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Beyond the 'Baby Blues': Defeating perinatal depression

Beyond the 'Baby Blues': Defeating perinatal depression
Iza Trengove
By Iza Trengove
9 Dec 2024
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Perinatal depression affects countless mothers yet remains widely overlooked. This story explores the importance of early detection, effective treatments and the urgent need to prioritise maternal mental health.

‘My baby was seven months old when everything fell apart. I couldn’t wait to become a mother and experience the blissful motherhood peddled by the media. But in reality it felt like the worst thing that ever happened to me. 

“I couldn’t eat, sleep, or even make a bottle for my baby. I felt frozen with terror. Anxiety skyrocketed, and it was as if a thick glass separated me from the world. No one heard me.”

Lyndy is a passionate environmentalist and motherhood was supposed to be a fulfilling break in her career. Instead, it became a battle for survival. 

Thankfully, her husband, who is a doctor, recognised the early signs of depression and insisted on Lyndy looking for professional help. 

For Anna, a mother from Lesotho, the story takes a darker turn. Anna was unemployed when she fell pregnant with her fourth child. They lived in a small, two-roomed corrugated-iron house with no running water or electricity. Her world started crumbling after a traumatic C-section.

“One morning, I woke up and didn’t know where I was. By evening, I heard strange noises and didn’t recognise my family. I was convinced they wanted to harm me and ran into the night.” 

Her terrified partner immediately called for help. Initially, Anna was sent to a traditional healer but a month later she ended up in hospital and was put on medication. About three weeks later, she explains, she started to feel somewhat better. 

What is perinatal depression?


Dr Lavinia Lumu, a Johannesburg psychiatrist, emphasises that perinatal depression doesn’t discriminate. It can hit anyone, regardless of race or income. 

In South Africa, about one in three women experience some form of perinatal mental health issues. It is defined as a mental health condition that could arise during pregnancy or within 1,000 days of giving birth.

Pregnancy brings huge hormonal shifts, which can wreak havoc on brain chemicals that regulate mood. While the “baby blues” is normal after giving birth, persistent sadness or weepiness beyond two weeks might signal deeper issues.

Why early detection is key


Lumu advocates for routine depression screenings during antenatal check-ups, just like testing for diabetes or HIV. 

Early identification and treatment can prevent complications later. Mild cases might require counselling only, while severe instances may call for medication as well as therapy. 

Fortunately, there are safe treatments that don’t interfere with pregnancy or breastfeeding.

Factors that could heighten the risk of perinatal  depression include, teenage pregnancy, poverty, substance abuse, a family history of mental illness, an abusive relationship or previous trauma.

If left untreated the illness could affect the development of the baby and lead to low birth weights, premature births and long-term cognitive or emotional challenges.

The road to recovery


Stefani Urdang, a social worker who has counselled many women battling perinatal depression and led a support group, points out that it exists on a spectrum. 

Many women don’t recognise their symptoms until things spiral out of control. 

She notes: “New moms often put immense pressure on themselves to be perfect.

“They feel guilt and shame when they can’t cope, hiding their struggles until they burn out. Parenting has a huge emotional impact and is often quite different from one’s expectations”. 

Symptoms range from mild to severe, including from mood swings, exhaustion and changes in appetite, to psychosis, confusion and hallucinations. 

In the worst cases women may pose a danger to themselves or their babies, requiring emergency intervention and hospital admission. 

Lumu adds that in extreme cases, when other treatments have failed, electroconvulsive therapy (ECT) may be necessary. The procedure is done in a hospital under anaesthesia; it is safe and has been used for many years. 

During ECT a controlled amount of electricity which is sent to the brain causes a seizure, which helps to “reset” certain areas that control mood, emotions and thinking. Over time it may improve feelings of sadness, confusion and hopelessness. 

The good news is that perinatal depression is treatable. 

Recovery takes time, patience and a solid support system, but it is absolutely possible. 

Lyndy believes the medication and her family’s consistent assurance that things will improve, was a game changer. 

For Anna, medication took six weeks to work, but it pulled her back from the brink and saved her life. Now, five years later she is employed. She says the medication made it possible for her to get her life back and care for her children.

Breaking the stigma


Both women urge others to seek help without hesitation. 

“It’s a disease, just like any other,” says Lyndy. Millions of people take antidepressants that enable them to live full, productive lives.

Lumu says she hopes that greater awareness will help spread the message that it is not a reflection of a mother’s strength or capability. It is a medical condition, just like any other illness, and if warning signs are spotted and treated timeously, countless women can avoid the battle. 

Lumu urges women who suspect they may have perinatal depression to contact their nearest clinic, health professional or the nonprofit South African Depression and Anxiety Group, which has a 24-hour helpline and offers a range of services and support for perinatal women. 

As Lyndy and Anna’s stories show, recovery is possible with the right support and treatment. Whether it’s medication, counselling or simply having someone to listen, these interventions can transform lives, not just for mothers but for their families too. DM

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