The mother of three, Tanzeela Niazi heard the good news of expecting a baby after three years of her marriage. She was on the cloud nine. She prepared herself for the big responsibility as she was just 19 years old when she got pregnant for the first time. She went through the nine months of pregnancy, counting each day as she got closer to giving birth to her first baby. But, soon after she became mother, all joys turned into tears and misery. Niazi contracted postpartum depression. It is a kind of depression, which mothers experience soon after they deliver a baby because of a dramatic drop in hormones produced by thyroid, estrogen and progesterone, leaving the mother sluggish, tired and depressed.
Moreover, there are also emotional reasons for the mental illness. The hectic routine mothers go through soon after delivery adds to the already present hormonal disorder. ‘When a mother is sleep-deprived, overwhelmed and has trouble handling problem, she may get anxious about her ability to care for her newborn. She may feel less attractive or may experience that she has lost control over life,’ said Dr Tuba Mir.
Postpartum depression is common among women in Pakistan, in fact, according to a study done by Salima Sulaiman, Kiran Shaikh and Jehanara Chagani, it is the highest in Asia with a prevalence rate ranging from 28 percent to 63 percent. Despite, the astounding numbers, women in Pakistan are not aware of the phenomena. ‘I used to feel terrible, I felt like crying all the time and I became way more sensitive,’ Niazi said. ‘In my nine months of frequent visits to doctors, they never told me about it. I learned about PPD [Postpartum Depression] from an article, I felt great about solving the mystery of that unfathomable depression,’ Niazi said.
Talking to Mohammad Arif, who recently welcomed his son in this world, was unaware of the name postpartum depression. On a question related to the mental illness, he replied, ‘I know about depression, but what is postpartum depression?’. After explaining him the symptoms and how women go through this mental torture, he identified his wife also suffered ‘baby blue’, a kind of postpartum depression, but a brief one. ‘My wife used to get upset, she had mood swings, she used to cry, but the elders of our family said she will be fine, they had suffered in their time, so they knew how to handle it,’ he shared. If the symptoms were long lasting, keeping in view the unawareness about the problem, it might have gotten severer.
Illiteracy is one of the core reasons for lack of awareness of this issue. According to a psychologist, Fareeha Kanwal people do not take mental illness seriously and act negligently towards it. ‘The only difference between depression and postpartum depression is, a woman suffers it after her pregnancy. It depends on individual to individual, but In-laws and family members are not usually very supportive because depression is not considered as an illness in our society,’ she said.
Niazi did not let anyone in her family or in-laws know that she was suffering from depression. Even after knowing about the phenomena, she kept it to herself and treated it just like a bad phase which will eventually pass. ‘I used to cry alone in the bathroom in order to avoid any question from anyone, I just knew about my disease, I did not know how to cure it, so I just waited for this time to pass.’ she said. The 35-year-old was lucky enough to get over it without any professional help.
If postpartum depression is not treated timely, it can be devastating for the sufferer herself and also for her baby. Women tend to hate their lives, their routine and even their babies. ‘There are cases where women not only want to commit suicide, but to also kill their babies,’ said Kanwal. Furthermore, the postpartum depression of mothers can leave never-healing scars on their children, making them vulnerable towards behavioural issues. ‘According to studies conducted on children of mothers who had suffered PPD, their children have the tendency to suffer behavioural problems twice as compared to other children. Adding to that, these children are seven times more likely to suffer depression by the age of 18,’ said Dr Mir.
Postpartum depression is treated in the same manner as a normal depression patient, it is just their onset that differentiates them. ‘The symptoms are same as a normal depression, thus it takes the same time span to cure, which can be stretched into months, it is treated by counselling sessions with psychologists and in some cases they are also prescribe some medicines,’ said Kanwal. On the other hand, Dr Mir told that doctors to ask them to have good sleep, do exercise, re-evaluate their breast feeding and stay in touch with their doctor.
There is a dire need to create awareness about postpartum depression. In a society, where the illiteracy rate is low, early marriages are common and mental illnesses are not taken seriously, it is a challenge. During the testing time of nine months of pregnancy, women either trust their doctors or their mothers and grandmothers. Dr Mir is an advocate for doctors telling their patients about the likelihood of depression, its symptoms and how to deal with it. ‘Moreover, doctors can in fact have sessions with patients’ mothers and mother-in-laws who tell them all the remedies during and after pregnancies,’ Dr Mir suggested.
On the other hand, Kanwal wants doctors to conduct workshops, special sessions and in fact government to play their part in spreading the knowledge. ‘Government should run ad campaigns on different mediums for the awareness, it is a real problem and it should be dealt diligently,’ said Kanwal. Niazi echoed the words of Dr Mir and Kanwal and urged the government to contribute. She believes had she was aware of this illness, she would have handled the situation better. ‘Some women dont feel like talking about their mental health or issues like sadness, irritability or depression,’ she said, ‘Like I couldnt discuss it with anyone but had I been aware of it, I could have talked about it with a doctor or a friend and I could seek help.’
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