Post-Partum Blues-How real are they???

"The most awaited moment of my life had finally arrived.  I had become a ‘mom’.  MOTHER is such a precious word.  To bear a life inside of you; and then to actually bring it into the world!!!

I should have been on cloud nine; isn’t it?

Nothing could have prepared me for the emotional emptiness I felt afterward!

After a gruesome labor, I gave birth to my beautiful baby boy.   I had awaited this moment ever since my marriage, but never in my wildest dreams did I imagine ‘not connecting’ with my own flesh and blood.  I remember feeling numb, lacking all feelings.  I saw my baby, as if I was just ‘seeing some baby’ and not my own.  I felt so detached.  I was afraid to carry him for fear of dropping him.  I was filled with guilt and shame for having ‘such a bad heart’ for ‘not loving him’, the fruit of my very own womb.  I knew something was wrong with me; this shouldn’t be happening; this couldn’t be right.

I did not know whom to speak to, I did not understand what was happening, I ended up crying and crying and crying…

My husband who would have been my greatest support worked out of the country and I was left to tend to my own emotional turmoil.

Days passed by and then weeks…

Nothing seemed to bring me joy.  I still did not like holding my child or taking care of him.  I didn’t feel like feeding him either. 

Once I had this irresistible urge to throw him from the 3^rd floor of the shopping mall.

  I remember crying and wanting to die for feeling this way!  I hated sleeping with him.  And I hated myself for feeling that way.  All this time, it was my mother who took good care of him.

I finally decided to see my doctor and confide in him.  He gave me the same medicine that I took prior to my pregnancy.  That was when, after a good six months of torture and suffering, I began feeling better once again.  I actually began loving my baby.

People might have thought ‘I was the worst mom’; But I did not choose to feel this way:  Today; I know and understand that it was my illness that made me feel the way I felt.

-Anonymous

Postpartum blues

Post-Partum blues are real!  It is said that about 50 to 85 percent of women experience the postpartum blues within a few weeks of childbirth, often characterized by quick mood changes, anxiety, quick irritability and tearfulness.

However, if she begins to experience confusion, paranoia or extreme depression, seek professional help as soon as possible.

Post-Partum Depression:

When the post-partum blues don’t go away after about 2 weeks of birth; or make it harder for the mother to take care of the baby, that’s when you know, it has transitioned into Postpartum depression. 

Postpartum depression is often caused by the hormonal changes that happen after childbirth.   These changes when accompanied by other stressors, like; decreased sleep, increased stress and anxiety about taking care of the new born can further exaggerate the symptoms.

Moreover, women who had suffered from depression prior to their pregnancy, or those with a family history of depression are more susceptible. 

“I had suffered from depression way before I became pregnant.  My doctor had actually cautioned me against becoming pregnant for he feared my depression may get worse.  But I was desperate to have a baby; to hold my ‘own’ child in my arms and to forget myself in his love.

Against my doctors’ well-intentioned advice, I soon became pregnant.  My doctor changed my medication at this point, so it would not adversely affect my baby.  But this new medicine was so expensive…. I could hardly afford it….and thus began my ordeal; throughout my pregnancy and even afterwards….  At this point, I not only had bouts of depression; but episodes of mania as well”, Says the lady whose story we read earlier.

Other things that might increase the chance of depression after childbirth include medical problems during the pregnancy or after birth and lack of support at home.

Post-Partum Psychosis:

“Working as a nurse in an acute female mental health unit, I once cared for a new mother, 10 weeks after she had given birth to a beautiful baby boy.  For confidentiality purposes, I am going to call her Jane Doe.  Jane Doe had stopped taking her medications for bipolar disorder during her pregnancy because she feared they would harm her baby.    As warned by her psychiatrist, she began experiencing symptoms few days after childbirth.  “I wouldn’t sleep for days on stretch.  I thought and felt like a super-hero.  I didn’t feel the need to either eat or sleep.  I thought that the TV in the house was speaking to me.  The music was created to mock me. I thought the baby was going to die from some infection.  I kept cleaning and cleaning and cleaning……I thought I loved my baby to death; until one day I wanted to drown him in my bath tub; that is when my husband took me to a psychiatrist and I landed here, in this hospital” says the sad mother.

While most of the women quickly recover from the normal ups and downs following childbirth, about 1-2 women in 1,000 experience a much serious condition called Post-Partum Psychosis.

This is a psychiatric emergency and can further be aggravated among women with an established diagnosis of bipolar disorder before pregnancy.  If left untreated, it could pose serious life-threatening risk to themselves, their babies and others.   In Jan 2020, BBC posted a story of a woman who suffered postpartum psychosis, tried to kill her newborn baby and husband by driving into a wall.

The Bipolar Connection:

There is a very special relationship between Bipolar Disorder and Post-Partum Psychosis, say the experts.  While research predicts, about 25-30 percent of women diagnosed with bipolar disorder pre-pregnancy will end up having PPP, the same can be said of women with no previous psychotic episodes.  About 75-80% mothers who experienced PPP following childbirth are more likely to have symptoms of bipolar disorder within the year, says research.

