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Emotional Labor: Postpartum Depression
After 36 hours of labor, a difficult C-section, and several stitches, Sukanya Bose* could finally look forward to the happiest moment of her life—cradling the baby she had been trying to conceive for the past six years. At least, that is what everyone who knew the 31-year-old office administrator believed. Instead, within months, the usually upbeat young mother felt despondent enough to consider taking her own life. When she started verbalizing her suicidal feelings, her family dragged her to a counseling NGO where I was interning after my postgraduate studies in psychology. I only got to meet her once, during her intake interview. She claimed she didn’t think of the child as her own, she didn’t feel capable of taking care of her daughter, she felt overwhelmed and numb all at the same time, it was impossible for her to comb her own hair or eat regularly, she couldn’t see a way out of the cage she felt trapped in. Her diagnosis: major depression with postpartum onset. The psychologist in charge immediately referred her to a psychiatrist; unlike psychologists, they have medical degrees and can prescribe medications, and that’s what Sukanya needed at that critical time. I don’t know what became of her, but if she got the right kind of treatment, chances are that she’s living a happy, healthy life right now. Postpartum Depression vs. “Baby Blues” It’s pretty normal to feel a bit down in the dumps after having a child—in fact, up to 70 percent of all women experience a syndrome, popularly known as the “baby blues.” Symptoms usually make their appearance three to seven days after giving birth and include mood swings, changes in appetite, fatigue, and sleep problems. This type of depression is fairly mild and the mother’s ability to function is minimally compromised says general physician and psychiatrist Melvyn Lurie in his book Depression: Your Questions Answered. “’Baby blues’ usually last for two or three months after childbirth. On the other hand, postpartum or postnatal depression (which occurs in about 1 in 8 to 10 women) is characterized by more severe and prolonged signs and symptoms.” It is also important to note that although it’s most common for women to start suffering a few days after birth, the illness, according to recent studies can develop more slowly and insidiously in others. You could be smiling and gurgling happily back at your baby for months before the disorder casts its pall; and if not treated properly, it can dig in its heels and gradually develop into a chronic mood disorder or, in rare cases, psychosis. Signs of Trouble Pay attention to your feelings, especially if you’re a young mother. Depression often creeps in innocuously enough and many of us seem to see some sort of strange valor in denying our feelings even if they persist for an uncomfortably long duration—“Oh, I’ve just got the blahs! No problem!” Young mothers are particularly predisposed to such denial. After all, they’re supposed to be happy, they are expected to be happy and to jolly well do a jig of joy to celebrate each malodorous diaper change. If they don’t do that? Well, they’re just bad mothers. None of these silly, indeed mythical, “values” mean anything. The onset of depression is just as controllable as diabetes is, and just like diabetes, it needs treatment. Yet, in a study published in the 2002 book Depressive Disorders, Hong Kong researchers Paul Yip and Dominic Lee claim that “despite the potential deleterious consequences of postnatal depression, research shows that as many as 90% of postnatal depressions are undiagnosed and untreated.” Just remember, you’ll get the right help only when you acknowledge the problem. The symptoms to watch out for echo those present in major depression: feelings of worthlessness and hopelessness, changes in eating and sleeping patterns, irritability, lack of motivation, and a hard time getting out of bed in the morning. These feelings—aptly described by novelist William Styron as a “gray drizzle of unrelenting horror”—and the behavioral stagnation they result in are bad enough to mess up your job and wreak havoc with your relationships, but the potential for damage multiplies when you have a young baby to take care of. According to the Gale Encyclopedia of Mental Disorders, mothers might become emotionally detached from the infant, fail to bond with them, neglect them, and may even have uncontrollable impulses to harm them physically. There is no dearth of horror stories on the news about moms who just “snap” because of postpartum depression or psychosis. Andrea Yates, the devoutly religious Texas woman who drowned her five children on the orders of the voices in her head is perhaps the most famous example, but instances of other moms who endanger their children in less dramatic ways are more common than most of us would like to think. Tackling the Demon It’s tempting to attribute all the mysterious vagaries of female behavior to “hormones”, but that is a far too simplistic way to explain away the illness. It is not that researchers haven’t been frantically following that line of enquiry, but the general consensus appears to be: “Heck, we don’t know!” What has been found, across numerous studies is that hormone levels for estrogen, progesterone, prolactin, and cortisol are not significantly different between women who suffer from postpartum depression and those who do not. Like other forms of depression, the biological processes in action are more likely to be neurochemical than hormonal. So while the doctors tinker around their labs, your own personal experiences with pregnancy and in other aspects of your life could tell you a lot more about the factors that might make you vulnerable to the illness. The Gale Encyclopedia says it straight up: “Postpartum depression is unlikely to occur in a patient with an otherwise psychologically uncomplicated pregnancy and past history.” Your risk of developing postpartum depression increases if you’re already prone to depression (or a previous episode of postpartum depression), have a family history of mood disorders, have experienced a stressful pregnancy, are in a not-so-happy marriage, and don’t have enough social and financial support. Also, as an Indian woman, you may be burdened by a host of other external pressures that distort and damage your experience of motherhood. A study conducted in Goa found that other than preexisting depressive disorders, poor marital relationships and economic hardship, women who were anxious about having sons were prone to developing postpartum depression. “The preference for male children is deeply rooted in Indian society. Thus, women who already have a female child face greater stress because of their wish that their new infant be a boy. In the event that the child is a girl, the risk of depression is greater. Mothers may be blamed for the birth of a female child,” say the authors of the study. While these internalized socio-cultural pathologies—because that’s what they really are—are difficult to control, you are not completely powerless when it comes to maintaining your mental well-being. Plan your pregnancy very carefully. Let your doctor know about your and your family’s history of mental illness and work with him/her to work out a course of preventive treatment for you. And since you’re signing up for that Lamaze class anyway, it may be worthwhile to minimize your stress level by taking a shot at couples therapy and individual psychotherapy. Whatever you do, don’t keep it to yourself. *Names changed to protect identities Chillibreeze's disclaimer: The views and opinions expressed in this article are those of the author(s) and do not reflect the views of Chillibreeze as a company. Chillibreeze has a strict anti-plagiarism policy. Please contact us to report any copyright issues related to this article.
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