As joyful and exciting as the birth of a baby can be to a mother, it can be emotionally draining, tasking, and stressful leading to a depressed mood which affects a woman’s quality of life, social functioning and economic productivity. Having a new baby brings on a lot of big feelings love, joy, excitement, frustration, and nervousness to name a few. Experiencing highs and lows in the first weeks and months after birth are to be expected given the big emotional and physical changes that come with having and caring for a new little one. But for many, feelings of depression and anxiety can overshadow the celebration of welcoming your new family member.
According to the National Library Medicine (NLM), Postpartum depression (PPD) is a mental health disorder that yearly affects about 10–15 per cent of mothers worldwide with Nigerian mothers not being exceptional.
It sets in immediately or about two to six weeks after delivery and may last for over a year.
It is characterized by symptoms such as fearfulness, a feeling of hopelessness, emotional lability, feelings of guilt, sleep problems and loss of appetite.
Some symptoms of postpartum depression to look out for include feeling overwhelmed, persistent crying, lack of bonding with your baby and doubting your ability to care for yourself and your baby.
Another warning sign for postpartum depression is not being able to sleep, even when your baby is sleeping. If you’re exhausted, but you are lying awake because your mind is racing, your brain is not being your friend.
Speaking with Africa Health Report (AHR) Psychiatrist, Dr Oluwatayo Femi, said “Babies are a precious gift from God that every woman wants. As such the process of childbirth comes along with a rollercoaster of emotions ranging from joy and laughter to sadness and crying.
So having a period of feeling exhausted, anxious, sad, crying, clingy, irritable and struggling to sleep within a couple of days after delivery is fairly common.
“It is referred to as Postpartum baby blues and occurs in about 3 out of 10 women after delivery.
It usually goes away by itself as the high hormones in the body before delivery readjust itself within a few weeks of childbirth.
“However, in a minority of women, about 2 or 3 out of a thousand women after childbirth, the baby blues becomes more intense and lasts longer with the presence of other classic symptoms of depression such as loss of interest in usually pleasurable activities, social withdrawal, guilt feelings and thoughts of harming herself or the baby.
“Even more uncommon is a condition we refer to as Postpartum Psychosis in which in addition to those symptoms, the woman has symptoms of psychosis such as obsessional thoughts that something terrible is about to happen to the baby, believing that people are out to get her including to kill her, hearing strange voices or seeing strange things and becoming agitated and restless.
“Postpartum depression’s presentation is universal all over the world and is not any different in Nigerian mothers. “Postpartum depression is easy to diagnose for people familiar with mental health conditions.
It is like any other Depression, only that it occurs after childbirth.
“There are screening questionnaires such as the Edinburgh Postnatal Depression Scale, that primary care health workers or other non-psychiatry professionals can use to screen women suspected of having it and if the score is high, they can be referred for further assessment and treatment by mental health practitioners.
“The key issues are being able to differentiate it from Postpartum blues and knowing when to ask for professional help.
“The rapid changes in hormonal levels after childbirth and stress of labour most certainly have a role in the cause of Postpartum Depression as prolonged labour and other birth complications are risk factors for it. So also, are psychological issues such as worries about motherhood responsibilities, feeling unattractive afterwards and feeling insecure.
“Even more important are other known risk factors for depression such as a history of depression, family history, stressful life events and alcohol and illicit drug use
“The are several concerns. There are immediate risks of harm to both the mother and the baby.
“In severe cases, the mother may act on thoughts that there is something wrong with the baby or her thoughts that life is not worth living. Fortunately, it is rare for a mother to harm herself or her baby after childbirth as a result of Postpartum Depression. If untreated Postpartum Depression may last for a long time and become a full-blown Depression which can recur in the future even outside of childbirth. Another risk is the impact of the condition on the child’s immediate well-being and the child’s long-term development.
“This is more likely when the symptoms are not severe nor alarming enough for the woman, her family and friends to seek treatment. In such a situation, the mother would be taking care of the child but unable to meet the child’s needs so the child may be crying more, clingy, anxious, and unable to achieve normal milestones like smiling, walking and talking on time.
“If the woman is unable to exercise the usual motherly love and warmth towards the child nor respond appropriately to the play and interactions that the child instinctively displays, I don’t think anyone would be surprised to hear that this would affect that child’s emotional development.
“They are crucial for the normal development of the child including personality and intellectual development. The first thing to do is to recognise it and educate the woman and the family and friends involved about it.
“Then we should be providing support and reassurance to her.
“For those of moderate severity that require treatment, talking therapies such as Cognitive Behaviour Therapy (CBT) are the treatment of choice – in general, they involve several weekly sessions of identifying negative thoughts and skillfully helping the woman to understand and challenge the thoughts and gain control over them.
“The more severe cases would require medications in addition.
“Most antidepressants and calming medications are safe for the baby and the mother can continue to breastfeed but should only be prescribed under the guidance of a mental health professional skilled in this field.
“If there are concerns around risks to either the woman or baby, they should not be left alone and appropriate professional advice should be sought.
“The good news is that in general, Postpartum Depression is a treatable condition with a good outcome, so no woman should be allowed to suffer in silence”.