Manda, a mother of twins, had a history of head injury, PTSD, Bipolar Disorder, Attention deficit disorder, GAD and panic disorder.  She had a 7-year history of psychosis before she knew she was pregnant; and pregnancy didn’t make her pregnancy or the post-partum period any more pleasant.

“Upon learning about the pregnancy, I was stressed.  Although I knew this was going to be bad, I never imagined how bad.  My pregnancy was miserable, despite taking psychotropic medication; (I took Quetiapine, Abilify monthly injections and Xanax).  

I continued to be tormented by panic attacks and severe bouts of depression.

Initially I obsessed about things turning wrong; gradually I began imagining that things were actually wrong.

When the kids were born, my condition worsened. The twins were here. It was a reality now. The whole delivery process felt like I was there, but I wasn’t. It felt like it was happening to someone else. Their prolonged stay in NICU made it impossible for me to breastfeed; I lost a LOT of bonding time, which once again made me feel like those babies were not mine. It wasn’t me who had given them birth.

I started to feel detached immediately because of my mental history. I really believed that they were going to take my babies away. I didn’t know who, but I was paranoid of everyone.

During the entire time that it took me to heal, I was fortunate enough to have my mom, aunt, brother, husband and father as my stronghold, my support. They each chose days of the week, so I was never alone with the kids during my postpartum depression. My whole family and my doctor were fearful that I was going to start having psychosis and start hallucinating again, but the closest I came was delusions, detachment from the kids and reality, I thought there was no point in getting close to them for fear they were going to be taken. 

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The whole nightmare lasted about 7 months, 3 of which were the worst.  However today, I here I am, happy with my twins and grateful for the gift of life.  At 20 months old, my twins are my bundle of joy.

Tell-Tale signs of PPP include:

Mania like symptoms:  reports of decreased need for food and sleep; and irritability, racing thoughts, labile mood (The mother may laugh uncontrollably one moment and become tearful and weepy the next).  One may find these moms more talkative, sociable, and excessively on the telephone.  They may speak rapidly, at times changing one topic from another, with no connection in between topics.

Depressive symptoms:  such as losing interest in normal activities, ignoring self-care or personal hygiene, having trouble sleeping, or feeling tired or anxious, feeling no ‘bond’ or ‘connection’ with the baby.

Paranoia:  Watch out when the new mother says, “He/She is trying to kill my baby”, “The nurse in the hospital switched my baby”, or “I’ve got the devil on my back” or makes any such delusional statement’s.  There are times when moms have reported feeling that things are connected in special ways or that stories on the TV or radio have special personal meaning

 Confusion:  A few mom’s report confusion after childbirth.  I remember experiencing mild memory loss and confusion; forgetting where I had placed the baby’s bib, and as silly as it might sound; getting confused about normal activities, such as how to warm up a baby’s formula or where I had placed my keys.

 Thoughts about harming the baby:  Although rare, some women with post-partum psychosis may actually harbor thoughts of harming their babies.   There have been a very small percentage of women who have actually killed their babies or have died because of suicide.

Insider tips to help you feel better:

Do not hesitate to accept any help that comes your way, especially in the first few days and weeks after birth.  It’s okay to let family and friends help with errands, buying stuff, household chores, or even to take care of your child while you take a nap or a shower.

Develop and maintain healthy eating and sleeping habits.

Talk to your friends or other new mothers whenever possible; to get help, support and any additional tips that you may need.

Stay Prepared well ahead if you are at a risk:

*Get in touch with your psychiatrist as soon as pregnancy is discovered; if you have an underlying mental illness and discuss the possibilities and strategies to dealing with a post-partum psychosis after delivery.   This will give the psychiatrist ample time to monitor your, moods and adjust your medication as necessary.

*Make sure you sleep:  Make sure you make time to sleep.  Sleep deprivation that new mother’s often experience, can often trigger symptoms of post-partum depression or psychosis.  However, if a woman is fully energized and unable to sleep, know that it is time to see her doctor.

It’s high time, we realized postpartum depression and psychosis is real!  Let’s learn to separate the person from the disease.  Just like the person suffering from high blood pressure or diabetes did nothing to deserve it, so did the mother suffering from post-partum blues.

All expectant mom’s, mom’s who just gave birth and mom’s experiencing any one of these symptoms- this one is for you.

Ditch the guilt and accept the fact that it is okay to seek and accept help!  You are not a bad mom if you want to take a much needed and deserved nap!  Take care of yourself, your needs and your self-care routine; so, you will be better equipped to take care of your baby!

Dad’s, grandma’s and grandpa’s, uncle’s and aunt’s, neighbor’s, friends and well-wishers’, it is not just for the mother to do it all alone; it takes an entire village to raise a baby.  Help the new mom sleep as much as she wants to; give her the time, the space and the support!

With the right treatment, full recovery is possible. Recovery may seem like a huge roller coaster ride; and the journey may be tough. The illness can be frightening and shocking for both the woman experiencing it and her family. However, good news is that, there is hope!

Women do return to their normal selves, and are able to regain the mothering role they expected!