1. Introduction: Addressing Perinatal Mental Health
Madhavi: Namaste and welcome to the Ananya Child Development Centre podcast. I'm Madhavi, and today, from Asha Hospital, Banjara Hills, we're discussing perinatal mental health with Dr. Swetha Reddy, who brings extensive experience from both Asha and Rainbow hospitals and specialized training from Massachusetts General Hospital. Dr. Swetha, your work has been transformative.
Dr. Swetha: Thank you for having me.
2. What are Perinatal Psychiatric Disorders?
Madhavi: Let's start with the basics. What are perinatal psychiatric disorders, and why do they often go unrecognized?
Dr. Swetha: "Perinatal" refers to the period from conception to one year after birth. Many women experience mental health issues during this time. "Perinatal psychiatric disorders" are similar to other psychiatric disorders in women but also impact mother-child bonding and the child's cognitive and neurodevelopment. The well-being of the mother is paramount for the child's development. If you have concerns about your child's development, consider an assessment.
3. Normal Emotions vs. Clinical Concerns During Pregnancy
Madhavi: How can we differentiate between normal pregnancy emotions and clinical concerns?
Dr. Swetha: Pregnancy is a joyful but stressful time. Some anxiety about the pregnancy, delivery, and childcare is normal. These feelings are usually fleeting, and the mother can engage in other activities. However, with mental health disorders, the woman becomes fixated on certain thoughts. For example, women who have experienced miscarriages may have persistent anxiety about losing the current pregnancy. Those with late pregnancies might worry about having a normal conception. In these cases, the anxiety becomes overwhelming, impacting daily life, work, and relationships. If you need support during your pregnancy, consult a professional.
4. Impact on the Family
Madhavi: So, what should be a happy experience can become stressful for the entire family.
Dr. Swetha: Exactly. It affects the whole family. Every woman who undergoes a miscarriage or abortion should visit a psychiatrist or psychologist. Grief from such an experience is akin to child loss. Many women need support to process these difficult emotions.
5. OCD During Pregnancy and Postpartum
Madhavi: Could you explain how OCD can manifest during pregnancy and postpartum?
Dr. Swetha: We need to differentiate between OCD developing for the first time during pregnancy/lactation and a pre-existing OCD condition worsening during this period. Intrusive thoughts are common, but in OCD, they are repetitive and distressing. During pregnancy, women may worry about losing the pregnancy, congenital anomalies, or their baby's health. Postpartum, obsessions often revolve around cleanliness. Mothers may not allow others to touch the baby without washing their hands or restrict visitors with any illness. They may also experience anxiety about handling the baby alone, fearing they might harm the baby, despite loving them deeply. These intrusive thoughts cause significant distress. Cognitive-behavioral therapy can be helpful in managing OCD.
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6. Stigma and Seeking Help
Madhavi: Do you think shame prevents women from seeking help, especially in India?
Dr. Swetha: Stigma is a factor, but ignorance is a bigger one. Many women don't recognize their thoughts as mental health concerns. Additionally, if a family member experienced similar issues, they might dismiss it as normal. Fear of medication during pregnancy is another significant barrier. However, untreated mental health disorders during pregnancy can be detrimental to both the mother and the fetus. It is crucial to treat moderate to severe cases. One in six women develop depression, one in four develop anxiety, and one in seven develop OCD during the perinatal period. These are much higher rates than diabetes. If you need help identifying the right therapy for you, visit our Therapies page.
7. Generational Differences in Seeking Help
Madhavi: The younger generation seems more open to seeking help.
Dr. Swetha: Yes, there's a positive shift. Just like you'd see a doctor for suspected diabetes, it's important to consult a psychiatrist if you notice changes in your thinking, emotions, sleep, appetite, or work performance, especially if there's a family history of psychiatric disorders. Early intervention is key. At Ananya, we offer various support and therapies for families.
8. Depression During Pregnancy
Madhavi: How is depression during pregnancy different from just feeling low?
Dr. Swetha: We all have mood swings. Depression is a persistent low mood. Hormonal changes, especially progesterone, can contribute to depression during pregnancy. Risk factors include a personal or family history of depression, domestic violence, interpersonal stress, perceived lack of support, substance use, previous pregnancy complications, or previous child loss. For more information, visit our Emotional Disorders page.
9. Bipolar Disorder and Pregnancy
Madhavi: What special considerations are needed for pregnant women with bipolar disorder?
