Non-communicable Diseases

Hello Mummy; baby blues or post-partum depression ?

Talia is four weeks old.

Irene, her mother, is overwhelmed.

Though the baby hardly cries, she feels unhappy, irritable, uneasy and her moods have become rather unpredictable.

Yesterday, she snapped at her five-year-old son, her nanny and husband. All in one day.

Last week, she couldn’t stand holding a phone conversation with her mother and siblings who called to check on her.

Since Tamara was born, she struggles to smile or see the beauty in her daughter’s eyes.

She is unhappy.

It is like a force dropping down on her.

She has decided to speak out to manage this invisible anvil that has stalked her.

But wait.

Are you angry at your new baby?

Could it be baby blues ? Something else probably ?

It could be post-partum depression.

Prof Lukoye Atwoli, a Professor of Psychiatry and the Dean of the Medical College, East Africa at the Aga Khan University describes post-partum depression as a significant public health problem which affects women within a year of childbirth.

Prof Atwoli draws the difference that baby blues can be seen around three to five days after the baby is born and this can go on for another two weeks whereas post-partum depression can go on until a year after birth. The symptoms of baby blues include  crying, a feeling or restlessness, being overwhelmed and anxiety attacks.

“Lack of social support during pregnancy, is a relatively high risk factor for postpartum depression, “ said Prof Atwoli.

Prof Lukoye Atwoli, a Professor of Psychiatry and the Dean of the Medical College, East Africa at the Aga Khan University

The World Health Organisation estimates that globally, one out of every ten pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. “The affected mothers cannot function properly. As a result, the children’s growth and development may be negatively affected as well. Maternal mental disorders are treatable,” reads a WHO situational paper on maternal mental health.

Medical experts advise that postnatal blues are time-limited and mild and do not require treatment other than reassurance, the symptoms remit within days. A 2003 paper by Toronto Public Health looking at the risk factors and  symptoms of post-partum depression found out that

Prof Atwoli notes that the following risk factors places an expectant mother at chances of havIng this condition.

  • Diagnosed with depression or anxiety during pregnancy
  • Recent stress, such as a divorce, death, or serious illness of a loved one
  • Unwanted or difficult pregnancy
  • Undergone a stressful recent life event
  • Poor social support
  • A previous history of depression
  • Having your baby born prematurely or with health problems
  • Having multiples (twins, triplets, quadruplets or more)
  • poor diet
  • drug or alcohol misuse
  • sleep deprivation and exhaustion

Signs and symptoms

Prof Atwoli describes the symptoms;

  • Sad
  • Tearful,
  • Has feelings of guilt
  • hardly sleeps
  • Loss of appetite
  • Has feelings of being inadequate
  • Unable to cope with the infant,
  • poor concentration and memory
  • Fatigue
  • Easily irritable
  • Your moods change suddenly and without warning
  • You feel out of control
  • You have difficulty remembering things
  • You want to escape from everyone and everything.
  • You have intrusive thoughts about harming yourself or your baby

Whereas some of these symptoms may be obvious to the new mother, close friends and family, Prof Atwoli notes that there could be some reluctance to admit to symptoms of depression because of cultural expectations of motherhood.

“Culturally, mothers are expected be strong after birth to take care of their newborn child. Any form of weakness like expressing emotional imbalance is frowned upon and taken as a sign of weakness,” said Prof Atwoli.

Here are severe symptoms of post-partum depression

  • Hallucinations, or seeing, hearing, smelling, or feeling things that aren’t really there
  • Delusions, or having irrational beliefs, placing too much importance on insignificant things, or feeling persecuted
  • Disorientation, confusion, and talking nonsense
  • Strange or erratic behavior
  • Rage or violent actions
  • Suicidal thoughts or attempted suicide
  • Thoughts of harming your baby


What treatment is available for new mothers just diagnosed with post-partum depression?

The rule of thumb, Prof Atwoli says, is to ensure that treatment provided is immediate and sustained so that the mother can continue taking care of the child and the larger family.

“The mother needs to see a mental health specialist where forms of treatment such as psychiatric medicines, talk therapy, counselling and Electro-Convulsive Therapy is offered as part of the management regime to ensure she is back as a fully functional mother,”  said Prof Atwoli.

The medicines known as antidepressants have a direct effect on the brain because  they contain chemicals that regulate mood. Whereas this may not act immediately, they are combined with other management methods like counselling, encouraging self-care.

Did you know that men too can develop depression related to the coming of a new baby ? It is known as  paternal postnatal depression. Whereas there is a scarcity of data on this, first-time fathers tend to have a higher level of anxiety in the weeks following a birth.

There is hope

The next steps

Here are take-home messages to fight post-partum depression;

  • Communicate your feelings
  • Cut back on household chores
  • Fight isolation
  • Delegate baby care certain periods the day or night
  • Take a short walk
  • Rest
  • Relax
  • Tap into your support network


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