Seek professional help if post-delivery depression persists

Qn. “I had my baby in late 2015 and experienced Postpartum depression (PPD) which doesn’t seem to go away more than two years later. Should I be worried?”

The answer to your question is yes. You should be worried enough to do something about the fact that you are not well. More importantly, you should seek to establish if indeed what you are suffering from is PPD.

Remember that even people who have not had a baby can, and do suffer from symptoms that can look very much like PPD.

Let’s start from the beginning by asking who made the diagnosis of PPD. Was it your mother, sister, husband, employer or was it just what you concluded yourself. Secondly what were the symptoms of the condition, and what was the relationship (in time of onset) to the birth of the baby. Did the symptoms start before the baby was born, or did they start more than a year after the birth of the baby.

Importantly, who treated you for the PPD? Was it left to “get better by itself”, did you see a doctor specialising in mental health or did you go for counselling? If the doctor prescribed medication, did you take the full dose as advised or did you feel better after two months and then stop?

Many people stop taking medication before they are told to stop by their doctors and this is a common reason for many persistent conditions.

What did the doctor tell you was the possible reason for the PPD? Were you simply one of the 15 percent of women who develop the condition or did you have other complications?

We know for example, that young single parents are at greater risk of PPD than their more mature sisters. We also know that women who go through what they might call difficult pregnancies have higher rates of PPD. A pregnancy that has many or serious threats of loss cause mothers to live under great stress and hence greater likelihood of later PPD.

Not all pregnancies are happy or wanted and women who are in difficult or hostile environments during pregnancy tend to suffer more (from PPD) than their happier sisters. If as in your case, you have continued to have a difficult relationship with your partner even after the birth of the baby, then you may want to work on this relationship even as you continue to get help from your doctor.

Remember that it is not only your partner who could be causing you stress. If, for example in addition to the baby you also have to look after your mother-in-law who has a chronic illness, your PPD might seem to persist.

A few years ago, we saw a 32 year-old mother of two who was simply not getting better from what seemed to be PPD.

A month after the birth of her second child, her mother-in-law “volunteered” to come to Nairobi to babysit. In her mind, she wanted to be near her son who seemed to have a problem with alcohol. He had received a number of warnings from his employer in this regard.

The old lady had also “heard rumours” that her son’s marriage was not going well, and she reasoned that her presence would “stabilise” the family. Nothing could have been further from the truth.

Upon her arrival, she made an attempt to take charge of her son’s home. She sacked the househelp and took charge of the kitchen. She ordered her daughter-in-law to “take rest” so that she can be ready for her husband when he got home in the evenings. Her reasoning was that her son drank so much because he did not get enough love from his wife.

Her presence over the next one year did two things. Firstly, her son drank more as he kept away from the fights of “these two women”.

He refused to choose between wife and mother and opted for the comfort of the bottle.

Secondly, the new mother became more depressed with time. She was denied the role of mother, wife and even owner of her own home. Her self-esteem took a bashing and she blamed herself for having had a baby “at this time”!

Tragedy saved this young mother. The interfering, dominating mother- in-law got a stroke and could no longer live in her house as she needed specialised care.

To her surprise, her husband “came back home and showed her much love”. He even brought her to us for the treatment of PPD, which had like yours persisted for a long time!