, my son was put on bottle to be fed properly. People around us tend to see situations only from their perspective, as a result, they fail to see what other might be going through. I assume, people prefer to ignore the mental health concerns because for some, there is no such thing as mental health issues, for some its a matter of shame and stigma which shouldn’t go out of four walls. I gasped for breath all the time ,I even stopped talking to anyone but everyone was so immersed in their lives that no one noticed change in my day to day patterns. Days passed like that. I felt I became a robot. Feeling of guilt resurfaces whenever I remember that I expressed no emotions towards my new born baby ,that I hated him for all the sudden changes life had brought, that I was unable to come to terms, of me being a mother of a child. I struggled day and night. I kept crying to myself but didn’t share with anyone what I was going through. Days turned into weeks, without any change. One fine day, it struck me as if something is not right-“This is not me”. I struggled to understand what I was going through. I decided to do what I like most. Write! I kept writing and writing, only my free flowing thoughts. I read again and again my own free flowing thoughts to find the gap. Once I gain insight into the issue which was lacking initially, I accepted that I was going through a condition known as PPD and I need to come out of it as soon as possible. But how was the question as I was still too vulnerable emotionally. So, first step I took was to leave the present location immediately. I decided to travel. Change of environment was refreshing and worked as a medicine for me. I started with scheduling my day, talking and reading to my baby on daily basis, daily walk along with my baby, writing journal to deal with my emotions and sharing what I am going through to someone who would not pass judgements. I just wanted someone to listen to me. Initially, I had to force myself to do whatever I planned for a day. So, I decided to take one step at a time than not doing anything at all. To be consistent was crucial for steady progress. If I was able to follow my planned schedule I would never forget to appreciate myself for success. I would give star or treat myself with my favorite dark chocolate or dessert. With each passing day, I became more and more aware and regained my previous state of mental well being. I can say that I was able to fight the battle with postpartum depression and I won!! I won because I decided not to quit, not to surrender. My joy was beyond words when I experienced feeling of attachment with my baby, when I felt pride in accepting that I was mother of a child. Such usual feeling of happiness, attachment, laughter associated with new born baby was difficult for me to experience initially. what would be the plight of a mother who was unable to express joy and happiness to celebrate the birth of a baby?! It was beyond my imagination but I came to terms with it because I experienced it. Feeling of guilt also accompanied my new found experience of motherhood. I kept assuring myself that, “It was not your fault” and It’s okay to let go of guilt and anxiety. Letting go gives freedom to enjoy life. It was a long wait to express my love for my baby. I held my baby softly to assure him that what may happen, I will always be there for him and I loved him from the day he was born but it took sometime to express it. I am sorry for the delay!.

If in case you are going through any such condition which I shared, don’t feel shy to seek help. It’s okay to seek help for your well-being. Let me share, in brief, about what postpartum depression is and how you can identify. It might be helpful.

In National Mental Health Survey released by the National Institute of Mental Health and Neurosciences(2015-2016), it was reported that 1 in 20 people in India suffer from depression. Particularly alarming are the statistics that depression rates are much higher for women compared to men. And women are particularly prone to depression in their child-bearing years ,commonly manifesting as postpartum depression (PPD). 

Fifty percent of “postpartum” major depressive episodes actually begin prior to delivery. Thus, these episodes are referred to collectively as peripartum episodes in the DSM-5.Postpartum depression is classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)(American Psychiatric Association, 2013) as Bipolar Disorder or Depression with Peripartum Onset. A person suffering from postpartum depression has to meet these symptoms of major depressive episode. Postpartum depression is diagnosed when the depressive episode occurs before or after the birth of the person’s child.

Postpartum depression usually manifests a few weeks after childbirth. The birth of a baby triggers numerous emotions in the mother, from zest and joy to fear and anxiety. Some may experience ‘postpartum baby blues’ along with physiological and hormonal changes that last up to two weeks after delivery. When these blues, along with physiological symptoms, continue beyond two weeks and manifest in more severe signs, it usually requires medical help. Depression impacts your ability to carry out everyday activities, and will even prevent a new mom from caring for their baby. Postpartum symptoms usually develop within the first few weeks after giving birth, but may begin later — up to six months after birth. The mother in such a case experiences severe mood swings, excessive crying, difficulty bonding with the infant, loss of appetite or overeating, insomnia or sleeping too much, panic attacks – or, in extreme cases, thoughts of harming oneself or the new born child. 

Some new moms (or dads) may experience the following postpartum depression symptoms also:

• Fear that you’re not a good mother
• Overwhelming fatigue or loss of energy
• Withdrawing from family and friends
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability or irrational anger
• Feelings of worthlessness, shame, guilt, or inadequacy
• Difficulty in thinking clearly, concentrating, or making decisions

Mothers facing emotional difficulties often do not come out to their families about it due to stigma or social norms. In some cases, they may even be unaware that their distress has a name and requires medical attention. As a result, even the mildest form of PPD is a battle for the mother balancing the home with childcare. Unsupportive partners or families often magnify the difficulties and working mothers may lose out on opportunities, promotions and even drop out of the workforce.

A meta-analysis reviewing research on the association of violence and postpartum depression showed that violence against women increases the incidence of postpartum depression. About one-third of women throughout the world will experience physical or sexual violence at some point in their lives. Violence against women occurs in conflict, post-conflict, and non-conflict areas. Psychological and cultural factors associated with increased incidence of postpartum depression include family history of depression, stressful life events during early puberty or pregnancy, anxiety or depression during pregnancy, and low social support. Violence against women is a chronic stressor, so depression may occur when someone is no longer able to respond to the violence.

Many cultures around the world observe specific postpartum rituals to avoid ill health in later years. organized support for the mother, periods of rest, prescribed food to be eaten or prohibited, hygiene practices and those related to infant care and breastfeeding, among others. These rituals allow the mother to be ‘mothered’ for a period of time after the birth. They may have beneficial health effects as well as facilitate the transition to motherhood. In today’s society, with modernization, migration and globalization, individuals may be unable to carry out the rituals or, conversely, feel pressured to carry out activities in which they no longer believe.

Among those at risk, providing psychosocial support may be protective in preventing PPD. This may include community support such as food, household chores, mother care, and companionship.

Links are shared for further reading:

https://archive.ahrq.gov/clinic/epcsums/peridepsum.htm

https://journals.sagepub.com/doi/10.2217/17455057.3.4.487

https://thewire.in/health/postpartum-depression-mothers-violence

https://psychcentral.com/disorders/postpartum-depression

https://link.springer.com/article/10.1007/s00737-011-0248-9

https://www.liebertpub.com/doi/10.1089/jwh.2008.0953

Animated Image Creator: Tatyana Antusenok | Credit: Getty Images/iStockphotopostpartum

***Pallavi***

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