Why the blues hit you after pregnancy
IT has been nine months of morning sickness, backaches, swollen feet and ankles, heartburn and exhaustion. After that comes labour, all 20 hours of it, followed by round-the-clock feeding and cleaning of the baby. Yes, that is the miracle of birth. As wonderful as it is to be blessed with a baby, the process of pregnancy and childbirth is incredibly stressful due to the hormonal upheaval occurring in the body.
These hormone changes affect a woman’s mental and emotional state as well. That is why she can experience some emotional rollercoasters, ranging from postpartum blues (sometimes called “baby blues”) to very serious psychosis. The baby blues can be overcome with proper rest, a healthy and balanced diet, and most importantly, support from family and friends. In this article, I will elaborate on the three main types of emotional reactions to childbirth: postpartum blues, postnatal depression and puerperal psychosis.
It’s normal to feel frustrated, experience mood swings and have restless sleep patterns in the first few months after childbirth. In some 80% of women, this is known as postpartum, or baby, blues. Baby blues can start between the second and eleventh day after delivery, and is caused by hormone changes in the body. It may last only a day, or up to a week. You may find yourself bursting into tears unexpectedly, for no apparent reason. You will be subject to mood swings, become extra sensitive, have difficulty concentrating and feel discouraged a lot of the time. These symptoms come and go, so you may feel perfectly normal at times, and very down at other times.
It is not uncommon to also feel frustrated, irritable, forgetful, lonely and, at the same time, guilty for having such reactions. These symptoms are caused by hormones, but also by the exhaustion that every new mum faces.
Baby blues can be overcome with proper rest, a healthy and balanced diet, and most importantly, support from family and friends. Your husband plays a crucial role in making you feel loved and appreciated, and in making sure that other people do not interfere in your family affairs. Do not be ashamed to ask for help when you need it, whether it is caring for the baby, household chores or if you just need someone to talk to. Baby blues do not last beyond the first four months after the baby is born. If they do, it might be part of a more serious psychiatric condition.
Not too long ago, the American actress Brooke Shields admitted that she had suffered from postnatal depression. She described an experience that affects one in 10 new mothers, but due to social taboos, few women dare to admit to it. Postnatal depression is a psychiatric illness that may set in after a new mother’s six-week checkup. It is unlike baby blues because the symptoms are continually present, and are more serious. A woman might experience all the feelings as with baby blues, but on top of that, she may also have panic attacks, obsessive thoughts and fantasies, as well as detachment from her baby.
When interviewed by the BBC, Brooke Shields admitted that she had no maternal feelings towards her daughter. “I had no desire to pick her up, no desire to gaze at her €” all I could do was cry.” She even fantasised about killing herself and her baby. This is why postnatal depression is such a taboo in our modern society. Nobody can understand or sympathise with a new mother who does not show “normal” emotions like joy and affection for her baby.
Nonetheless, mothers with postnatal depression should not be ignored. Left untreated, it can go on for years, or there could be immediate dangers, such as suicidal tendencies. Those around a woman affected by postnatal depression should support her in seeking the right medical treatment, which includes medication, psychological therapy and counselling.
The most serious postpartum emotional condition is puerperal (or postpartum/postnatal) psychosis. Fortunately, this serious psychiatric illness is very rare, occurring in only one in a thousand women. Puerperal psychosis is a severe mental disorder which occurs about two weeks after childbirth, where contact with reality is lost or highly distorted. The most common symptoms are delusions (false beliefs) and hallucinations (hearing voices or seeing things that aren’t there). It can also cause emotional upheaval, confusion, memory loss, obsessive behaviour, as well as rigidity or extreme flexibility of the limbs.
Women in this situation will not understand why they are suffering these symptoms. Their partners and family members need to recognise that this is a very serious condition and immediate hospitalisation is required. With the right treatment and support, a woman with puerperal psychosis can recover completely. The most important thing is to recognise that all of these three conditions can affect any woman
who has just had a baby. She needs all the support and understanding she can get, from everyone around her.
The Star Newspaper, Sunday September 21, 2008
By Dr NOR ASHIKIN MOKHTAR