Adjusting to parenthood isn’t always easy. Caring for a baby can be tiring and, at times, extremely challenging. Learning to take care of a newborn means adjusting to a new lifestyle and learning a completely different set of skills. Many moms have moments when they feel overwhelmed or even doubt their ability to take care of their baby. These feelings are very common and, with support and encouragement, can often be overcome. However, sometimes the experience can start to become unmanageable and may be an indication of something a little more worrying.
Mental health conditions during pregnancy & postpartum
1 in 3 South African mothers suffer from postnatal mental health conditions such as depression, anxiety or trauma. These conditions are serious and not only have an impact on a mother’s ability to cope with motherhood and life in general, but research has shown that these conditions can have a detrimental impact on baby’s development. The good news is that they can be treated or managed successfully, especially if help is sought early. We know that the impact of mental illness can build over time, placing mom and baby under increasing stress and risk.
One mom who struggled with her mental health after childbirth disclosed, ‘I wish I told people and got help earlier, but I felt too ashamed. I was a nurse, and felt I should have been able to cope. Everyone around me saw me as “a coper”, I couldn’t tell them I wasn’t’.
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Sadly, many moms are affected by the stigma of mental illness and don’t seek help. They often suffer alone because they don’t feel able to discuss these challenges openly or look for professional help.
As mothers, we need to be speaking about this. Rather than judging ourselves (or others), we need to understand what mental illness looks like so that we can identify it and put the right support in place.
Mental health during pregnancy
Mental illness can start in pregnancy, especially if the pregnancy isn’t planned or wanted. Moms who experience violence, unemployment or an unstable home life are also more at risk. It’s critical that moms seek out support and treatment as soon as possible in their pregnancy. Many women worry about taking medication during pregnancy but health professionals can guide them regarding which medications have been proven to be safe. Research shows that it’s actually more risky NOT to get help. For example, untreated depression has been shown to have consequences for baby’s growth and development during the pregnancy.
Mental health after having a child
Postnatal mental health conditions usually begin in the first 3 weeks to 3 months after birth. They can, however, start at any time during the first year. Women with pre-existing mental health issues, stressful life circumstances, or those who experienced mental, emotional or sexual abuse in their childhood may be more at risk. This is also true for those moms who have limited support systems or challenging/absent maternal figures.
Postnatal depression & the signs to watch out for
Postnatal depression is a specific type of depression that many parents experience after having a baby. It’s much more common that people realise, and can also affect fathers and partners. Symptoms include depressed mood, lack of interest in activities during the day, changes in appetite and feelings of worthlessness and guilt. One mom shared her experience, saying, ‘My husband would come home and I would still be wandering around in my nightie. I couldn’t get anything done. It was all too hard to face’.
In really serious cases, postnatal depression can cause a mom to feel suicidal. She may feel useless if she feels she cannot take care of her baby, believing that her baby (and family) will be better off without her. Very depressed moms may also be at risk of harming their baby. These feelings are an emergency and urgent, immediate action needs to be taken to protect both mom and baby.
Is it postnatal depression or postpartum anxiety?
While most moms experience some anxiety after giving birth, these feelings are usually temporary and settle over time. When the fear starts to become extreme and constant anxious thoughts or feelings make it difficult to manage the day, this may suggest a mental health condition called postnatal anxiety.
One mom explained her experience, ‘I struggled to get out of the house. I was just so anxious about everything. Ridiculous to a normal person but in the state I was in I couldn’t tell anyone for fear they would think I was crazy! I think depression is talked a lot about but anxiety is just as bad’.
The signs of post traumatic stress disorder (PTSD)
The experience of trauma can also impact a mother’s state of mind. If there has been a trauma in the months before or after birth, moms may be at risk of developing post-traumatic stress disorder (PTSD). Moms who have had traumatic births, premature infants or babies with medical conditions are particularly at risk. PTSD symptoms include nightmares, flashbacks, hypervigilance or difficulty concentrating.
The signs of postpartum psychosis
Perhaps, the most serious postnatal condition is postpartum psychosis. It’s a rare condition that affects about 1 in every 1000 moms. Postpartum psychosis leads to extreme changes in thought patterns and behaviour. This can be highly distressing for both for the mother experiencing them, and the family. Some of the early signs of postpartum psychosis include finding it hard to sleep, feeling restless, irritable or having too much energy, feeling invincible and having strange or irrational beliefs. It is, however, very serious and puts the mother at risk of harming herself, the baby and/or her other children. It therefore requires urgent attention and treatment. Postpartum psychosis usually occurs in the first few days or weeks after a baby is born.
What to do if you think you have postnatal depression or another postpartum mental health condition
If you are experiencing any of these symptoms, you need to reach out to a healthcare professional. Treatment may involve taking medication, as well as counselling. Health professionals who support maternal mental health include psychiatrists, psychologists and social workers. Sometimes, you may need to go through your local clinic to get access to the right mental health professional.
The Gauteng Association for Infant Mental Health has started a nationwide campaign to support mothers across the country (click here for more information). We’ve put together a database of support that’s available across the country. This includes private practitioners for those with medical aid as well as governmental clinics, NGO resources and tollfree support numbers.
For more information about where to access help in your area, send a whatsapp message to 0637696427. Parents can also follow our Instagram page for more information about maternal mental health and taking care of your baby.
By Nicole Canin – Chairperson of the Gauteng Association for Infant Mental Health