February 22, 2022
Radhika is a 30-year-old lady with a two-month-old daughter. Ever since she delivered she has been feeling very sad all the time. She is unable to look after herself and her child. She has been crying often and thinking that it is better for her to run away. Her husband is a shopkeeper and has to work till late in the night. She feels there is no one to help her. Radhika keeps lying in bed, unable to do any work. One day when she had decided to overdose on fever tablets, her husband saw her just in time and brought her to psychiatrist for treatment.
What was described above is a typical case of postpartum depression. Postpartum depression occurs in 10 to 20% of all the deliveries.
What are the symptoms of postpartum depression?
Feeling sad all the time
Lack of energy
Loss of interest in pleasurable activities
Unable to do work
Crying spells and irritability
Feeling worthless helpless and hopeless
Loss of libido
Lack of sleep
Death wishes and suicidal ideation
Thoughts of harming the baby
What are the causes of postpartum depression?
Past history of depression
Family history of depression
Poor social support
Uncontrolled medical conditions such as hypothyroidism and diabetes
What is the course of postpartum depression?
Almost 80% of all women who deliver go through postpartum blues. This is characterised by sadness, weeping, poor sleep, irritation, lack of interest. But postpartum blues are self-limiting. Most women recover without any problems.
But postpartum depression is more serious and requires urgent attention. It is important to understand that it is a common condition. Though child birth is a joyous occasion for the family, but it also brings additional responsibilities and financial burden. The new mother who is already exhausted due to sleep deprivation, hormonal changes, is rendered helpless due to depression. Family support is very important here. Mild cases can be managed by counselling alone.
Moderate to severe cases require medical treatment in addition to therapy.
Left untreated depression may become chronic or severe and in few unfortunate cases, the mother may commit suicide. Depression also inhibits the bonding between the mother and child resulting in mother infant relationship disorders. Here the mother may not feel love and emotions towards the baby and may not be able to look after it well.
How to treat postpartum depression?
Detailed assessment is done. The severity of depression is assessed. Family members are involved in treatment.
In mild cases, cognitive behaviour therapy, supportive psychotherapy and interpersonal therapy helps.
In moderate to severe cases, a combination of anti-depressant and therapy is given. Certain antidepressants can be given safely and do not get much secreted into the breast milk. These are preferred for treatment. First episode of depression is treated for a minimum period of 6 to 9 months.
In very severe cases with suicidal risk, electro convulsive therapy is life saving and very effective.
Postpartum depression is a common problem. It is important to recognise it early. Prompt treatment has good results. The health of the mother and the baby improves. Family support and care from the spouse is as important as medication. Treating postpartum depression makes this period truly blissful!