Friday, 21 April 2017

POSTNATAL DEPRESSION: AN UNAPPRECIATED REALITY


"Chi mu ooo!!!" Chiugo's husband exclaimed
Dropping his bags on the doorstep, he rushed forward to rescue his six week old son.
Lifting him from a pool of feaces and urine, he headed to the bathroom.
Chiugo watched the scene without saying a word. She had been sitting in the same spot since her older children left for school, the house was yet to be cleaned and her son still to
be given a bath.
Jimo on the other hand was more perplexed than furious. It was unlike his wife, Chiugo, to be tardy. He had noticed a remarkable change in her person since they returned from the hospital but had attributed it to grief.
In the last trimester of her pregnancy, Chiugo had lost her mother in a fatal accident. Shortly after, her elder sister had been dumped by her husband for a younger woman. The stress of these events had left her with increased levels of anxiety. She worried about her ability to care for her unborn child without the usual support of her mother, her husband's commitment to the family, regaining her figure post childbirth...these thoughts and more ran riot in her head.
Compounding these unresolved issues was the caesarean section she had  due to a difficult labour, a procedure she had prayed against all her life.
On her return from the hospital, her anxiety level had hit the roof. She spent more time feeling sorry for herself and had lost interest in the little things that once were the bane of her happiness.
Preparing her older children for school which used to be a delightful experience had become an unwelcome chore. Cooking which once was relaxing for her had also become a dreaded duty, her appetite for food and sex with her husband had markedly decreased. She had lost a lot of weight.
When she eventually falls aleep, she's tormented with recurrent dreams of suffocating her son hence, she avoids sharing a bed with him
Three weeks ago, she had shared some of her cconcern with her husband. Jimo in turn had  invited their pastor to hold prayer sessions with her. Fearing she would be labelled insane, she said no more and kept her innermost terrors to herself. The result... a worsening of her mental state.
Jimo knew he couldn't bury his head in the sand any longer. It was time to brace up to reality, his wife needed professional help. If Chiugo could watch her son play about in a pool of his urine and feaces, God only knew what he would come home to meet the next time.
Picking up his phone, he called his childhood friend, Dr Nduka to schedule an appointment at his clinic.
Three weeks ago, as well as discussing the changes in his wife with the Pastor, he had also talked with Nduka, a clinical psychiatrist who had advised him to seek professional help as his wife most likely suffered from postnatal depression.
Refusing to entertain the thought of his wife having a psychological disorder, he had gone ahead to invite the pastor to their home.
Remembering his grandfather's favorite quote "Sepu aka enwe n'ofe tupu o ghoro aka mmadu" he decided to take proactive steps.


Postnatal depression also known as Post partum depression is a type of depression that affects parents after childbirth. It could start anytime in pregnancy or weeks to months post delivery. Women are the most affected by this condition and men are not excluded though the prevalence amongst them is low.
Postnatal depression occurs irrespective of the outcome of pregnancy. In other  words, this condition may arise after a normal pregnancy/delivery or after a miscarriage.
The cause of post natal depression is not well understood. However, hormonal changes in pregnancy have been hypothesized.

Risk factors for Postnatal depression include:
Previous history of depression in an individual
Family history of depression
Unplanned pregnancy
Low social support/ single parenthood
Previous or current history of miscarriage
Difficult pregnancy/ delivery
Traumatic life changes such as loss of a job/loved one
Low self esteem
Stressful life events

In addition to the above, risk factors for postnatal depression in men include:
Young fathers
Inability to provide for the family/pay bills

It is interesting to note that, irrespective of the number of children a woman has had, PPD can occur in the latest child even if it’s her 10th  pregnancy. 

Symptoms of Postnatal depression
Sadness
Increased anxiety
Weakness/exhaustion
Reduced appetite for food
Reduced desire for sex
Difficulty falling asleep
Social withdrawal
Numbness

Many women experience mild symptoms of depression after childbirth (baby blues). When it is severe and has lasted longer than two weeks, post partum depression should be suspected. PPD interferes with childcare/family life and can last several months or years if not recognized and treated.
PPD is a treatable condition and most people respond best when management is started early.

The management of Postnatal Depression entails:
Social and psychological support
Medications

Prevention
Good social support from family and friends

Complications
Post partum depression can progress to major depression if left untreated
May put one at risk of harming self and/or child.