Post Partum Depression: Not Just the Baby Blues!

Post Partum Depression (PPD) can be a debilitating disorder, and I myself, have suffered it for 4 years after the birth of Ethan, who is now 6...untreated and undiagnosed, it later turned out to be full blown bipolar disorder.

A simple definition:
http://www.nlm.nih.gov/medlineplus/postpartumdepression.html explains Post Partum Depression as:
Many new moms feel happy one minute and sad the next. If you feel better after a week or so, you probably just had the "baby blues." If it takes you longer to feel better, you may have postpartum depression.
Postpartum depression can make you feel restless, anxious, fatigued and worthless. Some new moms worry they will hurt themselves or their babies. Unlike the "baby blues," postpartum depression does not go away quickly. Very rarely, new moms develop something even more serious. They may stop eating, have trouble sleeping and become frantic or paranoid. Women with this condition usually need to be hospitalized.

My definition:
I agree with most of the symptoms above, though want to add that it is a disease which can spiral out of control very very rapidly. Untreated and undiagnosed, the new mother feels more and more trapped, not in control of her feelings and emotions (caused by the huge hormonal changes of pregnancy and childbirth), angry, tired, and in many cases, even suicidal! The number of cases of infant mortality if the mother is suffering from PPD is also alarmingly high, and I must admit, however much I love my last 2 sons, Ethan and Liam, it did come to me, in flashes of manic craziness, that maybe all will be well if somehow they could die... gruesome and horrifying, as now, I cannot visualise life without them! But at the time, the illness takes over the mind, and it's very very dangerous.

Common reasons for PPD:
In my opinion, there can be many causes, I am listing some of the common ones, as well as mine.

Common causes & risk factors (from http://www.wrongdiagnosis.com/p/postpartum_depression/riskfactors.htm):
Pregnancy - any pregnancy, not just the first baby.
Miscarriage
Weaning from breastfeeding
History of mood disorders
History of depression
History of postpartum depression
Severe premenstrual syndrome (PMS)
Non-supportive partner
Stress
Bipolar disorder
Insufficient rest
Cesarean delivery

My causes:
Having 3 children at home under 5 (I had a demanding 5 year old, a calm 3 year old and an infant)
No help from mother and in laws
No help from domestic help (had a maid problem at the time!)
Husband too busy with work and though loving, was travelling extensively
Third and traumatic C-Section
Bipolar Disorder (though I did not know it at the time)
Was obsessed with starting a new business (was in mania, and was working day and night on plans for my maternity store, Motherware)
Insufficient sleep
Was filled with anger and resentment at having yet another son (at that time, had 3 sons)
No exercise/meditation/spirituality
Expectations from mother, angry at having expectations not met (like why can't my mother come and help me, etc.)
Superwoman syndrome: oh, Jhilmil can manage, she is superwoman!
Exhausted, mentally, emotionally, physically, but punishing my body more by refusing to eat, sleep, etc.

The Problem in India!
My tentative findings are:
• People are casual and dismissive, putting down the illness and shrugging it off as Baby Blues,
• The medical community, gynaes, paediatricians who would first notice this, or some symptoms, do not take it seriously at all,
• Women who suffer are "ashamed" to discuss it, thereby reducing any support they may get,
• With the joint family system in India breaking down, there's very little support for a new mother, therefore increasing the chances of PPD,
• There a link between the growing Csection rate and PPD,
• There is too much medical intervention, and thus, we are interfering with nature, and thus, higher incidences of PPD, and
• Declining breast feeding rates are increasing PPD rates!

The Solution:
Love! As with any mental illness, the first concern should be for the health of the mother, and then the baby. All other family members need to put their needs and concerns after these two. Sadly, that is not done. In my case, I was constantly put down for "shouting too much" or "not being kind to my parents" or being asked "get a grip, what is wrong with you?!" I did not know what was wrong, and as a 33 year old woman, who was so used to being in control, the feelings in my body were terrifying. As with most mothers, I was so used to pushing my requirements to the bottom of the family requirements list, I had no idea what to do. I was clueless as I had never thought mothers should look after their needs first, and that will make them better mothers... Similarly, allow a new mother the space to look after her needs first, give her the "permission" that she needs the space to heal, and allow her to accept help. And give her what she craves after the fuss of the pregnancy and everyone is now fussing over the infant: love and assurances that she is still important, pretty and vital!

Also, medical help. At my 6 week check up with my gynaecologist, top Delhi surgeon, Dr Urvashi Sehgal, she asked me a simple question, "how are you?" My mother had taken me for the appointment, and I just burst into tears and was sobbing hysterically, as if my heart would break. I mean, someone was asking how I was... and there were so many feelings in me, I had no idea which of them to reveal to my doctor. At that point, she should have immediately thought of PPD. She did not, and smiled and said, "oh, you've got the baby blues, try this ayurvedic feel good tonic for women..." I believe we need to set up support groups for new mothers (in 2001, I had set up a group like this called Mum's The Word...), breast feeding groups, etc., to help women have a space where they can air their opinions with their peers and not be looked down upon. And maybe there, women will receive the love and healing they need, or the diagnosis, if the condition is more than the baby blues...

Now, looking back, I can see so much of the trauma and pain of the last 6 years could have been reduced had my family or my doctors recognized the symptoms of post partum psychosis. But it took another 4 years of counselling, painful therapy, my relationship with my parents and friends becoming wounded and damaged, and finally diagnosis when a caring friend, Sindhu, took me to Harley Street in London, and I was diagnosed with bipolar disorder... Such a waste, and how much I emotionally scarred my sons while I was in that debilitating and difficult time... Think of how many new mothers are missing out on the joys of mothering and inflicting huge emotional wounds upon their babies and children...

Jhilmil Now:
The diagnosis of bipolar caused by severe post partum depression in June 2005 was the start of my healing. With diagnosis, after the initial anger (why me?!), comes acceptance. With meditation and prayer, from acceptance comes grace. And from grace, the healing.

I now manage my full blown bipolar disorder with yoga, chakral healing, and food. I do not take any medication, except Cetrizine on days when I just cannot stop sneezing (a symptom of mania for me). And I am surrounded by love, the best medicine of all!