Postpartum Depression in Covid Times

A very close friend of mine, Sanjana recently delivered a baby during these COVID times. Since the time she returned home from the hospital, she seemed to be anxious as well as worried about how she would cope up with this new addition in the family, the changing roles, the other daily chores she is supposed to take care of in the absence of support of extended family members as well as the household help. The COVID -19 pandemic significantly increased her feelings of hopelessness and caused severe mood swings due to the social and physical isolation that are critically needed to reduce the spread of the virus. 

As it is, being a new mom requires a lot of changes and adjustments. Also, the hormonal changes take a severe toll on the mental as well as physical well being of the new mom. On top of that, as told by Sanjana she was unable to get the rest, one needed to recover fully from giving birth. She seemed to be exhausted and under physical discomfort due to constant sleep deprivation. I believe all these changes made her more susceptible to mood disorders. The COVID-19 global pandemic which further added to her woes severely impacted her mental health and she continued to experience true symptoms of depression. 

As soon as I realized that she had no appetite, felt hopelessness and she felt she was not being a good mother, I coaxed her into consulting her doctor, who diagnosed Sanjana with postpartum depression.

Childbirth is one of the most surreal experiences a woman can have in her lifetime. But for the new moms facing the outbreak of the coronavirus disease (COVID-19), anxiety, worry, and uncertainty can have a deep impact. The new moms and their little bundle of joys, in these times are witnessing lockdowns and curfews. Not just that, health centers are overwhelmed with response efforts, supply and equipment shortages, lack of sufficient skilled birth attendants, closure of schools and daycares to name a few. The uncertainties of the situation and stay-at-home advisories especially during pregnancy and post-delivery have presented unique challenges. In fact, the coronavirus pandemic has recast motherhood.

Postpartum "baby blues" are not uncommon after the birth of a baby. It may begin within the first two to three days of delivery and may last up to two weeks. Some new moms experience a more severe, long-lasting form of depression also known as postpartum depression. It shouldn't be taken lightly as it's a serious disorder. Although, it is possible to overcome it through treatment without which it might worsen .. 

Some of the factors that may contribute to increased rates of postpartum depression during COVID-19 times might include:

• Hospital stays during an emergency due to complications related to birth,

• Fear of catching the virus herself or a loved one catching it,

• Worrying about transmitting the virus to baby,

• Limited physical activity due to delivery,

• Not having family or friends around,

• Absence of household help,

• Social isolation which increases stress,

• Not getting proper care which is taking a toll on physical as well as mental health,

• No help available to take care of the newborn,

• Having other young children to care for.

The symptoms of postpartum depression may vary from person to person. They may vary from day to day as well. Some of the indicators would include:

• feeling moody,

• feeling fatigued but still not able to sleep or sleeping too much,

• feeling sad or crying a lot without a known cause,

• not being able to stop eating or not interested in even looking at food,

• various unexplained aches or pains, or illnesses,

• sudden mood change,

• difficulty in concentrating,

• losing interest in things that earlier used to bring joy

• difficulty in remembering things,

• difficulty in making simple decisions,

• feeling completely out of control,

• feeling disconnected with your baby,

• feeling overwhelmed  and hopelessness,

• feeling worthless and guilty about one’s feelings,

• having a feeling to escape from everyone and everything,

• withdrawing by not sharing your feelings with anyone,

• having intrusive thoughts about harming yourself or your baby.

Coping skills for dealing with postpartum depression would include:

1. Recognizing that you are experiencing postpartum depression: This is the first and foremost step. Unless the problem is identified it will be difficult to take control of recovery. For this, a new mom needs to identify the symptoms, reach out for help and seek therapy.

2. Holding and stroking the baby and engaging in lots of baby cuddles decreases the risk of postpartum depression. Holding your baby releases the love hormone, oxytocin which has a lot of therapeutic benefits including making the new mom feel better emotionally. Also, breastfeeding helps a lot. 

3. Make time to unwind: The new mom should engage in some activities she enjoys doing. This shall give her the much-needed break and make her feel rejuvenated.

4. Limit the amount of time that a new mom spends each day listening to news reports: Instead, make use of reliable information sources and listen to one piece of non- sensationalized trustworthy news.

5. Connect with others: Talk with her family members or friends. This shall make her feel she is not alone and has people around who care for her.

6. Practice Gratitude: Forming a gratitude practice helps relieve symptoms of depression.

7. Establish bedtime rituals: Getting enough sleep might help in relaxing and developing a sense of routine and calm. Nap when your baby naps.

8. Small accomplishments each day may give you a sense of victory thereby taking care of the mental well-being: Planning smaller tasks and accomplishing those might make you feel the slightest bit better.

9. Enjoy nature: This can be done by standing in the balcony, sitting on the front porch, or the terrace of your house or society’s park while observing social distancing and taking all the necessary precautions can be therapeutic. 

10. Remind yourself of other hardships in the past that you have overcome: By remembering that she has been a resilient, strong and an adaptable individual, might make a new mom feel emotionally stronger and less depressed.

Postpartum depression and anxiety can lead to, reduced mother-infant bonding, delays in cognitive / emotional development of the infant which may persist into childhood. Furthermore, the COVID-19 pandemic is anticipated to decrease access to diagnosis and psychological treatment, in these unprecedented times. For the new mothers, the effort should be to take extra care to be emotionally healthy during pregnancy.