Post Natal Mental Health

The postpartum period brings about a whole new experience and transition in life. Having a child is one of the most beautiful and enriching experiences for parents. But for some, it may get turbulent emotionally and psychologically because of certain factors. Pregnancy and lactation are critical periods in a woman’s life. Depression may occur for the first time in a woman during the postpartum period or maybe a recurrence or relapse.  Postpartum blues (PPB) are a relatively common phenomenon, occurring in 50 to 80 percent of women.PPB usually starts after the third postpartum day, typically peak by fourth or fifth day and spontaneously remit within two weeks of delivery. PPB is a group of transient symptoms mainly characterized by rapid mood shifts such as tearfulness, irritability, anxiety, insomnia, lack of energy, loss of appetite. However, 20 to 25 percent of women may continue experiencing more severe symptoms which may persist for more than two weeks. This condition is classified as Postpartum Depression (PPD). It is equivalent to major depression that occurs within four weeks postpartum. The symptoms include depressed mood, frequent crying spells, feelings of inadequacy and guilt, irritability, inability to cope, unusual fatigue, lack of interest in pleasurable activities, decreased sexual interest, sleep, and appetite disturbances.  

The common risk factors or maintaining factors are financial instability, low education levels, depression in a spouse, relationship issues, and pre-existing mental health issues. Factors such as lack of intimacy with the partner or lack of time spent with the spouse can also be major contributory factors. Postpartum depression among parents in no way reflects a character flaw or intentional act.

Despite being fairly common, very little awareness about Postpartum Depression makes it go unrecognized and hence untreated. Unrecognized and untreated Postpartum Depression in a mother may negatively affect mother-infant/ mother-child bonding. It may also affect the infant’s well-being and development. For children, it increases their risk of delays in cognitive development, emotional and social dysregulation, and exhibiting behavioral problems such as sleep and eating difficulties, temper tantrums, attention deficit hyperactivity disorder, and attention-seeking behavior. It also puts the child at risk of early onset of depressive illness. It affects the attachment the child has to his/her mother which is important for the child’s development and deep emotional bond with her.  For mothers, it increases the risk of further complications, self-harm tendencies, emotional neglect towards the child, active suicidal ideation, and physical problems as well due to poor sleep and appetite. 

One can get over it by talking about it, by being more communicative to the partner but by avoiding a complaining tone and also being receptive to the partner’s needs. This would encourage empathy among the new parents towards each other. By sharing responsibilities with a partner so that both get a fair share of experiences, both enjoyable and stressful, with the baby. This would allow both the parents to have some ‘ME-TIME’ which is very important for psychological rejuvenation and would help them from being exhausted. Also participating in decision making as new parents right from the beginning as a unit would prove to be beneficial.

At a community level, encouraging an equal number of postnatal programs for the new parents would be of great help. During the postpartum depression, it is very important to take professional help either from a mental health professional or by expressing it to the gynecologist, as it is crucial to speak about what is being felt. A separate counseling session proves to be very beneficial for new mothers as it helps them release their burden without the fear of being judged.

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