When Sharada* had her first child three years ago, she hadn’t expected the turmoil she would experience post-delivery.
“I remember looking down at this baby, and just feeling so overwhelmed with sadness. I felt hopeless and I didn’t understand where it was coming from. Everyone else seemed so happy though, and I felt this incredible sense of guilt because I was supposed to be happy, but I wasn’t,” she says.
Postpartum depression is a mood disorder which can affect women after the birth of a child. In most women, it manifests in anxiety, an overwhelming feeling of sadness, or lack of energy. Suicidal tendencies have also been reported in a number of women.
According to a study published in the International Archives of Integrated Medicine, postpartum depression plagues up to 15% of Indian women. However, Dr Swetha Raghavan, a psychiatrist from Chennai tells us that the actual statistic could be a lot higher.
“Indian women probably have a higher rate of presenting with it, but it doesn’t always get reported. People abroad are more educated and aware of it and easily come forward and talk about it. We lack such awareness here,” says Dr Swetha.
At her first visit to the gynecologist after her delivery, Sharada’s doctor sensed that something was wrong. The latter began to suspect that Sharada might be suffering from postpartum depression and she was referred to a psychiatrist for the same - a fact that many members of her family do not know to date.
“New mothers usually stay in the hospital for about 4 to 5 days after their delivery. During this time, we are usually able to pick up on any symptoms which we might need to keep an eye on, such as a change in her mood,” says Dr Tejeswini Potluri, an Obstetrician and Gynecologist (OBGYN) from Hyderabad, "During the subsequent check-ups we assess their mental well-being which allows us to determing if we need to send her to psychiatrist for further treatment."
Some doctors rely on the ‘Edinburgh Postnatal Depression Scale,’ which is a questionnaire given to patients and is used by doctors as a screening tool to determine whether a woman has symptoms indicative of postnatal depression.
“It is available, but it’s not always used. We see them before and after the delivery, and a drastic change in their mood can easily be assessed,” says Dr Tejeswini, “If needed, we refer them to a psychiatrist.”
Even after being referred to a professional, however, some patients still feel hesitant.
“There are so many people in my family who still don’t know the extent to which I struggled. I did not want to meet the psychiatrist at first, but luckily my husband was quite supportive and insisted that we go,” says Sharada.
After meeting the psychiatrist, she was started on medication for her symptoms. Sharada even went for a few counseling sessions with her husband, hiding from her family the extent of her struggle.
“I really don’t know how my in-laws, or even my own mother, would react if they knew that I had to take medications. My mother kept telling me it was normal to feel ‘tired’ after delivery, but I knew it wasn’t just about that, I just couldn’t understand what it was that I was feeling," she shares.
Stigma surrounds mental health illnesses, and postpartum depression is no exception. Some doctors stress that there should be more attention to preparations given during antenatal visits for patients and their families.
“Most of the patients are referred to us. Very few are brought in by family members who have noticed a change in the patient’s mood or behaviour, but that’s not the case primarily,” says Dr Akshay Singh, a psychiatric consultant from Lucknow.
A less privileged socioeconomic background, lack of support from family members, and lack of the father’s involvement are all reasons cited by Dr Swetha for such a lackadaisical attitude towards getting help for postpartum depression.
“It is important to educate people about mental health awareness, in general," Dr Swetha says.
She also notes that the lack of paternity leaves in our country, combined with a general notion that child-rearing is a ‘woman’s job’ add to the problem. “There are some companies which are now starting to offer paternity leaves. This enables the father to be more involved and provides the new mother with some relief. Support from one’s spouse becomes a very crucial thing for someone struggling with postpartum depression.”
With the right combination of medication, counselling and support from loved ones, postpartum depression can be overcome.