Dr. Swetha: Many pregnancies in India are unplanned. Women often stop their bipolar medication without consulting their psychiatrist, leading to a high relapse rate (around 80%). Studies show that continuing medication during pregnancy reduces relapse rates to 25%. Ideally, women with bipolar disorder should discuss pregnancy plans with their psychiatrist a year in advance. This allows for medication adjustments to safer alternatives and gradual tapering of less safe medications. Abruptly stopping medication is dangerous. Close monitoring and collaboration between the psychiatrist, obstetrician, and the woman are essential. Consult a specialist for proper management.
10. Anxiety in New Mothers
Madhavi: When does anxiety become a clinical concern in new mothers?
Dr. Swetha: Anxiety becomes clinical when it's persistent, overwhelming, and interferes with daily life. Symptoms include palpitations, tremors, sweating, and constant worry, often related to the baby's health or the mother's own health. Perinatal anxiety disorder is a recognized condition. Cognitive-behavioral therapy can help manage anxiety.
11. Postpartum Psychosis
Madhavi: What should families know about postpartum psychosis?
Dr. Swetha: Postpartum psychosis is rare but serious. It occurs in one in a thousand childbirths and usually develops within the first week after delivery. Symptoms include irritability, aggression, delusions (false beliefs), and hallucinations (hearing voices). It's a psychiatric emergency requiring immediate hospitalization. The baby may need to be separated from the mother temporarily for safety. Asha Hospital has mother-baby units. Immediate medical attention is crucial.
12. Medication Decisions During Breastfeeding
Madhavi: How do you approach medication decisions during breastfeeding?
Dr. Swetha: For mild cases, we might use non-pharmacological approaches like counseling or TMS (transcranial magnetic stimulation), which is safe during pregnancy. Biofeedback can also help with anxiety. For moderate to severe cases, or if there's a history of suicide attempts or the woman is already on medication, we consider medications. There are safer medications during pregnancy and breastfeeding. We start with the lowest effective dose, monitor for side effects, and assess the baby's response. Untreated mental health conditions can have significant negative consequences on both mother and child. The risks and benefits of medication must be carefully weighed. Explore different therapy options on our website.
13. Support Systems for Women
Madhavi: What support systems should be in place?
Dr. Swetha: Awareness is crucial. Families need to understand that pregnancy doesn't protect against mental health disorders. Support the mother's decisions, whether she's working or staying at home. Encourage positive activities and healthy interactions. Minimize interpersonal stress. Don't dismiss a woman's concerns about her mental health. Fathers can also experience depression during the perinatal period. It's important to address the mental health of the entire family. Listen to our podcasts for more information on parenting and child development.
14. Importance of Planning and Professional Support
Madhavi: I agree. Parent education is vital.
Dr. Swetha: Planning for a baby is as important as planning to buy a house. You need to plan your work hours, finances, and role transitions. The transition from wife to mother, husband to father, is significant. Seek professional help when needed. Consult with a specialist to create a plan.
15. Conclusion: It's Okay to Ask for Help
Madhavi: Thank you, Dr. Swetha. This has been a powerful conversation. To our listeners, remember, pregnancy and motherhood are emotional journeys as well as physical ones. It's okay to not be okay. Help is available. You can reach Dr. Swetha at Asha Hospital or Rainbow Children's Hospital, both in Banjara Hills. Our teams at all Ananya centers are also here to support you. Taking care of your mental health isn't selfish; it's essential for both you and your baby.
Dr. Swetha: Thank you.
Our Locations in Hyderabad
Ananya Child Development Centre has five convenient locations in Hyderabad to serve you:
- Banjara Hills: 101 Orion Plaza, Rd No. 3, Resham Bagh, Banjara Hills, Hyderabad – 500 034, Telangana | Tel: +91 98485 13192
- Manikonda: Rd Number 25, next to Crayons Preschool, opposite Anuhar Nature Walk Apts, Alkapur Twp, Manikonda Jagir, Hyderabad, Telangana 500089 | Tel: +91 98485 13192
- Kokapet: 3rd Floor, Plot 21, Gandipet Main Rd, above Vijetha Supermarket, Narsingi, Kokapet, Hyderabad, Telangana 500075 | Tel: +91 98485 13192
- Madhapur (Head Office): Hightech Chambers, 55/A, Jubilee Enclave, Madhapur, Hyderabad, Telangana 500081 | Tel: +91 98485 13192
- Nallagandla: First Floor, Plot 169/34, Nallagandla Huda Extension layout, Nallagandla, Hyderabad – 500 019, Telangana | Tel: +91 98485 13192
Disclaimer: This blog post is for informational purposes only and not a substitute for professional medical advice. Always consult with a qualified healthcare provider for any health concerns.
Take the first step towards a healthier you. Book a consultation with Ananya Child Development Centre today.
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