A 30 year old woman was brought to my clinic by her close relative. This woman looked extremely restless and anxious. When I asked what the matter was the woman started crying and her relative explained to me that she was not behaving like herself and that her nature had changed. On further case-taking I learnt that she had delivered her first child just a month ago after which all these problems had started. Her relative told me that she was constantly depressed, crying a lot and not wanting to do anything. She felt that she was not capable of taking care of her child and had no self-confidence. The relative said that she was obsessed with the baby and kept feeling as if something would happen with her child. Lately even her appetite had decreased and even when the child was sleeping she could not rest. This woman was suffering from depression after delivery, which is medically known as POST-PARTUM DEPRESSION.

Contrary to what we think this is one of the commonest problems faced by a woman after her pregnancy. However not much is known about this since most families do not want to openly talk about it and the woman feels ashamed to tell anyone how she is feeling.

WHAT IS POSTPARTUM DEPRESSION?

Postpartum depression is a term used to describe a range of physical and emotional changes taking place after delivery. Most people think that a woman should be happy and thrilled after having a child but this is not usually the case. Even though she may be happy there is a lot of emotional and physical stress she may go through during this period. There are constant changes happening in her body physically, emotionally and hormonally which can cause a new mother to feel anxious, sad, confused, nervous etc… These symptoms are usually present a few days after the delivery and normally disappear in a week or two. But if these symptoms persist or become worse then the woman may be experiencing Postpartum depression.

WHY DOES IT OCCUR?

There are several theories and research studies done on why postpartum depression occurs however there is still no definite cause. A lot of doctors believe this problem occurs due to the hormonal changes taking place at a very rapid rate. One study showed that the drop in Oestrogen levels after delivery, were to blame for the problem. Another study showed the close ties between this problem and Hypothyroidism. There are also certain factors that can contribute to the depression like:

1. Lack of Sleep – disturbed sleep patterns and not enough rest can make the woman feel weak and tired hence adding to the depression.

2. Responsibility of a baby – this may be difficult for a new mother especially if she herself is very young.

3. Loss of control – the woman feels as if she has lost her identity, she has lost control over her body and figure and feels less attractive.

4. Changes in work and home – if the woman is a working person she may try to handle too many things at the same time. However after delivery this may not be possible and this might make her feel depressed.

WHO IS AT RISK FOR DEVELOPING DEPRESSION AFTER DELIVERY?

Depression can affect any woman at any age however it has been seen that those in their reproductive period tend to be more susceptible. Also any woman who is pregnant, breast-feeding, or has miscarried recently can develop depression. It does not matter how many children the woman has already delivered. However research has shown that a woman who has suffered from depression in the past is at risk of developing postpartum depression. Also if there is a history of depression in the family then the woman is at risk.

WHAT ARE THE DIFFERENT TYPESOF POSTPARTUM DEPRESSION?

As mentioned earlier postpartum depression is a term used to describe a range of physical and emotional symptoms experienced by a woman after giving birth to a child. This can be broken up into three main types.

1. Baby Blues – Just after childbirth many women experience mood swings, they feel very happy at one moment and sad in the next. They may feel like crying for no apparent reason at all. There may also be a degree of anxiety, restlessness and irritability. However all these symptoms and signs seem to last for a few days or weeks and gradually they disappear. These women do not need any treatment just family support and talking to someone about this makes them feel better.

2. Postpartum depression – this problem can occur anytime from a few days after delivery to even months after childbirth. The difference between Baby Blues and Postpartum depression is the severity and duration of the symptoms and signs. If a woman’s ability to function is affected then she is said to be suffering from depression, which needs to be treated. Here the intensity of the symptoms like anxiety, sadness, restlessness, feeling of loneliness, lack of self-confidence is greater than that felt in Baby Blues and they do not disappear over time. The woman needs medical help along with counseling and support.

3. Postpartum Psychosis – this is the worst form of depression after pregnancy. Here the woman loses touch with reality and suffers from hallucinations and delusions. She becomes obsessed with the child and can cause physical harm to the baby. There is also an inability to sleep no matter how tired she may be. These women are at risk of harming themselves or the child physically. They need immediate psychiatric help and medication.

WHAT ARE THE SIGNS AND SYMPTOMS OF POSTPARTUM DEPRESSION?

Here are a list of the common signs and symptoms seen in depression after delivery. If you have 3 or 4 of the symptoms listed below please consult your physician and seek help or talk to someone about it.

