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Nnenna Uneke is a clinical psychologist and founder of Integrative Wellbeing Inc. In an interview with THE WHISTLER, she sheds light on the often-misunderstood condition of postpartum depression, the importance of support for new mothers and the crucial role of husbands, families, and society in supporting new mothers.
What is postpartum depression, and how does it affect new mothers?
When a woman is pregnant, there are a lot of hormones at work. There are high and elevated hormonal levels for a woman. It means that the way that the person experiences sadness, joy, and fears is going to be heightened. A lot of the fear that comes with having a baby for a lot of women is around the safety of that baby. So, imagine that you become so afraid of this child’s future. This fear numbs you. This fear almost takes you out of reality. You’re not focusing on taking care of the baby because now you’re so depressed.
How does postpartum depression differ from normal depression, and what are the criteria for diagnosis?
The only difference is that it is heightened because you just finished giving birth. This means that how depression would normally feel would be like two times of it. So, when we talk about postpartum, it is probably someone who has tendencies for depression. And now they have had a baby, it is heightened to the point where they are tired, they have no interest in things that we think they should be enjoying, which is this new baby. You bring them the baby, and they’re like, “Oh no! I don’t want the baby”. So, they are sleeping too much, which is one of the criteria for the diagnosis of depression… at least five criteria; fatigue, a feeling of worthlessness, a feeling of hopelessness, insomnia, or hypersomnia; either sleeping too much or not sleeping enough. When we talk about worthlessness, it speaks more to the person. It’s like the person feeling, “I’m worth nothing. I don’t have any value”. Hopelessness is the feeling that things won’t get better. You don’t see a good future? You don’t see a future? You are not thinking about the future.
Can past experiences of depression contribute to postpartum depression?
Yes, previous episodes of depression may predispose someone to it. There have been so many things that happened in their lives that would cause depression, but they never just really had the time to deal with it. Or slowed down enough to stay with that thought. Or to allow those feelings to come up. Now, when you are pregnant, a lot of things come up. There is not much you can do to manage it. So that might be the time that, say, for instance, hypothetically, someone who had been sexually assaulted as a child will now start to think about it.
How can husbands support their spouses during this time?
There was an important research that was done, and it says that what determines the health of children is their mother’s emotional well-being at that time when she is pregnant and having a baby. So, if men understood that, even if you don’t care about that woman, you have to understand that this is the woman that is going to be raising your children, your generation, your legacy and her mental well-being, her emotional well-being impacts the well-being of the baby. That is all men need to know. If men know this and they understand it, they will treat their women kindly. They will be supportive, especially during pregnancy. So, it is very crucial for men to step up, especially with emotional support during pregnancy.
You mentioned a case where a woman was treated poorly by her husband’s family after giving birth. Can you elaborate on that?
This happened years back. Every time the woman had a baby, she became depressed. So, the protocol around her giving birth became that her husband’s family would come, she would have the baby, and they would separate her from the baby…like pretty much isolate her and they would take care of the baby. When she needed to feed the baby, they would bring her. They pretty much treated her like an outcast. Now, did you think that made her feel better? No, no, that made her worse.
So, when it became worse, did she get treatment for depression? No. When she had the baby, they would actually separate her and the baby and send her back to her parents’ home. Now, that progressed, and it got worse. I think about it now because that is how much I remember it. Her having the baby was always like this, hush, hush. Oh, she is pregnant… and then you see her family start to come in. And you already know what’s going to happen, and I never understood it then.
Most people do not take postpartum depression seriously. Or we attribute it to a ‘marine’ husband. They will say, “Oh! Her marine husband is not happy that she is having a baby for her ‘earthly’ husband. But now that I think about it, that poor woman was struggling with postpartum depression. And because of how she gets no support, because of how she gets treated, because of how her husband’s family treats her, it got progressively worse to the point where her mental state was pretty damaged.
How can we better support new mothers and prevent postpartum depression?
Having good support is key. And understanding when there are changes. So, when you are going through pregnancy, you start to notice that you don’t feel as excited as you used to be…food doesn’t taste good, you are losing appetite, you’re unnecessarily tired. Normally, when you give birth to the baby, it is expected that your life revolves around the baby. And if you’re noticing that it is not, then it is time to talk to somebody. In a lot of houses, or a lot of communities, they’ll say, go pray about it. Go pray about it, but you also need a therapist. There is a saying that you can have Jesus and a therapist at the same time. You can have both. So, there are things about your mental health that a prayer is not going to solve, like a prayer might even make it worse. So talking to a therapist is very important..and support is very crucial.
Do you think awareness of postpartum depression during antenatal care can help prevent it?
Absolutely. Knowledge is power. It’s probably the most wonderful thing you could have. You could know it. And just say, okay, maybe it will never happen to me. But it is important you are aware. It is important to include this in antenatal care. Women will know that if they start to feel a certain way, they need to talk to somebody about it. The nurses should be able to do the basic assessments. This is someone you can talk to who will understand, and then if it is down to a level, there should be other professionals that the women should talk to. These professionals should walk in collaboration with the nurses. The nurses should be able to make a basic assessment.
What do you think the government should do in this regard?
Hire people like us to train nurses. To exclude this in antenatal care is almost like a big error because our mental health affects everything. Even if we don’t want to call it a disorder, I am not big on disorders. I am more focused on mental wellness. Like, if we take care of our mental health, if we take care of ourselves and if we are aware, then we have a chance of pushing away the more chronic mental health disorders.
