Last week, the world celebrated International Maternal Mental Health awareness week. It did not have the same fanfare and attention as some of the other days/weeks marked to create awareness about diseases such as cancer and AIDS but it is an important one.
Maternal Mental Health looks at depression in women from the time she conceives to the time the child is 24 months old. It has various degrees of severity from the more common baby blues due to hormonal changes, to the more severe pre and postpartum depression and even psychosis which can lead the woman to inflict self-harm and also harm the baby. All of this is covered under the medical term called perinatal depression.
Its symptoms include increased anxiety, mood swings, lack of sleep, difficulties in bonding with the baby, negative thoughts and hallucinations and it can be caused by biological changes, feeling of isolation, domestic violence, poverty, gender preferences to name a few.
Twenty percent of women in India develop some form of perinatal depression…But the illness has negligible recognition. Shame, stigma and lack of awareness about the condition often prevent most women from getting diagnosed and receiving treatment.
But every now and then we see the ugly manifestation of this illness when it makes headlines.
In October last year, the Bangalore police found the body of a 7-month-old baby girl in a water sump. Her mother later confessed to killing her. She was suffering from Postpartum Depression
A woman in Ghaziabad reportedly threw her 11-month-old baby boy from the second-floor balcony of her house in April 2012. Her medical report said she was depressed.
In September 2010, a mother drowned her 8-month-old baby boy in a washing machine at her home in Alappuzha, Kerala.
It may be long before we give this problem its due attention but it is important to highlight the work being done in India to address Perinatal Depression.
Madhya Pradesh has become the first state where screening for perinatal depression is possible as a part of its public ante-natal program.
The state government along with the NGO partners Sangath and the Public Health Foundation of India began project PRIME six years ago to integrate mental health care into primary care in some of its district hospitals.
The program found it was making an impact on the diagnosis of pregnant women with depression. And so the project was scaled up. Now in all 55 district hospitals in Madhya Pradesh, one medical officer and 2 nurses have been trained to diagnose perinatal depression during ante-natal check-ups.
By doing so the state has set up a model that will hopefully be replicated by others so that we can someday achieve universal screening for perinatal depression.
Another step to address this illness was taken by the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore, when it started its first mother-baby unit in 2009. This seven bedded facility supports mothers with severe forms of postpartum obsessions and psychosis.
Dr. Prabha S. Chandra and her team have been helping mothers with Perinatal Depression for several years but having a facility like this has helped them treat women who would have otherwise struggled to cope. The facility also ensures that all nutritional and cognitive requirements of the newborn are met which otherwise would have been neglected.
And while these efforts must be applauded, given the sheer number of children that are born in India each year, we must scale up efforts at all levels to see that women struggling with this illness get help.
While there are no studies to link suicide and postpartum depression, it is a well-established medical fact that depression plays a significant role in suicide. The data released by the National Crime Bureau shows that the largest demographic committing suicide in India is that of housewives-four times more than our farmers. Yet this never makes headlines.
Over 20,000 housewives in India have been killing themselves every year since 2007.
This figure should make us want to address all forms of depression in women, including that of the much neglected perinatal depression.
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