POST NATAL DEPRESSION  
   
The period after child birth (Post Natal Period) is a time of enormous physical, social & emotional changes. During this period, more than half of women experience some type of mood disturbance such as mood swings or tearfulness (Baby Blues). However, around 1 in 10 women go on to experience a more severe mood disorder called post natal depression (PND). 

PND can be particularly distressing when you have very much looked forward to having your baby through the months of pregnancy. It usually starts within 6 months of child birth, although, it can also occur any time within a year. When experiencing PND you feel low, anxious, irritable, overwhelmed, hopeless and miserable for most or all of the time. Although you may feel absolutely exhausted through the day, you may find that you cannot fall asleep when you are finally in bed. You may not have the time or the interest to eat, making you feel run down. Sometimes you could be eating for comfort, followed by feeling guilty about it. You find that you cannot take pleasure in or be interested in most things you used to enjoy in the past. This is particularly true regarding your sexual relationship with your partner. You may feel overwhelmed with the smallest of tasks, later feeling anxious & guilty about it. You could be worrying that your baby is crying too much or is too quiet, may choke or be harmed in some way. Sometimes you could be feeling detached towards your baby along with an inability to recognise your baby’s feelings. As a result, you may feel that you are a bad mother and be afraid to stay alone with your baby fearing for his or her safety. Occasionally, when you are severely exhausted and desperate, you may feel like hitting or shaking your baby. Although many mothers feel like this once in a while, most of them never act on it. 

 You are more likely to get PND if you or your family had a previous history of depression or PND. Your risk of developing PND is increased if you have an unsupportive partner, a premature or sick baby and if you have experienced several stressful events in a short period of time. However, you can still suffer from PND in the absence of any of these risk factors. Although it is not strongly established, PND may have something to do with the huge hormonal changes which take place at the time of giving birth. It is observed that some women are more sensitive to these changes than others. 

Quite often, when you are going through PND, you may not realise what is wrong with you. With greater awareness of depression these days, it is possible to recognise it early enough so that you receive prompt treatment. If you notice any of the above mentioned symptoms you need to speak to someone. If you do not want to talk to your family or friends, you can talk to your doctor who will guide you to the right place for help. Once you are clear that it is PND, it is often beneficial to share the information with your partner, friends and family, since it would enable them to understand you better and offer support. The recovery period from PND, if untreated, varies from few weeks to more than a year. This can be significantly shortened with early recognition and effective treatment. The treatment methods generally include psychotherapy, cognitive behavioural therapy or even some form of supportive counselling from a psychiatrist, psychologist or a counsellor. If you have a more severe depression or you condition has not improved with any of the above mentioned treatment methods, you may need antidepressant medication. You may want to discuss all the available options before you finally decide what form of treatment you are going for. Finally, it is important for you to know that PND is a fully treatable condition, whether you have presented for treatment in the early or late phase of your illness. Treatment often makes a remarkable difference in the quality of life for you, your baby and your family.

Dr Aju Abraham 
Consultant Psychiatrist
 
   
 
   
 
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