Dr Sindi van Zyl explores postpartum depression and offers solutions to help you cope with it.
The birth of a baby is a joyous occasion for most mothers. You have waited nine months to see your bundle of joy, and they finally arrive. The first few weeks of motherhood are daunting, especially if you are a first-time mother. You have to adapt to a lot of things, and may be tired all the time. This comes with feeling emotional and frustrated, which is normal. For some mothers, this phase passes once they have adapted to having a new person in their lives. But for others, this is not the case because of postpartum depression (PPD). The South African Depression and Anxiety Group (SADAG) says statistics on the prevalence of PPD are not available. But, the World Health Organisation gives some insight on international statistics. “Worldwide, about 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. In developing countries this is even higher; i.e. 15.6% during pregnancy and 19.8% after child birth.” In April 2013, I was admitted to a mental wellness hospital with clinical depression. During my sessions with the clinical psychologist, I was diagnosed with PPD that had started shortly after my second child was born. The symptoms had been present for at least a year, but I had not recognised them. I had thought that I was just going through the tiredness of being a mother. Getting admitted got me the help I needed. Firstly, I had to learn how depression actually works. This is a mood disorder that normally starts with feelings of self-doubt and sadness as well as loss of interest in activities that you once enjoyed. Depression is more than just feeling down; it is a serious mental illness that has an impact on both physical and mental health. PPD usually arises from a combination of hormonal changes and adjusting to psychological changes of motherhood and fatigue.
SYMPTOMS OF PPD
Sadness – You experience an enduring sense of sorrow and hopelessness. You may be in low spirits all the time, causing even former hobbies and passions to fail to interest or please you. Often, mothers cannot pinpoint reasons for this sadness, though some connect it to their newborn. In rare cases, PPD can make you resent your children and ignore parental duties.
Mood swings – You exhibit unpredictable mood swings and temper, feeling fine one minute and agitated or saddened the next. The most commonplace occurrences may incite intense reactions. The mood swings leave you further exhausted and confused, and that can lead to shame and self-loathing.
Feeling overwhelmed – A lot of new parents experience PPD due to the overwhelming prospect of parenthood. You suddenly feel inadequate as a caregiver and doubt your ability to support and nurture your children. In extreme cases, you entertain thoughts of abandoning your children. That further exacerbates guilt when the feeling passes. You may also regret having a child.
Crying spells – PPD tends to provoke frequent crying spells. You might cry at odd times, and without an obvious cause. The bouts may occur several times a day, with violent intensity in severe cases. During these events, the other parent or caregiver should try to give you a break and ensure that you are safe in your surroundings.
Problems with memory and concentration – You may begin to ignore work, getting lost in your thoughts and worries. This can exacerbate anxiety. You may also exhibit less obvious signs, such as forgetting where you placed items or whether you have fed, changed or bathed the baby.
Changes in sleep cycle – You experience disruptions in your sleep cycles. This includes stretches of insomnia or sleep for longer than you used to. You feel fatigued at odd times, often when the situation demands concentration. Of course, a newborn changes your sleep cycle. But, if they are intense and feel unmanageable or persist for several months after the baby is born, you may be suffering from PPD.
Altered patterns of eating – A significant increase or decrease in your appetite may be a sign. Once the pregnancy is over, eating habits return to normal. But, continuously rejecting your favourite foods or gorging on those you previously disliked, as well as eating at odd times, can signify PPD.
Loss of libido – Many people report a loss of libido and lack of interest in sexual intimacy. This may be attributed to the anxiety and distraction caused by the increased responsibilities of parenthood. A subconscious association of sex with conception and childbirth can also cause this avoidance, as can depression.
Social withdrawal – The sense of sadness and anxiety that you feel can make you avoid social interaction, friends and family, and possibly isolate yourself from social settings. You may stop taking calls and responding to messages as well as avoiding work to maintain your solitude.
Enduring sense of exhaustion – Fatigue and exhaustion are common if you’ve just had a baby. But, this persisting to the point of incapacitating you several months later, may be a consequence of PPD.
HOW TO GET HELP
- See a healthcare professional.
- They may refer you to a clinical psychologist or psychiatrist.
- They may admit you to a mental health hospital if the situation is deemed to be very serious.
- Psychotherapy is important. You may get medication if necessary. There are myths about medication being addictive, but that is not true. It is important to know how it works, and you need to take it every day. The medication kicks in after about six weeks, and you have to take it for at least six months to see a change. It does have side effects, but don’t be afraid. Make sure you understand what each medication is for as well as its side effects.
- Do not stop taking medication without consulting your doctor.
Living with a mental illness is not easy. The stigma makes it difficult for you to speak up about how you feel. But, remember that happy mothers have happy babies! If you are physically and mentally well, you will be able to look after yourself and family properly. Contact SADAG on 011 783 1474/6 or SMS 31393, 7 days a week from 8am to 8pm.