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BEWARE! First-time mothers likely to suffer mental disorders

•  Babies may be at risk

By Chioma Obinna

Childbirth brings happiness and a feeling of completeness in the family. It is a significant life-changing event although it comes with its own challenges.   According to medical experts, these challenges can present in various ways in unsuspecting mothers.

Sadly, through this life-changing experience, many Nigerian women have been maimed for life while some lost their lives.   Thousands of helpless women in this clime live and die with the scars due to ignorance.

Cases abound of women who, in the process of bringing another life, end up with obstetric fistula and mental illnesses such as postnatal depression and postpartum depression.

Out of ignorance, many of these cases in Nigeria are most times tagged spiritual.

Such was the case of Mrs Juliet Egbuna. Few days after Juliet gave birth to her child, she noticed a feeling of bitterness.   She broke down. But no one knew why she was down. Her husband and medical personnel around tried to cheer her up all to no avail.   She was not ready to look at her baby or breastfeed him.

Meanwhile, Juliet had followed the instruction she was given during her nine months of pregnancy.

A diagnosis showed she may have slipped into postnatal depression.

Her discharge from hospital was delayed and treatment began almost immediately. Juliet’s case is just one out of many cases that happen in Nigeria without being identified.

Although postnatal depression was not a condition common among Nigerians, a controlled study entitled, “Prevalence of postnatal depression in Western Nigerian women”, by Adewuya AO and colleagues, found that the prevalence of postnatal depression is comparable to that of the western world.

Findings also show that first-time mothers are seven times more likely to have some mental disorders within the first 10 to 19 days after giving birth than women who have children before.

In a report on postpartum depression, Team Leader, Monitoring and Evaluation, Postpartum Support Network Africa, Tunji Johnson, disclosed that one in seven nursing mothers suffer from postpartum depression.

According to Johnson, despite the seriousness of the condition, there are no measures in place in Nigeria’s health institutions to address the condition in mothers.

Throwing light on the problem, the investigator explained that children born to women that have post-partum depression have the tendency to exhibit behavioural problems when they become adults.

“In this part of the world, mental illness is more perceived as spiritual, and so we have to do something about it”, he said.

Johnson, who posited that there was the need to create more awareness among mothers and train more nurses to attend to pregnant women in the antenatal clinics, said: “While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks.”

In a chat with Sunday Vanguard, Principal Partner, MindPlus Practitioners, Dr. Olusola Olowookere, explained that postnatal depression is a depressive illness that affects 10 to 15 in every 100 women having a baby and also involves experiencing symptoms of depression such as low mood, loss of appetite, poor sleep, loss of libido, irritable, anxiety, hopelessness, suicidal thoughts, psychotic symptoms and many more for a period of at least two weeks.

Olowookere explained that people who have had mental illness, including depression, and lacks family support and social network, suffer stressful life events, could be predisposed to postnatal depression.

According to him, the timing varies from one or two months of giving birth and some experience it during pregnancy and it continues after birth.

He, however, regretted that although Nigeria is a very religious country and religious organizations have been a very supportive structure to individuals and the community as a whole, stigmas are associated with mental illness thus preventing people from seeking or accessing the help they required.

“It is important for religious organisations to be involved in mental health awareness especially as this encourages victims to speak up about their emotions. In Europe and other developed countries, churches now have mental first aiders who provide immediate support regarding mental and emotional well-being of its congregation,” Olowookere stated.

How it affects baby

On how it affects babies, he explained that symptoms of the condition have a lot of impact on day-to-day functioning and looking after a new-born.   Due to the condition, the woman may or may not love her baby. Sometimes, she feels guilty such that she doesn’t feel the way she is expected to. The person may not feel close to the baby and may blame the baby for the way she is feeling. Once any of the above symptoms is noticed, it is important to commence treatment urgently.   Most times, the individual suffering from depression might not realize she is depressed, but family and friends would notice the changes.   Some people also suffer from postpartum psychosis which is a different presentation from the above.

A research which was done in Denmark observed that mental disorders like postpartum depression, schizophrenia and bipolar disorders were common during the first three months. The study found that about 1, 000 mothers in three months were likely to have some form of mental disorders within three months of giving birth.

What you should know about postpartum depression and perinatal mood disorders

Postpartum depression is one of a number of conditions that fall under the umbrella term “perinatal mood disorders,” which has become the more commonly accepted way to reference mental health issues following the delivery of a baby.

A mother does not have to be depressed to be diagnosable.   Many people are not depressed but they are very anxious. Others have intrusive thoughts.

Postpartum psychosis is a separate condition in which the mother experiences a break from reality. Unlike perinatal mood disorder, postpartum psychosis is rare, occurring in just one or two of every 1,000 births. It includes delusional thinking and irrational judgment and should be considered an emergency that requires immediate treatment.      Postnatal depression can happen at any point.

Some women think that if they are fine following the birth of their first child that they won’t have any issues with their second child, but that’s not always the case.

Experts say mothers can struggle at any time. Just because it didn’t happen with their first baby doesn’t mean it won’t happen with other children.

It is treatable. Experts say of all the mental illnesses, perinatal mood disorders are probably the most treatable. What’s frustrating is that so few people get treatment and get good treatment.

There is a big difference between the baby blues and perinatal mood disorders. The “baby blues,” or a period of sadness or anxiousness after the birth of a baby, is very normal and quite common. The baby blues are often connected to the typical hormonal shifts and the lack of sleep new mothers experience.

What is not normal, however, is when those feelings last for beyond a month or two, or if they are impacting the mother’s ability to function.   Other symptoms of perinatal depression include inability to sleep, even when you have the chance to sleep or sleeping too much, loss of pleasure or interest in activities, crying a lot for no reason, feeling overwhelmed and not being able to cope, decreased concentration or ability to make decisions and thoughts of death or suicide among others.

Ways to seek help

The best way to be the best mother you can is to start with taking care of yourself. If you are not addressing what is going on with you, you are compromised and that compromises your ability to care for your children.

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