Image Copyright: Sushmita Chatterjee
“You guys wouldn’t understand because Indian society does not fully understand post-partum depression”. Those were the words of 31-year-old Nima Bhakta, who took her own life in July 2020, leaving behind her son Keshav; who was just seven months old at the time.
Like Nima, many Indian mothers suffering from depression do not report it, owing to social stigmas or misunderstanding surrounding the issue. In too many cases, this leads to suicide.
With post-partum depression according to some studies affecting one in every five Indian mothers, it has become a silent killer – at a tragic moment of having brought new life to the world. Lack of awareness is one of the leading cause of it going unreported. Many mothers simply judge/harshly criticise their own parental abilities, rather than seeking help.
Like all things, making progress on this issue starts with understanding it…
What Is Post-Partum Depression?
According to the Royal College of Psychiatrists, Post-partum depression (PPD) is a depressive illness which affects between 10 to 15 in every 100 women at some point after birth.
The symptoms are similar to those in depression at other times. These include low mood and other symptoms lasting at least two weeks. Depending on the severity, those affected may struggle to look after themselves and their baby. They may find simple tasks difficult to manage.
Sometimes there is an obvious “reason” for PPD, but not always.
Mothers may feel distressed, or guilty for feeling like this, as they expected to be happy about having a baby. However, PPD can happen to anyone – nobody is to blame.
What are the symptoms of PPD?
According to experts, the main symptoms include:
- A persistent feeling of sadness and low mood
- Loss of interest in the world around you and no longer enjoying things that used to give you pleasure
- Lack of energy and feeling tired all the time
- Trouble sleeping at night and feeling sleepy during the day
- Feeling that you’re unable to look after your baby
- Problems concentrating and making decisions
- Loss of appetite or an increased appetite (comfort eating)
- Feeling agitated, irritable or very apathetic (you “can’t be bothered”)
- Feelings of guilt, hopelessness and self-blame
- Difficulty bonding with your baby with a feeling of indifference and no sense of enjoyment in their company
- Frightening thoughts – for example, about hurting your baby; these can be scary, but they’re very rarely acted upon
- Thinking about suicide and self-harm
Culture and Stigma
Cultural inhibitions can exacerbate symptoms.
As Ektha Aggarwal, who is a US-based psychotherapist, notes : “South Asian women worry that speaking up about their symptoms is a sign of weakness. Often they worry if they may not be fulfilling their obligations as a mother. They don’t experience the feeling of unconditional love for their child. Medication is not always the preferred solution as it has the potential to poison the child (via breastfeeding). The challenge is access to culturally and linguistically competent psychotherapists is limited…and sometimes, even frowned upon.
“Culture plays a significant role for all human experiences and is rooted in shared ideas and perspectives, standards for community responses, and cognitive styles. Culture can impact the way South Asian women not only experience PPD, but also the way they may ask, or even, not ask, for the support they require. The cultural challenges surrounding mental health play a significant role in preventing South Asian women suffering from PPD from reaching out for support.”
In India, women are more at risk of PPD especially if they are in a vulnerable socio-economic system. “Domestic violence,having a female child,lack of support from husband has been a major contributing factor”, says Dr Sabiha Anjum, who is a practising gynaecologist and a PPD survivor herself.
Speaking of Stigma, our Indian society is very averse to the idea of anti-depressants and a lot of mothers worry about it effecting the new born through breastfeeding and therefore actively choose to compromise their mental health instead. But new studies have found that “infant exposure of antidepressants through breast milk is generally low to very low.”
Whilst therapy and medication can help in the treatment of post natal depression, Dr Sabiha Anjum says, “The husband is the first person who needs to be there! Once he ‘listens’ and understands and just be there for her, she can feel confident to seek medical help and try to work on her situation.
“Everyone else too shouldn’t try to ‘fix’ the situation. Sometimes being there and saying ‘ I understand’ works wonders!”
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