Helping mothers with depression
Jul. 10, 2017
In Japan, one in ten mothers is said to develop mental instability, called postpartum depression. Having a baby can be a life-changing and stressful experience for a new mother. In addition, the accompanying dramatic hormone changes can contribute to causing depression. In some severe cases, mothers harm themselves or their children. In Tokyo, a new system to help mothers has been put in place.
Childbirth should be a time of joy, but there are cases of mothers who struggle with their emotions.
"I kept crying for no reason," says one woman. "I couldn’t think; I just sat in a daze."
"It’s no one’s fault, but I’m irritated all the time," says another.
Sometimes, the symptoms escalate. One mother who experienced postpartum depression agreed to an anonymous interview. When her son was born, she found herself irritated all the time.
"I felt like my son was pushing me into a corner," she says. "I didn’t know what to do about him or myself. Whenever I walked on an overpass while I was out shopping, I would think about jumping off with him."
A recent study found that women are at the highest risk of developing postpartum depression two weeks after giving birth.
In response to the results, new efforts to recognize depression during the high-risk period are underway in Tokyo’s Setagaya Ward.
A new mother and her baby usually receive their first checkup a month after the birth, but at this OB-GYN clinic it is done after two weeks.
They use a checklist to determine the mother’s mental state. They carefully go over the answers on the checklist to make sure they do not miss any signs of postpartum depression. The clinic found one in five mothers had signs of depression.
"Two weeks after giving birth, I had a lot of questions," says one mother. "It was a relief, emotionally, to have a check-up at this point in time."
Along with encouraging early detection, cooperation between OB-GYN clinics and psychiatrists was promoted in Setagaya Ward.
In a monthly meeting, the ward’s gynecologists, midwives, and public health nurses as well as psychiatrists get together.
Under the new system, if the healthcare providers suspect the mother has postpartum depression, they can easily refer patients to local psychiatrists.
"Even if a gynecologist notices a mental health problem in a mother, it's difficult to follow up on it without outside help," says Yoshiyuki Tachibana, a psychiatrist at the National Center for Child Health and Development. "Professionals in different departments must work together to give adequate support."
One psychiatric clinic is part of the group. A woman who visits the clinic once a week agreed to talk to us on the condition of anonymity.
She says that even though her family is very supportive, she is becoming increasingly anxious.
"I was lucky to be in a supportive environment, but I was the only unstable mother out of my friends," she says. "My public health nurse recommended that I go to this clinic."
She was examined by a psychiatrist who prescribed a drug that can be taken even while breastfeeding. Currently, her condition is under control.
"There is a widespread misconception that mothers should postpone seeing a doctor because treatment with drugs can be risky, but if professionals from a variety of disciplines cooperate to respond to the mother's needs, we can eliminate problems before they get serious," says Yoko Ikuta, a psychiatrist at Clinic Ogura.
The woman also uses daycare services provided by the clinic.
She says being able to ask clinical psychologists anything, no matter how trivial it seems, has enabled her to finally enjoy raising her child.
"I'm glad I came here," she says. "I still get a bit irritated, but in general I feel better."
Doctors and government officials are busy working on guidelines to treat postpartum depression. The model set out in Setagaya Ward may be expanded into use in other parts of Japan.