Healing Space | Finally, much needed support for new mothers

The global instance of postpartum depression is over 18 percent. The US FDA-approved pill for it will at least set straight a few facts about the medically diagnosable condition. (Illustration by Suneesh K.)

Note to readers: Healing Space is a weekly series that helps you dive into your mental health and take charge of your wellbeing through practical DIY self-care methods.

The Food and Drug Administration of the United States (US FDA) approved the first ever pill for post-partum depression a week ago. It is said to be quick acting and is prescribed over a short duration, a period of about two weeks, and will come as a relief to many - the worldwide prevalence among women is thought to be 18.6 percent. As a first pill for the condition, it will probably stand to be improved; however, the focus on post-partum depression itself is welcome.

The bestselling South Korean novel Kim Ji-Young: Born 1982, by Cho Nam-Joo (also a Netflix film), is a portrayal of life with depression after the birth of a child, and the casual everyday sexism that makes it so hard to carry on. After she gives up her career, the protagonist Ji-Young is treated and taunted as a freeloader, someone who lives off her husband. She is expected to ‘deal with it’ and quietly support and participate in all family events regardless of how she is feeling. The novel was a great influence on the feminist movement and the #MeToo movement in South Korea, largely known to be a conservative society. The book and its picturization became popular worldwide, including in India, since it is a condition common to women world-over.

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A systematic review and study of research on all postpartum cases in India over 16 years was published in 2017, and found that in 38 studies citing 20,043 women, 22 percent of women faced postpartum depression, most within two weeks of delivery. The study further categorized three kinds of postpartum depression: blues, psychosis and depression. Psychoses tends to be more severe, may occur up to four weeks after giving birth, and may require hospitalization. Blues is more common and is generally resolved with reassurance and support. Depression can be chronic or recurrent, and can affect the mother-child or other-partner relationship long-term. “Children of mothers with postpartum depression have greater cognitive, behavioural and interpersonal problems compared with the children of non-depressed mothers,” the study stated, also noting that as India is facing a decline in maternal mortality, there will be an increased focus on maternal health and mental health, going forward.

In India, typically young mothers are not guided towards therapy by the family. Mothers can feel overwhelmed, may be slow to bond with the child, have associated feelings of guilt, feel disconnected from their partners. Hormones can feel out of whack, they may face spells of crying, mood swings, hunger pangs, feel unattractive or bloated, like they have lost their body shape, their careers, freedom, and will never return to that phase of their youth again, they can feel anxiety and overwhelmed by the new responsibilities, lose appetite and sleep in varying degrees of severity. While blues pass within two weeks, depression that lasts longer does need treatment by a certified mental-health provider. Women who are depressed may have recurring thoughts of self-harm or harm to the baby and need urgent attention. Many withdraw from society, connections and face hopelessness and extreme loss of self-worth. Some may face hallucinations, panic attacks, paranoia or feel confused and lost.

The primary function that the pill is serving by coming into existence, whether it proves effective in the long-term or not, is that it is indicating that postpartum conditions are not ‘in your head’, are not imagined, a character flaw, or an abdication of responsibility, but a clinically diagnoseable condition that requires attention and care. Even if the pill does nothing beyond offer a placebo effect, the fact that it is able to bring this into the public view is itself a relief of sorts for mothers, especially in countries like India where mental health considerations are not taken seriously, or worse, used as an excuse to label the women as ‘emotional’, ‘overacting’, ‘dysfunctional’ or ‘mad’.

Incidentally, fathers can face paternal postpartum depression too. Feeling anxiety about their roles, their financial abilities, and the responsibilities may feel overwhelming and elicit inadequate responses from them.

In such cases couples counselling is recommended. Understanding the symptoms, the duration to expect them to linger, and how to support each other, can go a long way to alleviate the stress. Young mothers who face depression still have the basic work of tending to the baby, especially when there is an unequally divided workload at home. Thus, they also tend to be sleep-deprived, nutritionally deprived, and overburdened by the household chores or looking after other children in the home, or attending to the needs of elders and partners, if they are not adequately supported. This complicates the situation further. Relieving the burden on women to fend for themselves, their households, partners, families, children and their own mental health is a vital first step in the battle against postpartum depression.

Seek a mental health care practitioner’s help if you are a new mother who:

* finds everyday basic tasks difficult to get on with

* has recurring thoughts of self-harm or harm to others, including the baby

* is unable to communicate the kind of support you need

* are facing a problem bonding with or looking after your baby

* are in a ‘phase’ of anxiety, stress, low mood, loss of self-worth that doesn’t seem to go even after two weeks.