Technical writer Effath Yasmin, 37, always wanted children, so being pregnant was a dream-come-true for her. After her baby was born, the elation was replaced by panic, followed by anxiety and depression. Yasmin soon turned reclusive, reluctant to leave her room or meet people.
"I would sob over the smallest incident and I became obsessed with protecting my daughter," she says.
When her mood didn't improve a month later, she turned to the Internet for help. And she found it in llli.org/india. html, a website set up by international mother and babycare NGO La Leche League.
Yasmin learned online that her condition sounded like postpartum depression and she should consult a doctor.
"No one around me seemed to understand how I was feeling," says Yasmin, whose daughter is now five. "Thanks to the website, I realised I needed to seek help. It still took me 18 months to get back to my normal self."
Postpartum depression (PPD) affects one in every five new mothers in India. What begins as insecurity, usually within 30 days of the baby's birth, rapidly expands to other symptoms that typically include sadness or anxiousness through the day that often worsens in the evening; crying spells; low self-esteem; lethargy and sleeplessness.
"As it is, women feel overwhelmed by the big change in their life. Add to that the sudden stress associated with looking after a little newborn, sleep disturbances, poor emotional support and the added financial burden and you have a potent trigger for depression," says Dr Vimal Grover, senior consultant, department of gynaecology, Fortis La Femme.
The milder version is called Postpartum Blues, where the mother's feeling of being overwhelmed, low and having difficulty sleeping resolves on its own within a month.
A cycle of stress
Improved diagnosis, rising work stress and the increasing absence of extended family support has caused a spike in PPD cases. Mumbai-based clinical
psychologist Seema Hingoranny's clinic now has an average of six cases a month, up from one or two a month in 2008. Psychiatrist Vivek Chincholkar says cases at Jupiter Hospital in Thane went up from four or five a month in 2008-09 to 15 or 20 a month last year.
"We are expected to be thrilled and happy when our babies arrive, and so the idea that we could be sad or anxious or angry is surprising to people. Moms with PPD have a lot of guilt around this, even though the truth is that PPD isn't their fault and they didn't do anything to cause it' says Katherine Stone, 43, American blogger and columnist who shot to fame after she began a tell-all blog about PPD following her first delivery in 2001.
PPD is also more likely to affect women with a history or family history of depression; women who have had a difficult pregnancy or a very difficult delivery; women with a troubled marriage or poor support from spouse or family; women with a sick or colicky baby; women with several other stressors in their lives, such as pressure to get back in shape and return to work or her other regular routine.
"Counselling, a good diet, adequate sleep and family support are usually enough to treat depression in new mums, only 5% need medication and antidepressants," says La Femme's Dr Grover.
Awareness is key
Typical reactions to PPD can also exacerbate the case. Often, when a new mother is angry and depressed, saying she doesn't want to hold her baby, the family reacts with dismissal or anger.
"Either reaction can be harmful," says Mumbai-based social psychologist Nayreen Daruwalla. "The best solution is awareness that this could be PPB or PPD, and that treatment is easily available."
When her baby was six months old, Yasmin became a full-time volunteer for the website that helped her beat PPD to help other new mums navigate their first few months as mothers. She also started her own website, nourishandnurture.com, which offers an online forum for anxious young mothers.
"I realise now that women across the country feel like the way I was feeling, and many never get the help they need," she says.