Perinatal depression is a serious health problem, but once recognised, it can be treated effectively. A psychiatrist helps us understand the risks, impacts and treatment for perinatal depression.
“Statistics from a study on perinatal depression among mothers in a South African birth cohort indicate that between thirty and forty percent of South African women will experience perinatal depression compared to a global rate of ten percent,” says psychiatrist Dr Bavi Vythilingum, who practises at Netcare Akeso Kenilworth, Cape Town.
a growing concern
Dr Vythilingum believes that to address what is becoming a growing health concern all women should be screened for perinatal mood symptoms during pregnancy and for postnatal depression after giving birth.
“Perinatal depression is an umbrella term covering depression both during and after pregnancy. We refer to it as perinatal depression because many women who have depression during pregnancy go on to develop postnatal depression. Also, postnatal depression is a risk factor for depression in subsequent pregnancies, so the term perinatal depression covers all these periods,” she says.
Read one mother’s account of her battle with postnatal depression.
Dr Vythilingum warns that perinatal depression can have serious consequences for mother and baby. “The mother experiences extreme suffering, emotional pain, difficulty bonding with her baby and, even thoughts or acts of self-harm and suicide.
“Regarding the baby’s health, depression during pregnancy is associated with risks of high blood pressure, preterm delivery and babies not growing and developing as well as they should. Postnatal depression, if left untreated, is one of the biggest risk factors for mental illness in the affected mother’s children, particularly as they become young adults. It interferes with the mother’s ability to bond with her baby and her ability to act sensitively and responsively to her baby, which can have marked effects on the development of the child. Perinatal depression affects the whole family and has a generational impact on mental health.”
risk factors
“The biggest risk factor for perinatal depression is having had a previous episode of perinatal depression,” notes Dr Vythilingum.
“Other risks include a history of mental health disorders, such as depression or anxiety, a substance or alcohol abuse disorder, particularly if the woman is still using substances during pregnancy, and having an unwanted baby, although this should not be generalised to unplanned pregnancies as many pregnancies that are unplanned are greatly welcomed. Other factors, like an unsupportive partner or intimate partner violence, also contribute to the risk of perinatal depression,” she explains.
recognition and hope
The good news is that perinatal depression can be treated effectively. “The first step is to recognise it,” says Dr Vythilingum, which is why all women need to be screened during pregnancy and after giving birth. “Simple, accurate screening tools are available to identify signs of perinatal depression.”
If a diagnosis of perinatal depression is reached, the mother and family should receive holistic multidisciplinary treatment with support from all their healthcare providers, including the gynaecologist, the paediatrician and the clinic sister, for example.=
Perinatal depression can be treated with psychotherapy, also known as talk therapy and medication. “Talk therapy is very effective, particularly for mild to moderate depression, and many women benefit from this. However, for moderate to severe depression or for a mother who has suicidal thoughts or thinks of harming herself or her baby, medication is indicated,” Dr Vythilingum adds.
“Nowadays, there are many safe medications to use during pregnancy and breastfeeding, which mothers can take. There is no need for them to suffer. Where appropriate, taking prescribed medication for moderate to severe perinatal depression is better for the mother and the baby because it enables the woman to get well and take care of herself and her child.”
Dr Vythilingum stresses that mothers should be supported and affirmed, not just in practical terms, for example, cooking a meal or looking after the baby, but also with emotional support and reassurance that they are good mothers, even though they are ill.
“We must recognise perinatal depression for the serious health problem it is, and through greater awareness help affected mothers by providing the treatment and support they deserve,” she concludes.
Resources
In any mental health emergency or for advice in accessing mental health care for yourself or a loved one, reach out for support. Netcare Akeso offers a 24-hour crisis line on 0861 435 787. Trained counsellors are available to talk to you without judgement and can guide you through the various options for assistance. The South African Anxiety and Depression Group (SADAG) also provides a 24-hour suicide crisis helpline on 0800 567 567. The postnatal depression group also provides telephone counselling to support women, contact them on 082 882 0072.
