Childbirth is a time of immense vulnerability for women as it is physically and mentally exhausting. Hence some childbearing women tend to face mental issues following the delivery. Although postpartum mental illnesses are considered significant health issues worldwide, only a few cases are diagnosed and managed promptly. People often refuse to address these
issues at the right time. Women are reluctant to seek professional help because they aren’t willing to disclose their emotional issues.
There is a popular misconception that motherhood is always related to happiness. They are often worried about being labeled as a poor parent. In many cultures, even the women’s families might discourage from taking outside help due to the general stigma associated with being diagnosed as mentally ill.
What is postpartum mental illness?
Postpartum mental illnesses include a heterogenous group of depressive syndromes that are presented during the first year following delivery of a baby, and the initial manifestation of such symptoms usually occurs within four weeks of delivery.
What causes postpartum mental illness?
Postpartum mental illnesses are believed to occur due to rapid fluctuations in hormones after delivery, precisely due to a decrease in progesterone, estradiol, and estriol levels.
What are the risk factors involved?
Risk factors for postpartum mental illnesses include younger maternal age (more in the age group of 13-19 years), lack of education, single parent, lower socioeconomic status, personal or family history of mood disorders, depression during pregnancy, obstetric complications, and caesarian section, glucose metabolism disorders, psychological and social stress, lack of social support and marital disharmony.
Psychiatric manifestations during the postpartum period include three categories, namely maternal blues, postpartum depression, and postpartum psychosis.
Maternal blues is considered normal and affects about 50 -80 % of new mothers. The symptoms include mood fluctuations, increased crying spells, irritability, and unreal feelings in the first ten days after birth. These symptoms are usually minor and resolve by themselves and usually do not require any particular intervention.
Maternal psychosis, on the other hand, is a very rare (1/1000 live birth), extreme and severe condition that is considered a psychiatric emergency and requires urgent intervention. Symptoms include hallucinations, delusion, rapidly changing moods, loss of inhibition, feeling of suspicion or fearfulness, and confusion.
Postpartum depression comes in the middle of the spectrum of postpartum mental illnesses. It affects 10-20% of women and includes mild to severe depressive symptoms. Symptoms include sadness, anhedonia, irritability, insomnia, difficulty concentrating, poor memory, anxiety, decreased appetite, hopelessness, not feeling worthy, feeling overwhelmed, and suicidal thoughts.
There are various repercussions of maternal depression on parenting which include guilt and anxiety about parenting, loss of love for the baby, thought of harming the baby, bizarre thoughts about the baby, expectation about the infant’s developmental milestones, reduced interaction with the baby and refusal to look or hold the baby.
Long-term implications of postpartum depression include a higher risk of future depression, being addicted to alcohol or illicit substances, negative impact on parenting skills, and refusal to become pregnant again to avoid another depressive episode.
An insight from mamahood
It is imperative to recognize and address your mental issues and emotions post-childbirth and seek professional help immediately to combat these effects. Regular health checkups and assessments should be done post-delivery for at least six months. Professionals take various approaches to treat postpartum mental illnesses, mainly postpartum depression. This includes interpersonal psychotherapy and cognitive behavioral therapy.
Increasing peer and partner support during the postpartum period has a significant impact on reducing mental health issues. In some cases, antidepressant medications are also prescribed to treat such conditions. Several other approaches have also been effective in a few cases. These include hormonal intervention, relaxation or massage therapy, bright light therapy, and maternal and infant sleep intervention. All these treatment strategies should be tailored according to individual needs.