"What if they think I'm a bad mom for complaining like this?"

Ask any mother and they’ll share a long list of the things nobody told them to expect during pregnancy and childbirth. You’ll feel like one of the zombie extras from Go Goa Gone because you haven’t slept properly in three months. Your pain threshold rivals that of the Incredible Hulk. And you may need to pick up a pack of adult diapers along with ones for baby. But some women find themselves battling an uninvited guest that can rob them of the joy of becoming a mother — Postpartum depression (PPD).

Estimates put the number of women experiencing postpartum depression at about 22% in India.

For Radha Gupta* it was an experience that was given a proper name years later. “Postpartum depression was unheard of 22 years ago. All I can say is that after the birth of my older daughter I was just not happy. I thought something was wrong with me,” she says.

“The time which was supposed to be happiest turned out to be harrowing.”

Understanding postpartum depression

There are three types of mood changes and mental health ailments that women can experience after childbirth. “The most common mental alteration is what we call the ‘baby blues’. This is right after you give birth and is triggered by the delivery which causes a sudden change in hormones,” says Sandhya Apte, OBGYN.

The added stress of childbirth on the body, fatigue and sleep deprivation can make you feel overwhelmed, helpless and on edge, she adds. These feelings can last about two weeks and slowly fade away on their own.

Apte stresses that such feelings are completely normal, but if they intensify and last longer than a few weeks, then it’s time to seek professional help for postpartum depression.

The third, postpartum psychosis is the least common among the three, globally affecting women in 0.89 to 2.6 per 1000 births. A serious disorder that includes feelings of disconnection from reality, hallucinations, rapid mood swings and more. This requires hospitalisation and in-patient treatment, says Apte.

Apte says that previous episodes of depression and postpartum depression can make you more susceptible to it happening postnatal. Problems at home, domestic abuse, relationship issues and personal stressors make the downward slope to mental health problems even more slippery.

The struggle is very real

Radhika had the kind of pregnancy we see in movies. There was minimal discomfort, barely any morning sickness and the love and support of her family that made it “smooth sailing, compared to what I’ve witnessed my friends go through.” She was all set to bond with her bundle of joy.

“I had read books about pregnancy, spoken to numerous women about their experience and sought advice on how to be best prepared. But everything after labour is a blur. It’s like I lost three weeks of my life. I do remember becoming listless. There was a weird kind of jealousy that my baby was getting more attention than me. I felt as if my job was done and now everyone’s focus shifted. There were bouts of unexplained anger, sadness and hopelessness and I didn’t even want to breastfeed.”

Her doctor called it baby blues and sent her home with her family. But her mental health slowly worsened over the next four months. “I was doing my ‘maternal duties’ but there was no joy in it. Then I felt guilty for even having these thoughts and it would become worse.”

While her family brushed it off as normal new mommy panic, Radhika knew it wasn’t. She saw a therapist and her feelings were finally given validation, as the therapist recognised that it was postpartum depression.

Finding allies and support

“After the birth of my daughter, I had sleepless nights and days. My days started at 6:30am because of family duties and till late at night, sometimes till the next morning because of the baby. I felt isolated as others were in their regular routine, but I was in a forced one. The postpartum phase is that time of life when you need more mental support, more love and care than the pregnancy phase,” says Aliya*.

Megha Sachdeva* got the support she needed in a mommy group. “My husband wasn’t able to understand what I was going through. I didn’t know it was real depression.”

Late one night after spending hours trying to get her baby to sleep, she spilled her guts to a Whatsapp group of women. “Then I panicked. What if they think I’m a bad mother for complaining like this? Who goes to a shrink just because they’re struggling a little with their baby?”

She was about to delete her message when she got the response she had needed for months. “It’s OK, I felt this too”. Those words finally let her take a breath of relief. “I had felt so alone this entire time. I learned that it was something other women also experienced and have sought help for.”

That morning she finally sat her husband down and told him that she needed professional help.

Yasmeen Sayed found an unlikely ally in a neighbour. She was recovering from an emergency C-section while dealing with a new baby, demanding in-laws who wanted a caretaker bahu and a husband out working for many days. “I felt isolated, trapped, abandoned and unloved all at the same time. I felt I could not do anything right.”

Her neighbour became her escape and saviour. She got the emotional support she needed, a helping hand and listening ear. “She cared for my baby while I rested, had a bath, washed clothes and went to the market.”

Treating and recovering from postpartum depression

Apte says that talk therapy can be tremendously helpful for new mothers experiencing symptoms of postpartum depression. Especially if they’re wary of taking antidepressants, though in some cases, both have to work in conjunction.

For Sachdeva, a weekly session with a therapist was enough to get her through her period of depression. “From my experience, a lot of the women who come in with depression symptoms just need to talk about what they’re experiencing. It helps them organise their thoughts and work through some irrational thoughts and correct them,” says therapist Nishita Khanna.

Therapy can help women understand and adjust this major transition in their life in a healthy manner. “It’s quite an upheaval of everything you’ve been accustomed to for all those years right up till that moment,” adds Khanna, noting that at times when it’s more progressive, low doses of antidepressants could also be prescribed.

Sanjana Patel admits she was never a major supporter of antidepressants. “I’m ashamed to say I was close-minded about mental health. When a distant relative disclosed her son had started taking antidepressants my first reaction was ‘Why, what is the need, he just needs exercise.'”

It took her months to confront her own feelings of postpartum depression and anxiety. After the second childbirth, she experienced those symptoms more intensely. “I’d spend days in bed, ignore my baby and refuse to even hold him. I was regretting getting pregnant, questioning everything, everyone, especially myself.”

A few weeks into therapy her doctor suggested medication. She refused. “What if it got into the breast milk and affected the baby?”

The effect of different medications on pregnancy and breastfeeding have been and are still being studied. But the newer studies have found that “infant exposure of antidepressants through breast milk is generally low to very low.”

While Patel agreed to medication, Apte says that this is a conversation that is different for every woman after taking into consideration their medical history, diet and lifestyle.

“Only us women can help other women. We need to talk to one another about motherhood and mental health as part of the whole pregnancy experience. If nothing else, it will help others identify their struggles, feel less alone and reach out for help instead of feeling like they are failing as moms,” says Radhika.

*Name changed upon contributor’s request to maintain anonymity.

A note of caution: This article is for educational purposes and includes personal experiences and inputs from experts. If you’re struggling with your mental health, please consult your healthcare provider. iCALL has put together a crowdsourced list of mental health professionals across the country, you can find it here. 

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