Postpartum Depression: Symptoms & Management

Mrs. A was a 30-year-old happily married woman with two children. She had recently given birth to her second child. Few months after her delivery, she started feeling restless, had sleepless nights and showed anger towards her children. She became reclusive and stopped talking to friends and family members. She felt insignificant and guilty. Burying her head into a pillow, she used to cry every night, wondering if she was a good mother or not.

Birth of a child comes with a multitude of emotions, from joy and excitement to fear and anxiety. Many women experience ‘baby blues’ after the delivery of a child because mothers have to tend to the physical and social needs of the child. However, it is pertinent to note that if the symptoms become more intense, like Mrs. A, and last more than a week, then one must seek help from a health care practitioner, as it may be a case of Postpartum Depression (PPD). There is no single cause for PPD. A sudden drop in hormone levels after childbirth, complicated childbirth, lack of family support, financial difficulties and history of mental illness, all may contribute to onset of PPD. The characteristic features of PPD are mild mood swings, decreased concentration, irritability, anxiety, insomnia, tearfulness and crying spells. These interfere with the ability of a mother to take care of her child and disrupt her daily activities. If left untreated, the symptoms might persist and affect maternal and child health in the future. 
There are a few steps one can follow in order to manage PPD.
Acknowledge the Problem
The foremost criterion for management of PPD is to acknowledge that there is a problem and understand its nature, severity level and management or treatment options. Women may feel embarrassed or reluctant to talk about their deteriorating symptoms after a joyous occasion of delivering a child. Therefore, a strong social support system along with accessible professional medical help can ease the process of disclosure about symptoms. Mothers should be made comfortable and have venues to express how they are feeling instead of repressing their emotions.
Reconnect with Your Partner
A lot of relationship problems emerge along with PPD because family members do not provide space for trust and communication in a society like ours. For many couples, there is no discussion on the post-baby division of labor, which causes frustration and parenting challenges. There is need to reconnect with your spouse and take on parenting as a team. 
Social Health First Aid from Family Members
People with depression might not acknowledge or recognize changes in their mood or behavior but partners, friends or family members may be able to notice the symptoms at an early stage and therefore should offer ways to help a mother. Mothers have to focus on the physical needs of the baby, which include provision of adequate nourishment at appropriate timings along with monitoring of developmental milestones, protection and management of sicknesses. Family members and friends can share tasks and assist mothers with their daily activities, taking care of the baby and in extreme cases, should encourage women to seek professional help.
Find Ways to Bond with The Baby
Mothers usually feel a lack of competence related to their duties, which decreases their self-esteem and tends to aggravate the symptoms of PPD. One can reduce this overwhelming feeling by adopting diverse ways to bond with the baby. Skin-to-xskin contact with baby and baby massage helps release oxytocin, which is also known as the ‘cuddle hormone’ that makes you feel happier. It helps the baby sleep, stay alert and respond to their mother. Engaging with your child by smiling and singing not only helps the child respond to sensory stimuli but also helps distract the parents from any negative thoughts they might have.
Healthy Lifestyle
After childbirth, a mother must follow a healthy lifestyle for their own wellbeing along with catering to the needs of the child. This includes taking a balanced diet, getting sound sleep and making exercise a routine. One can include a simple 10-minute workout in their daily routine that does not require handling of any technical exercise equipment. Women need to create quality time slots for themselves where they can practice self-care, take a nap, enjoy a movie, and spend time with friends. Sharing stress reduces it for everyone.
Reflect On Your Experience
Many young, new mothers opt for journals and checklists to organize their day and tasks, which helps reduce stress. Every other mother may be going through a similar phase of life and sharing experiences can help others. There has been a significant contribution of our mothers and grandmothers in giving us tips and tricks on childbearing and rearing. However, if girls, irrespective of their marital or motherhood status are sensitized about the experiences of a mother, they can contribute to a healthy experience of mothers prone to PPD. 
Seek Professional Help
Regarding help from a psychiatrist, studies indicate that a form of psychotherapy called Cognitive Behavioral Therapy (CBT) can be beneficial for treatment of moderate symptoms of PPD. It involves talking about thoughts and feelings with a mental health professional. During these sessions, one can find ways to set goals and strategize plans to deal with different situations. With each visit, a progress chart indicates how people feel better and are more in control of their lives. Doctors may also prescribe anti-depressants or medication for digestive and sleep related issues.
Contemporary discourse looks at shared parenthood and the significance of fathers in the child rearing experience. Therefore, as academics, clinicians or community members, we should have an understanding of how new fathers may also face fatigue, be overwhelmed or experience anxiety as they adapt to the role of a father. Both mothers and fathers can experience PPD and all the members of the household have a role to play in contributing to a healthy parenthood. HH

The writer is a lecturer at National University of Medical Sciences (NUMS). 
Email:[email protected]

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