The depression no one really talks about

July is Mental Illness Awareness Month and this year specific focus is being placed on depression statistics both internationally and locally among pregnant women and new mothers. According to a recent World Health Organisation (WHO) study 13 % of women globally suffer from either antenatal or postnatal depression, while in South Africa a staggering 40% of women experience this.

“Compared to the global average, a 40% incidence of perinatal (period shortly before and after childbirth) depression among South African women is worrisome. It is a major public health problem in the country with potentially devastating consequences for the mother, baby and other family members,” says Shouqat Mugjenker, mental health portfolio manager for Pharma Dynamics.

While no woman is immune to this type of depression, the chance of women in developing countries experiencing this is significantly higher, according to a recent Pharma Dynamics release. This is because often within developing nations and specifically in the South African context, these factors typically include poverty, intimate partner violence and the threat of HIV.

In addition to these factors, most public health clinics don’t have routine mental health screening programmes in place to identify possible cases of postnatal depression.  

Another issue that South African society faces is the high rate of drug abuse. This is often exacerbated by certain mental health issues like depression.

Drug abuse may follow as a coping mechanism to deal with perinatal depression, putting both the mother and baby’s health at risk. Therefore, early detection is key, Mugjenker says.

For many women from underprivileged areas in developing countries access to necessary and inclusive health care is a challenge. While there are state clinics and hospitals, often these facilities are understaffed and simply don’t have the necessary resources.

So, how is the public sector versus the state facilities dealing with these issues?

In many of the private clinics, nurses and doctors regularly screen for depression in pregnant women and those who have just given childbirth.

“However, there is room for improvement,” Mugjenker says.

Screening methods primarily consist of a questionnaire that the medical practitioner conducts with the patient. However, in state care there often is not enough staff at hand to facilitate mental health treatment and so many women slip through the cracks.

On the other hand, for those that are identified as suffering from either antenatal and postnatal depression the treatment course at state facilities scrapes the surface.

The treatment process

“When it comes to treatment, antidepressants are usually prescribed by a doctor, most of which also boosts milk production,” says Mugjenker. “Antidepressant medication costs between R70 and R90 on average for a month’s supply in the private sector. In the public sector these meds are made available free of charge.”

If there is no improvement, talk therapy will also be advised.

The reality however is that many women and young mothers often fail to deal with their depression - especially if they don’t take the prescribed medication, are not monitored by a loved one or don’t have a good support system.

But antenatal or postnatal depression does not only affect the mother.

Perinatal depression is typically associated with preterm birth and low birth weight, malnutrition and poor growth in infants and children.

These babies may also experience delayed initiation of breastfeeding. Impaired cognition and motor development are also concerns, along with increased child mortality.

The key to assisting anyone is to identify symptoms early on.

Symptoms:

• Loss of interest in life
• Lack of energy
• Increased irritability
• Persistent feelings of sadness, guilt and hopelessness
• Lack of appetite or increased appetite
• Difficulty sleeping or insomnia
• Suicidal thoughts (hurting yourself and your baby), among others.

If you suspect that you or anyone you know suffers from these symptoms it is vital to consult your local clinic or general practitioner.

Getting help

For more information on antenatal and postnatal depression contact:

-The South African Depression and Anxiety Group (SADAG) or call 0800 21 22 23.

-Pharma Dynamics’ Let’s Talk website or contact the toll-free helpline on 0800 205 026, which is manned by trained counsellors who are on call from 8am to 8pm, 7 days a week.

-Huggies Postnatal depression support 

- Post Natal Depression Support Association South Africa