1. Feeling of restlessness or irritability.

2. Feeling sad, depressed most of the time.

3. Crying for no apparent reason.

4. Feeling tired and lack of energy. Not wanting to do anything.

5. Suffering from physical symptoms like headaches, palpitations, breathless or even numbness all over the body.

6. Having difficulty in focusing or concentrating on any thing. Making any decision becomes very difficult.

7. Changes in appetite. Either there is loss of appetite or there may be overeating and weight gain.

8. Lack of interest in the baby is a sign of depression.

9. Feeling worthless, guilty or low self-esteem.

10. Trouble sleeping even when the child is asleep.

11. Overtly worried about the child. 12. Loss of interest in other activities including sex.

TIPS ON HOW TO DEAL WITH POSTPARTUM DEPRESSION

Here are a few things you can do if you feel you are suffering from depression after giving birth to a baby.

1. Get enough rest. This is extremely important because the body has gone through many changes physically and hormonally. Try and take a nap when your child is sleeping.

2. Do not expect yourself to do everything you did before you delivered. Do as much as you can and get someone to help you in the housework. Remember you are not superhuman and accept the fact that things will not be the same as before.

3. Talk to someone you trust or confide in someone you are close to. Talking will make you feel better. If you have an understanding husband, make sure he knows what you are going through.

4. Avoid being alone by yourself and the baby. If there is someone to take care of the child, leave the house and go out even if it is just for 15 minutes to half an hour. Dressing up and going out will help change your mood. Go for a brisk walk in this time, this will not only help you lose weight but also make you feel better and fresh.

5. Talk to other women who have had children recently and share their experience. Take advise from your physician and do not be afraid to ask any question no matter how silly you may think it is.

6. Spend some quality time alone with your husband while someone is taking care of the child. This is extremely important for both partners.

WHAT IS THE TREATMENT FOR POSTPARTUM DEPRESSION?

The most important thing is to seek help for this problem because if left untreated it can cause severe problems for the mother and the entire family. The child can get neglected in the bargain. Also the hormone levels must be checked by doing a blood test. Especially the Thyroid levels must be checked because Hypothyroidism can also cause symptoms of depression, anxiety, fatigue, tiredness etc….

Counseling is an important part of the treatment and it is important that the entire family go together. There are a number of anti-depression drugs available however very few are safe to be taken while the woman is breast-feeding. Also these drugs have lots of side-effects.

In Homoeopathy there are a number of excellent remedies to help a mother battle postpartum depression and get cured. We take the entire case-history of the patient including the constitution, physical and mental make-up and emotional symptoms. Family history and past events are also very important.

Here are a few remedies I have used to treat such cases.

CIMICIFUGA RACEMOSA

The case of the 30 year old woman narrated in the beginning was given this remedy. She had all the symptoms of Cimicifuga. She was worried all the time and anxious about the baby. She told me that she felt as if there was darkness surrounding her and she felt confused all the time. Sleep was difficult as she kept thinking negative thoughts as if something wrong was going to happen. Her relative told me that her moods were constantly changing. She kept sighing loudly without knowing this.

I gave her Cimicifuga 200, 5 pills daily to help her throughout her postpartum period till she recovered fully.

AGNUS CASTUS

Here the patient has deficient milk production, which may trigger the depression. She feels guilty about not being able to feed her child. There is sadness and she feels as if she is going to die soon. There is confusion and she is unable to understand things. There is also no sexual desire and the woman does not want to sleep with her husband. She experiences great changes in mood, one minute exhilarated and the next depressed. There is also a peculiar symptom of starting from her sleep, which leads to loss of sleep.

This woman needs Agnus Castus 200, 5 pills in frequent doses till the symptoms cease.

NATRUM MUR

Another case of a woman going through depression just after delivery was given this remedy. This lady had been trying for a child for years and had tried several fertility treatments without success. Then she conceived naturally but started going through depression even during her pregnancy. The family could not understand this because they thought she should be happy after delivering a healthy normal child. She told me that she just wanted to be alone by herself and felt like crying all the time. Her mind would keep thinking about past negative events that had happened to her. This lady described herself as being sad but did not want sympathy from others.

Natrum Mur 200, in constitutional doses was give to this woman, which made her feel like her normal self again.

PULSATILLA

This Homoeopathic remedy is well known as a female remedy. Pulsatilla is often used in problems pertaining to the female sexual system where the symptoms correspond. It is also very useful in treating emotional problems like depression especially after delivery where the woman is most vulnerable. This patient will weep easily even while narrating her symptoms. She will not like to be alone and will want someone around her all the time. Even darkness causes uneasiness. This uneasiness and anxiety is better when she is in open air and when consoled. This remedy is also often used in postpartum depression where the mother weeps every time the child breastfeeds.

Give Pulsatilla 200, 5 pills 4 times a day to help improve her emotional and mental state.

I have written this article in order to make people aware of depression after delivery. We think that this is rare and uncommon because most women feel ashamed and embarrassed to speak about it and express themselves.

This can cause harm both to the mother and the child. If you are suffering from this or know of someone who is please consult your physician and do not try to self medicate.