Perinatal Psychiatry NIMHANS
  • Home
  • Patients
    • Services >
      • Out Patient Services >
        • Nature of Treatment
      • In Patient Services
    • Procedures
    • Symptoms >
      • Postpartum Blues
      • Anxiety Disorders
      • Mother Infant Bonding Disorders
      • Postpartum Depression
      • Post Traumatic Stress Disorders
      • Postpartum Psychosis
    • FAQs >
      • Prevention of Recurrence of Postpartum Psychiatric illness
      • Downloads
      • Support for Husband and Family Members
    • Contact US
  • Professionals
    • Services
    • Training
    • Gallery
  • CONSULTANTS
  • Research
    • Articles
    • Books and Chapters
    • M.D and Ph.D Thesis
    • Projects
    • Publications
  • Resources
    • Video Resources
    • Useful Links
  • Blog

The Mum Who Loved Too Much

6/17/2013

7 Comments

 
Picture
  By Dr. Prabha S Chandra

Her husband brought her to me because she was not caring for the baby. She was fine till the baby was 6 weeks old and then started withdrawing from her, not wanting to hold her or bathe her. She would feed her but that too as if it was a chore. She didn’t appear to be depressed but was definitely distressed.

She was sleeping well and eating fine. She was also doing other household chores. Strangely, she seemed to prefer to do house work rather than baby care! Her husband was at his wits end. He had tried cajoling, sympathizing, scolding and even threatening that he would leave the baby with his parents, but to no avail.


When I met her, she looked ahead, her eyes filling with tears, as her husband described what he felt was `difficult’ and `unnatural behaviour for a new mom’.

I decided to speak to her alone. I had seen this too often and knew the signs. “I know that you really love your baby”, I told her gently. “I also know that sometimes, when you love too much, you also have fears for the baby’s well being and that can be scary”.

She looked at me with grateful eyes. Relief writ on her face, as I carefully  tried to understand the reason for her fears of being with her baby. “I know you are a good mother but sometimes even the most loving mothers can have very difficult thoughts. Thoughts that you can’t talk about or share because they are so scary” I told her.

“Sometimes mothers get thoughts that they might do something to the baby and that it is safer for their baby to be away from them. Can you tell me if such thoughts worry you? “I asked.

She nodded and burst into tears. It was as if a dam had burst. She shared with me how she feared that she might harm the baby or be negligent. How she was plagued with thoughts that her presence in some way would cause the baby an infection or an illness. She had tried her best to care for her baby and knew that her thoughts were not real.  She adored her baby and would never let anything touch her beautiful child but then every time she went near her, the thoughts would take over and she would flee from the room trembling with anxiety.

Anxiety disorders in the postpartum period, may often present as a bonding disorder. Family members may complain that the mother is uncaring and does not love the child. They may get angry and even separate the baby from the mother.

The mother may have severe anxiety related to the infant or may have obsessions about the infant, especially that the baby may get infections, fall down or she might hurt or harm the baby in some way. The anxiety usually comes down with avoiding the baby and this causes double distress to the mother. She is dismayed about getting these unnatural thoughts about her baby and at the same time not being a good mother.

My experience in treating and helping mothers with severe anxiety and obsessions related to the infant has been extremely rewarding. The relief on a mother’s face when she realises that you understand her and are not judging her; the gradual improvement with medication and behaviour therapy; the support they get from their husband once he realises what is amiss and finally the joy on the mother’s face when she is able to bathe and feed her baby, able to cuddle and coo to her precious one and is not a slave to her fears!

You can check out these websites for more information on postpartum OCD and for experiences of mothers who had OCD.

http://www.babble.com/baby/postpartum-ocd-symptoms-anxiety-depression/

http://community.babycenter.com/post/a24466837/postpartum_ocd_who_has_it



7 Comments

The Motherhood and Mental Health Blog by Dr. Prabha

6/14/2013

4 Comments

 

Blues after the Baby Shower

She had looked forward to this baby so much. Pregnancy was easier than expected. None of the morning sickness issues that her friends had warned her about. In fact she blossomed during her pregnancy, her office work was of high quality and everyone who saw her said  that motherhood suited her.

She had read magazines and books on pregnancy and often read parts of it aloud to her husband who teased her indulgently about her constant preoccupation with this baby who was yet to come. She had thought of a name for a girl and a boy and had started thinking of the baby’ room and clothes.  It was all fine till her `Srimantha’ during her 9th month.  This was her baby shower and all her friends and relatives were literally showering her with blessings and gifts. By the end of the day she  was exhausted and had a restless night.

