Birth of a baby is usually seen as a happy moment in a family. However, when most of the family’s attention goes to the newborn, mothers often feel sidelined, especially by their husbands. 

This is a common scenario in postpartum depression or postnatal depression, a common mental health condition that new mothers face soon after giving birth.  

But ironically, it is also a topic that most people don’t discuss openly. Experts in the city talk about ways to address it, adding that the situation is quite grave.

Dr Shobha Krishna, consultant psychiatrist, Apollo Hospitals, Bannerghatta Road, gets at least 10 to 15 cases of postpartum depression in a year.

“The number will be huge when we take into consideration all the cases in the city. And these include patients who had a pre-existing condition and not exclusively the ones with onset postpartum depression,” she says. 

What are the red flags to watch out for?

Depression related to pregnancy and post-delivery can arrive either in the last trimester or within six months post delivery.

“Crying, withdrawn behaviour, lack of energy or interest in taking care of the child, increased irritability and negative cognitions about self and others, suicidal ideation, feeling hopeless and helpless are some of the common signs to watch out for in the
mother. Thankfully, suicide in such cases is not that prevalent now as most people are able to identify the problem and act accordingly,” says Shobha. 

It can also sometimes give rise to psychotic symptoms, where they have difficulty in differentiating real from the imaginary.   “Though pregnancy and birth of a child are considered happy moments, labour and childbirth are stressful processes, which bring about hormonal and lifestyle changes in an individual,” says Shobha.

She points out that if an individual has had depression earlier, chances are that she is more vulnerable to get another episode post delivery. Extensive support from the family along with medicines can help one, if the depression is mild. Otherwise, therapy along with medicine can help one get out of postnatal depression. 

Shobha says that though postpartum depression is common, the scene has improved considerably over the years. “With easy access to the internet and growing awareness about mental health in general, people are able to identify the symptoms early on.”

With good antenatal care education being given to young mothers, there is awareness about what postpartum depression is.

However, not everyone gets continuous antenatal care. The rural sector is one where awareness is quite lacking about this phenomenon.

Dr Sireesha Reddy, consultant, obstetrician and gynecologist, Motherhood Hospitals, Hebbal, points out while even fathers may go through stress during the process, it cannot be termed as postnatal depression

Only women suffer from this biological condition. 

“Early identification can help the mother. Post delivery, family members should keep a close check on whether there are any behavioural changes, like sadness or bouts of crying. They should also make sure not to leave the mother unattended. If they see something amiss, it should be brought to the notice of the caregiver and doctors rather than handling it themselves,” says Sireesha.   

Does it happen only during the first pregnancy?

“No, it can happen anytime. There is no pattern to it. However, it is helpful if the mothers know they have depression in the first pregnancy. This will make them more aware the second time. Mothers should be open about their mental health issues (if any),” adds Sireesha.

A mother’s account

Priyam Bortamuli,
communication professional
“I delivered my baby in the seventh month. The unplanned and premature delivery led to the baby having to stay in the NICU. This took a toll on my physical and mental health. Even after we brought her home after 60 days, we had to take extreme precautionary measures until she reached a safe zone. This period was quite strenuous and I started developing anxiety, panic attacks, along with lack of sleep. A feeling of extreme guilt and lack of confidence, which also led to weight gain, took a toll on me. This continued for about eight months until I rejoined work.”

How did you cope with it?
“Getting back to work did help to a certain extent. I soon joined a fitness center when my daughter was nine months old. Working out helped me a lot in getting out of my depression. I had a job change around that time and my new bosses were extremely supportive, just like my family, husband and friends. This, coupled with ensuring sufficient help at home, led me to have enough time for myself.”

Short film on postnatal depression
Not many Indian filmmakers have brought this issue to the big screen. Director Swati Semwal recently released ‘Newborn Mother’, a short film that highlights the subject of postpartum depression.
She says, “I was always interested in child psychology, and studied somewhere that a baby cries when the mother is anxious. This caught my attention and I wanted to go deep into this condition. With this film, I wanted to show the other aspect of pregnancy. This side of motherhood is not touched upon by filmmakers. We only see that everyone is happy after a baby is born.”

She says that some mothers don’t understand why they aren’t happy. This leads to frustration, which they take out on the child or their husband.

“We have to first accept the fact that it is a real condition and it exists where a new mother doesn’t connect with their baby or feel happy about it.”

She adds that there is a pressing need to spread awareness about this mental health condition

How to identify postpartum depression?
Hormonal variation, stress of going into labour and the delivery takes a toll on a woman.

The first two weeks after delivery is a time for postnatal blues. If after two weeks,
the new mother is withdrawn, is not taking care of the baby, is less interested in life and has mood changes, it is a cause for alarm.