Postpartum depression is more than just ‘baby blues’ & COVID made it worse — here’s what the doctors say

From being happy and excited to feeling sad, anxious, and fearful, a new mother might experience an emotional rollercoaster soon after giving birth. If this mental turmoil persists for more than two weeks, one should be alarmed, for it could be a condition called ‘postpartum depression.’

International Day of Action for Women's Health 2022, we take a look at postpartum depression, or PPD, which is much more than just mild 'mood swings'. As the name suggests, postpartum depression is depression that is witnessed among new mothers after childbirth. PPD "often starts within one to three weeks after a childbirth" but unlike ‘baby blues,’ it may last for “weeks or months at a time", the National Institute of Health and Family Welfare said.

‘Baby blues’ is a term to describe the crying spells, irritability, sadness, sleeping issues and tiredness that a woman might experience after having a child. Its symptoms are likely to subside within a week or two.

Symptoms of postpartum depression include severe mood swings, difficulty bonding with the baby, loss of appetite or eating too much, insomnia, fatigue, fear of not being a good mother, feelings of worthlessness, shame or guilt and getting frequent panic attacks. Suffering from depression, some women might even become suicidal or think of harming their baby themselves, the Mayo Clinic said in one of its reports.

"Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ― during pregnancy ― or later — up to a year after birth," it said.

Two years ago, the COVID-19 pandemic came in and not just robbed millions of their livelihood, but it also severely impacted mental health. According to the World Health Organization (WHO), the "global prevalence of anxiety and depression increased by a massive 25 percent" in the first year of the COVID-19 pandemic.

In its report published in March this year, the WHO also cited the finding of the Global Burden of Disease study. The global health body said the study suggested that "women have been more severely impacted than men..."

Moreover, a study published in the National Library of Medicine published this year revealed that "the prevalence of PPD in women is relatively high during COVID-19." Back in 2017, a study focusing on India showed a "high prevalence of postpartum depression in Indian mothers."

During pregnancy, a woman experiences many hormonal changes. Sometimes, her relationship with her partner, financial and family issues, and even lifestyle factors might add to their woes, degrading mental health.

The surge in the number of women suffering from PPD during COVID-19 might be a result of fear associated with the pandemic. "What happened is that all kinds of mental issues became more prominent. People have techniques to cope with stress. They go to movies, and go to the gym...but that coping was denied due to restrictions imposed during COVID-19. This led to an increase in all kinds of mental health problems, even postpartum depression," Dr Vishal Chhabra, Senior Consultant Psychiatrist, Fortis, said.

"Mothers had fear...some people died when they had COVID and they were pregnant. That stress was there for a lot of people when the COVID came... people delayed pregnancy sometimes, they were sceptical about pregnancy," Dr Chhabra said.

A counselling psychologist based in Bengaluru, Diana Sam, said: "All therapists in this field would accept that there was a surge in mental health issues, that led to many people reaching out for help...COVID-19 is still causing stress among individuals. Pregnancy, on the other hand, also causes stress."

Ms Sam, who has helped several corporate employees cope with stress and depression, recalled her experience with her clients and said many mothers would be extremely worried about the health of their babies and be worried about their families at the same time.

"Unfortunately, (there have been cases where) women came from places where they don't have a supportive partner or family members. It could also be that a woman is trying to fulfil a lot of responsibilities — towards their baby, family and themselves. In this case, the women will be stressed," she said.

Explaining about difficulties women working in the corporate face after childbirth, Ms Sam said: "Yes, they do have two to three months of leaves, but they stress about going back to the work… (They think), will I have the same position, will I have the same team, are the things being reassigned. How do I start from scratch?”

"Some of them who have gone back to work are finding the transition difficult. Even if colleagues are supportive, it could be a feeling of (being) overwhelmed. They experience hormonal changes as well. Also, significant lack of support from friends and family (can add to their stress)," she said.

"During COVID-19, I had some clients who were anxious about what will happen if they go to deliver, what if they get COVID, what if the baby gets COVID. I have also clients whose babies did get COVID right after birth," she said.

"Emotional support is important for a new mother. One thing I observed is that there is no work distribution at home. It is important to encourage work distribution. It is important to have physical and mental rest. They should talk to their partners and prepare themselves when planning to go back to work."

"Also, ensure you are having enough quality sleep. There would be challenges — you might see yourself more anxious, or sad, see certain thoughts creeping into you, certain self-harm thoughts, and degrading thoughts might also come. You might feel that reaching out to your support system isn't enough. Then that could be a cue to know that you need professional help. Mothers should also focus on self-care," Ms Sam said.

Meanwhile, Dr Chhabra said, "For people living in metros, they would realise that they are living in a rat race. We need to take a break, find a 'me time' — that doesn't mean watching video after video — but doing meditation, yoga, going for a walk, exercise — that are some ways to cope with this."

There are effective treatments for depression and postpartum depression. Even severe depression can often be treated successfully. The key is to be aware of the situation and reach out for help as soon as possible.