Hormonal changes, loneliness and personal loss are among the factors that make women more vulnerable to depression than men

“I remember pouring water for myself and letting the water just flow into the glass and on to the floor while the baby cried and cried. Then I had to literally shake myself and get out of the this-is-going-nowhere mood.’’

SHINIE ANTONY, who went on to write about mommy blues in her first collection of short stories Barefoot and Pregnant, suffered from postpartum depression after the birth of her first child. “When I came home with my newborn, it seemed to me that my life had effectively ended,” says Antony, who has edited several of author Chetan Bhagat’s books, including Half Girlfriend that released last year. “Suddenly all my decisions had someone else at the centre. Everyone cooed over the baby and then disappeared. My body, my lifestyle, my sense of being all entered an unknown territory. Sleep deprivation and this absolute responsibility for another being.... I was growing smaller and smaller and the baby was growing bigger and bigger.’’

Most working mothers go through spells of guilt when they leave a small baby at home, but Antony felt “a guilty pleasure’’ in the escape. “At work, I never mentioned I had a kid, never took a day off citing the baby, couldn't pretend to rue leaving it behind,” she says. “That moment when I ran out the door—to work or shop—the relief was indescribable. Without someplace to go to, motherhood would have left me a wreck. Looking back, it was a vague depression.’’

Antony, who had her first baby at age 30, was more prepared the second time round. “I did not expect things to be picture perfect,” she says. “I knew the baby would take time to become an individual, to go from blob to special. Plus, I had the pleasure of my firstborn's company this time round.’’

In retrospect, Antony feels that postpartum depression is not just a kind of moral weakness that would go away if ignored. “In the west, for a long time now, it is an acceptable health issue that can be treated with pills or counselling,” she says. “New moms need help, some more than others.’’

Mom in distress: Shinie Antony suffered from postpartum depression after the birth of her first child | Bhanu Prakash Chandra

Professor Michel Botbol, chief of department of child and adolescent psychiatry, Brest University Hospital in France, would agree with Antony. In his lecture at the Annual National Conference of Indian Psychiatric Society, held in Bengaluru, Botbol pointed out that postpartum depression is “an important problem of public health’’.

Depression in mother could affect her relationship with the baby and leave a negative impact on the child’s mental health. If the woman doesn’t make an effort to mend the psychological problems, it could have a negative impact on her marriage, too.

Women can develop postpartum depression one month to a year after childbirth. It is one of the most under-recognised and under-treated medical conditions. Hormones may play a key role in the genesis of postpartum depression. “The high levels of female hormones during pregnancy decline rapidly after childbirth. This sudden decline may be an important cause for postpartum depression,” says Dr Ambrish Mithal, chairman, endocrinology and diabetes, Medanta the Medicity.

“There may be fluctuations in the mother’s thyroid hormone levels, which could be playing a role in postpartum depression. In addition, some studies indicate stress hormones released from the placenta during pregnancy [placental corticotropin-releasing hormone] may correlate with the development of depression after delivery.”

Recently, actor Deepika Padukone broke the silence over her battle against depression. She said she had felt “empty and directionless” despite being at the top of her career. Her revelations are, perhaps, just the tip of the iceberg. Modern-day women face tremendous stress, say experts. External stress is one of the major causes of depression in women. They suffer a lot because of socio-cultural norms, which put them at a disadvantage.

“Women are now doubly burdened. The demands on them keep increasing,” says Dr Sarada Menon, 92, India's first woman psychiatrist. “They find it hard to cope with the requirements of a nuclear family. Men just have to go to work. A lot of other burdens fall on women. As a result, they are doubly prone to depression than men.”

Studies indicate that women are 70 per cent more likely to suffer from depression than men. New treatments and therapies, however, offer hope. Even those with severe depression saw improvement with treatment. But due to the stigma attached to depression, women still hesitate to seek medical help, say experts.

“I feel terribly lonely. Despite doing all their duties, stay-at-home moms are ignored and devalued. They fall prey to depression.”