Postpartum mood disorders are commonly found among some newly delivered mothers, either 2-3 days after delivery or sometimes after 2-3 months. These include a spectrum of problems ranging from minor (baby blue or postpartum blue) to serious psychiatric problems (postpartum psychosis). Sometimes family members are engaged with the newborn and these problems are overlooked or neglected/unattended and most of the time get serious.
Women's body undergoes not only physical but also emotional, psychological changes due to interactions of different hormones and chemical neurotransmitters. The intricate balance system can be disturbed by biological or environmental factors as chronic illness, trauma, sudden death or bad news of near ones, domestic violence, family or personal history of anxiety or depressive illnesses, attention deficit hyperactive disorders (ADHD), obsessive compulsive disorder (OCD), serious childhood trauma, difficult delivery or extreme unhealthy family environment even sometimes too much loneliness might trigger to outburst these problems. It can affect all reproductive age groups irrespective of education, social or economic level.
As many as 1 in 5 expecting or new mums and 1 in 10 will experience perinatal anxiety or depression. Expecting or new dads can also suffer from pregnancy-related mood problems as when their partner is pregnant, his testosterone level drops and produces higher levels of oestrogen, cortisol and even prolactin. So the father might feel stressed, aggressive or depressed along with social factors like more responsibility and lack of sleep also contribute to it.
Postpartum or baby blue: Almost 50% of women suffer from this transient state of mental state, which occurs 2-3 days after delivery. It is manifested by unusual tiredness, crying, irritation, too much stress and some negative feeling towards the baby. It usually persists for 2 weeks. Reassurance, close family members' love and affection, attention and care cure this condition. If it persists for more than 2 weeks it can progress to postpartum depression.
Postpartum depression: Usually occurs within 2-3 months following delivery or miscarriage in 10-20% of women – similar to postpartum blue but it is a painful condition that lasts longer and hampers her daily activities. Signs include sadness, apathy, not showing interest in anything or anyone even to her newborn baby, less sleep/less food intake or too much eating, unusual tiredness or hatred to others and/or constant crying. When severe enough she can hurt herself or the baby and even maybe suicidal. So, as soon as symptoms manifest it is better to seek consultation from a psychiatrist as she needs medication and psychotherapy.
Postpartum psychosis: This is the extreme form of the postpartum disorder. It usually occurs within the 1st week after delivery. Every 1 in 500-1000 mothers with a past or family history of such illness will have this. It is manifested by unusual attitude and behaviour, delusion, hallucination, unnecessary laughter or crying and insomnia. As postpartum psychosis is a medical emergency, it is best to seek treatment from a psychiatrist as soon as possible. Medication, psychotherapy and counselling are extremely helpful.
A mother has to undergo a great many physical changes, mental stress and psychosomatic outbursts but all these can be relieved if she received warm greetings, proper empathy and sympathy from close family members especially from her husband. Simple kind words, sincere assistance in her daily activities like cooking, taking care of the baby - these mean a lot especially for a new mother in a completely new environment where she is trying to cope up. Family members must remember to not unduly criticise or try to find faults in every activity, never compare with other mothers and using harsh comments to willingly hurt her, rather should try to praise her to sustain her personality, self-respect and to keep her overall functioning. It is our sacred responsibility to help every mother to lead a healthy decent life by giving her proper care, attention and affection.
The writer is a Gynaecologist and Obstetrician working at Widad University College, Malaysia.