The next morning was when the gloom and panic began. What if labour was difficult, what if  something happened to the baby or what if something happened to her? Thoughts crowded around like a whirlpool, dragging her down further every minute.

She insisted on seeing her obstetrician for an unscheduled appointment who assured her that the baby was fine and that calmed her down a bit.

Three weeks later, she went into labour and needed a Ceasarian section. She got up from her anaesthesia groggy and confused. They brought her baby to her but she did not feel the joy that she had expected. How would she look after this little creature who was so dependent on her?

Somehow, she mustered enough energy to breast feed. At home there was her mother for help and all the relatives who  came exclaimed how beautiful the baby was but she did not feel anything. And then came the tears and the guilt.


Thoughts went round and round her mind- “I must be an awful mother she thought not to feel happy.”

“All this seems such a chore, I am tired and don’t feel like feeding my baby”.

“I wish someone could look after the baby and let me lie in bed”.

Her husband was befuddled and confused. Had he done something wrong? Should they not have had a child just yet? Would she be like this forever? How would he manage the baby single handed?

Notes from a Perinatal Psychiatrist – The Solutions


How could we have prevented this from happening?

How can we help a woman, her baby and family when something like this happens?

Depression in pregnancy, especially in the last couple of months is not uncommon. Early detection can help in treatment and preventing it from worsening in the postpartum.

The obstetrician could have referred her to a counselor first or a psychologist to assess the anxiety and depression. They would have suggested some simple `mental techniques” based on cognitive therapy which could have made our young mother feel a lot better.

If that didn’t work, we would have started her on a low dose antidepressant with a good safety profile. We could have started the same antidepressant soon after delivery which would have helped the mother a great deal and also counseled her and her husband on simple methods of handling this postpartum depression.

We would have reassured the mother that its ok not to be a `perfect’ mom! Mothers will feel tired, frustrated and sometimes get angry and one might not feel attached and loving towards the baby at all times.

We would have spoken to the husband and told him about depression linked to childbirth and what he can do to help. Importantly, we would have assured him that he was not to blame and this can be treated.

I would urge readers to look at this website on postpartum mental health, www.postpartumprogress.com. This site has been voted as the top website for information and I found it very useful too!

Please write to me at this website or at chandra@nimhans.kar.nic.in  if you think you have similar experiences and if you would like to know more about a specific mental health problem related to childbirth and mothering. This blog is for all the mothers who have struggled or are struggling with mental health concerns related to  childbirth, for those who overcame these struggles and for those husbands and family members who helped them.

4 Comments

    About Author

    Picture
    Name: Dr. Prabha S Chandra
    Gender- Female
    Profession- Medicine, Psychiatry
    Occupation- Professor of Psychiatry
    Location - Bangalore, India

    Why this blog?- The purpose of this blog is to write about the topic that I am most passionate about- mental health issues related to childbirth and the mental health of mothers.

     I will write about my experiences as a perinatal psychiatrist in the last 15 years, the jubilations and trials in my job, patient experiences and stories ( complete confidentiality assured), the latest medical news in the field and important links and websites that you folks may want to visit.

    I will invite guest bloggers who are experts in their respective fields to offer to you their stories and words of wisdom.

    Through this blog I hope to reach out to the countless mothers and fathers who have struggled or are struggling with mental health concerns related to childbirth, for those who overcame these struggles and for those husbands and family members who helped them.

    I hope you will accompany me into this journey of stories, musings, my own dilemmas, the stories of my great colleagues and also the grit and courage of my wonderful patients who are determined to survive.

    My Not so Professional Bio-

    I adore babies and dogs. I enjoy writing about things that I feel strongly about. I am passionate about books and travel.  

    I believe in recycling; in the goodness and strength of all human beings; in listening to patient’s illness narratives and stories.

    I enjoy teaching young students and listening to their insights. I feel medical ethics is a neglected subject and strive to discuss it whenever possible.

    For me, motherhood has been the most rewarding experience of my life,  from which I have learnt to be honest, patient, non judgmental, accepting, modest, brave, funny and a combination of being a Tiger Mom and a Teddy Bear Mom as the situation demands!

    I would like to make motherhood as stress free as possible for women who are already struggling with mental health issues and hence this blog.

    Archives

    March 2016
    August 2014
    July 2014
    February 2014
    November 2013
    July 2013
    June 2013

    RSS Feed

Powered by Create your own unique website with customizable templates.