Burden of Post-partum Depression

In 2011, a World Health Organization (WHO) study reported that nearly 36% of Indians suffer from major depressive episodes (MDEs). Research shows that women are more vulnerable to depression with a 50% higher burden of cases (Bromet et al 2011). However, depression among women in India often goes undiagnosed or untreated due to lack of public understanding of the condition, the disadvantaged position of women in multiple facets of life, stigma attached to mental disorders and paucity of mental health professionals. Women’s risks of developing depression are greatest during their child-bearing years, manifesting in post-partum depression (PPD) (Bohra et al 2015).

The birth of a child can trigger numerous emotions, from zest and joy to fear and anxiety. But many mothers experience “baby blues” post delivery, which commonly include symptoms such as mood swings, crying spells, anxiety and difficulty sleeping. These baby blues typically begin within two–three days after delivery and may last for up to two weeks (Mayo Clinic 2018). When these symptoms last for more than two weeks and show more severe signs, it leads to PPD. While PPD usually develops two–eight weeks after delivery, sometimes it may manifest up to a year after the child is born (NHS nd). In extreme cases, it may transition into post-partum psychosis. Symptoms of PPD include severe mood swings, excessive crying, difficulty bonding with the infant, loss of appetite or eating more than usual, insomnia or sleeping too much, reduced interest in activities, panic attacks, and thoughts of harming self or the infant. Clinicians have attributed PPD to mainly hormonal and emotional reasons. Hormonal issues like sharp decline in estrogen and progesterone are likely to be important factors in the development of PPD. Reductions in hormones produced by thyroid glands can also make the mother feel sluggish. Additionally, emotional factors can magnify the symptoms of PPD as mothers may feel overwhelmed handling the infant and may be sleep-deprived (Mayo Clinic 2018). However, while these factors are experienced universally by mothers, not all mothers develop PPD. It is likely that cultural and psychosocial dimensions play an additional role in influencing risks of developing PPD.