Dr. Rijusmita Sarma
(The writer is a counselling psychologist.
Can be reached at 8638716076
Pregnancy and postpartum are often portrayed in movies and social media as an ecstatic experience. It is expressed as a rewarding and magnificent experience of a lifetime. Many mothers share that this experience is unparalleled and fulfilling but a mixture of rewards and challenges. But, for some women, it can be complicated. Through this article, I would like to share some common mental health concerns that manifest during the perinatal period, the reasons behind such conditions, and ways to be adopted to proceed towards recovery.
Some perinatal mental health concerns are:
1. Perinatal depression: It is said to be one of the most common complications of childbearing. Studies reveal that one in five women and one in ten men may experience depression during the perinatal period. Symptoms like persistent low mood, loss of interest, increased irritability, feelings of guilt, hopelessness, changes in sleep and appetite, thoughts of harming oneself or the baby, etc., could appear at any time during the postpartum period. If these symptoms persist for more than two weeks, medical assessment and help are strongly recommended.
2. Perinatal anxiety: Studies suggest that 20 percent of people develop anxiety during the perinatal period. It could manifest as constant worry, fear, and restlessness and also include biological symptoms like palpitations, breathing difficulty, dizziness, etc. It could occur independently or as a co-morbid illness with depression.
3. Perinatal obsessive-compulsive disorder: It is characterised by repetitive, unwanted obsessive thoughts (obsessions) and irrational, excessive urges to perform certain actions (compulsions). The obsessive thoughts and images can be frightening. They are anxious by nature, and the parent may experience fear of potential harm to the baby.
4. Perceived or real trauma during delivery or postpartum can cause postpartum post-traumatic stress disorder. The symptoms of postpartum PTSD are intrusive re-experiencing of past traumatic events, flashbacks or nightmares, hypervigilance, startled response, anxiety, panic attacks, etc.
5. Bipolar disorders: A study reveals that 50 percent of women with bipolar disorder are first diagnosed in the postpartum period. It can look like severe depression or anxiety. Some more symptoms could include periods of severe low mood and irritability, episodes of mood being much better than normal, rapid speech, little need of sleep, continuous high energy, impulsiveness and poor judgement, grandiose ideas, difficulty concentrating, etc.
6. Perinatal psychosis: Perinatal psychosis is a serious mental health concern that needs immediate medical help. The onset of this is usually in the first few weeks of childbirth. The symptoms of which can be hallucinations (commonly seeing, hearing, smelling, or feeling things that are not there), delusions (false rigid beliefs), increased irritation, suspiciousness, changes in sleep, impaired judgement, etc.
Some common factors contributing to perinatal mental illness are:
n Hormonal changes that occur during and after pregnancy
n A personal or family history of mental health concerns
n Complications in pregnancy, childbirth, or lactation
n Inadequate support and care during pregnancy or post-childbirth
n Marital difficulties
n Financial concerns
n Health problems of the newborn
n Thyroid imbalance
n Difficulties at work
n Emergency or conflict situations and natural disasters
n Unplanned pregnancies
What can be done?
Perinatal mental health difficulties are treatable. Identification of the symptoms and seeking professional help is the key. Adequate care and support in addition to medication and therapy can be very beneficial.
Why is it important?
The incidence of perinatal mental health concerns in developing countries is increasing. A recent study conducted at Gauhati Medical College and Hospital by Dr. Marami Baishya in the year 2023 revealed that 37.6 percent of women (7 days or more into postpartum) had signs of depression. Mental health difficulties take a toll not only on the mental health of pregnant women and new mothers but also increase the risk of physical illness in them. It is also reported that suicide is an important cause of death among pregnant and postpartum women. Untreated mental illness also declines their ability to take care of the needs of the newborn. This can lead to frequent health issues in the newborn. Evidence suggests that treating the depression of mothers leads to improved growth and development of the newborn and reduced likelihood of diarrhoea and malnutrition among them. Besides the short-term difficulties, hindrances in forming a secure mother-child relationship can contribute to the child developing emotional and behavioural problems later in life.
The happiness and excitement of welcoming a newborn into the family can be unparalleled. And taking care of the newborn is crucial. But taking care of the physical and mental health of the mother is also of no less importance. Adequate care and support extended to the mother in taking care of herself and the newborn can be extremely beneficial in both the prevention and recovery of perinatal mental health concerns.