Postnatal depression signs – what to do

“Postnatal depression is something no one talked to me about, even though I attended all my antenatal clinics at a reputable hospital,” narrates one mum. “I had also heard of baby blues but I thought it meant an irritable baby.” 

Within a few weeks, however, all this would change. She reveals, “A few days after the birth of my daughter, I found myself crying day and night without having quarreled with anyone. I cried for two good weeks. I could not understand what was happening to me until a delayed visit to a doctor revealed I had postnatal depression.”

The assumption of maternal bliss

A new mother should generally be a happy mother. The birth of a child is assumed to be the ultimate manifestation of a woman’s femininity, and the authoritative confirmation of her fertility and procreational ability. She is expected to be overwhelmed by maternal bliss.

However, the birth of a baby in some cases puts the mother in both emotional and psychological confusion. She may be torn between her new-found physical freedom (through separation with the
baby) and the entry into a new phase of captivity and 24-hour responsibility in maternal care.

The mother may be torn between the joy of seeing her own offspring and the circumstances which led to the pregnancy. She may both love the baby and hate the reasons for its existence.
Earlier experiences of a difficult pregnancy (which sometimes may be inter-twined with the risk of losing one’s life), may also weigh on a mother after delivery.

The mother may be torn between the happy prospect of bringing forth a family and the demise or interruption of her career or professional dreams. She may love being a mother and hate what it has done to her physical looks.

She may be torn between breastfeeding her baby and surrendering her role to a nanny. The mother may be torn, torn, torn, about many issues. In this state, she is in a sense, ripe for an attack by postnatal depression – unless someone warns her fast or comes to her aid real quick.

What is postnatal depression?

Also referred to as postpartum depression, postnatal depression is a temporary condition characterised by altered behavior.

How long does postnatal depression last?

Postnatal depression does not normally last for more than six weeks after delivery. If it persists beyond six weeks, it is classified as a psychiatric condition that needs medical help.

What causes postnatal depression?

The cause is not known, though it can be pre-disposed by familiar history of psychosis (severe mental disorder resulting in loss of contact with reality). However, pressure arising from adjustments necessary to adopt to the new lifestyle after the birth of a baby do cause an overload on the demands of motherhood. Little support from people around you, the sense of loss of freedom and hormonal fluctuations, only make it worse. A postnatal depression situation can get out of hand if not attended to. If you notice any of the symptoms, you need to seek help as soon as possible.

What triggers depression after delivery?

After delivery there are several changes that take place in the body as it tries to get back to its normal state. These include hormonal changes whose levels suddenly fall after delivery.
Within the first 72 hours, the hormones will have dropped back to their normal levels. This sharply contrasts with the period after conception when the rise in hormone levels is gradual.

When these hormone levels drop, the body may find it difficult to cope with the sudden changes within it. There are also other adjustments to make now that there is a baby in your life. You may find that your relationships with various people are being strained as a result.

These are factors that make adapting to the new situation seem difficult. If you fail to adapt, you may slip into  depression. This is the type of depression called postpartum or postnatal depression.

When does postnatal depression attack?

Signs of postnatal depression can start showing as early as a few days after delivery to as late as several weeks after the birth of the baby.

Do therefore watch out for symptoms of postnatal depression as it does not always appear immediately after delivery; it may occur weeks or months afterwards.

Do all women go through postnatal depression?

Not every woman goes through postnatal depression after delivery. Even to those who do get postnatal depression, it may not occur after every pregnancy.

Is postnatal depression equally severe in all women?

No. Its severity varies not just from one woman to another, but also from one pregnancy to the other.

Can a happy mother get postnatal depression?

Postnatal depression is not the preserve of any one type of mother; it has occurred even in happy pregnancies.  Despite the spouse being supportive, it can be triggered. Even where the baby is appreciated and awaited, labour and eventual delivery were superb and there is no history of postnatal depression in the family.

Postnatal depression can happen when least expected. Watch out for symptoms as it does not always appear immediately after delivery; it may come about weeks or months afterwards.

How serious can postnatal depression get? Is it fatal?

Postnatal depression is a serious condition that may derail you from your normal activities. It may prevent you from looking after your baby.

Can postnatal depression go un-noticed?

Yes, it can. In the majority of cases, this attack stays hidden by the patient who may feel ashamed of it or refuse to accept it. In other cases mothers do not recognise postnatal depression altogether.

Who is at risk of getting postnatal depression?

At least ten per cent of all women exhibit some form of depression after delivery. Since it is not clear how postnatal depression starts, it is not possible to identify a particular risk group. Nevertheless, certain circumstances precipitate postnatal depression. These include an unwanted or accidental pregnancy or a rape-related birth.

Delayed labour or prolonged labour are also causes, as is a premature birth. An emergency or unexpected caesarian section or delivery complications may trigger depression. So may baby defects noted upon birth or a stillborn baby.

Women whose family has a history of depression, difficult pregnancies or pre-delivery stress build-up may be more susceptible. Others at risk are those with unstable or no spousal relationships. More of those believed to be in the risk circle are those with no close confidants at all. Women battling with declining relations with their mothers and those who have lost parents at a young age, especially those whose mothers died at child birth, are at risk.

Is postnatal depression the same as baby blues?

No. Postnatal depression is different from ‘baby blues’. Baby blues is a more common mood condition that occurs following childbirth. It is normal for mothers to experience baby blues for a few days following the child’s birth. This is characterised by feelings of irritability, gloom and episodes of crying.

Baby blues is more common in first time mothers and in those who had problems with premenstrual syndrome. This is a condition affecting some women before menstruation, where they experience temporary physical and mental variations like irritability, moodiness and headaches.
Baby blues have no specific treatment other than reassurance. The condition usually resolves on its own.

What should I do when I feel depressed after the birth of my baby?

If you have recently delivered a newborn and are feeling unusually down, try these tips:

• If you feel depressed, talk to a counselor or a close friend.

• Rest as much as possible. Fatigue only makes PND worse. Take a nap during the day. At night get help with feeding the baby. Grab every opportunity to take a rest whenever it arises.

• Ensure that you take a balanced diet: eat plenty of fruits and vegetables. Avoid snacks and junk food. Do not diet at this time. Eat little but often to ensure a constant supply of energy.

• Engage in gentle exercises such as walking. Or go on a drive. Let somebody responsible take care of the baby while you are away.

• Avoid major stressing situations such as moving into a new home or redecorating the house. The stress involved will only leave you feeling worse.

• Do not worry unnecessarily over your child especially when the baby has no problems.

• Do not bother yourself or worry about the things you do not want to do. Forcing yourself to do certain things will only end up upsetting you.

• Feel free to ask for help whenever you need it, and when offered help, take it.

• Try to spend some time with your partner if you can.

• Talk to other mums with new babies, for instance when you are at the clinic. You may find that they have the same difficulty.

• Accept that you need help and that it is not your fault that you developed postnatal depression.

READ also: ‘Postnatal depression – symptoms, prevention tips‘

END: PG 3/48-49