Hyderabad: Postpartum depression is often seen as a temporary phase of emotional turbulence after childbirth, but for some women, it can spiral into severe psychosis, leading to tragic consequences, including self-harm and even criminal behaviour. Experts are now calling for heightened awareness and early intervention to address this critical mental health issue.Dr S. Shantha Kumari, senior consultant OBGYN, explained that hormonal changes after childbirth can trigger postpartum depression, manifesting as mood swings, irritability, crying spells, and neglect of both the mother’s health and the newborn. In extreme cases, the condition can escalate to postpartum psychosis, where mothers may harm their infants. “Most mothers need psychological support, therapy, and family encouragement to deal with these phases,” said Dr Kumari. “Some cases require medical intervention with antipsychotic medications and psychiatric consultations.” While postpartum blues and depression affect up to 10 per cent of new mothers, postpartum psychosis is rarer, impacting about 2-4 per cent of women. However, increasing isolation due to nuclear family structures and reduced support systems in Indian households may be contributing to a rise in cases, according to Dr Kumari. Dr Swetha Gullappalli, a consultant psychiatrist and psychotherapist, shed light on the progression from postpartum blues to severe psychosis. “It can start with feelings of being overwhelmed, evolve into depression, and, in extreme cases, lead to delusions and harmful behaviour toward the child,” she explained. She shared one distressing case which involved an IT professional who, after years of longing for a child, struggled with guilt and exhaustion post-birth. “She was feeling guilty for not being able to enjoy the process of raising the child anymore. She was fatigued, and felt like running away from the child. Everytime the child cried, she felt she wasn’t a good mother, and she was responsible for the child’s suffering. She was put on antidepressants and weekly therapy sessions to deal with the guilt. It helped in processing what pregnancy was doing to her and how her personality was coming into the way of handling it efficiently. After six months, she was happy and looking forward to having another child,” Dr Swetha shared. Conversely, another case escalated dangerously. A mother’s postpartum depression morphed into paranoid delusions, causing her to believe her in-laws were plotting against her. “This fear drove her to harm her six-month-old child as she felt that the child was part of the conspiracy hashed by the in-laws. Luckily the grandparents intervened and the mother and daughter were safe. She was later treated with antipsychotic drugs for a year. She got better and the medicines were weaned off,” Dr Swetha said. While symptoms of postpartum depression are often dismissed as ‘baby blues’, for some women, they spiral into destructive crises and even criminal activities. This can be due to women experiencing hallucinations and what is termed as ‘extended suicide’. According to Dr K. Sudha Rani, in-charge professor, perinatal psychiatry clinic, Indian Mental Health Institute (IMH), postpartum depression leading to killing, is a rare scenario, but points to an urgent need for awareness and action. Several socio-economic factors contribute to the severity of the condition. “Often, the patient feels hallucinated and believes that a voice inside them is prompting them to kill the child. Having experienced extremely difficult situations at some point in life, they develop a psychosis which sometimes creates a sense of fear that looms over the head of the patient, where she might feel that someone out there would kill their child and then killing it themselves is the only way to protect the child. This fear is largely created because of their surroundings or sometimes because of the circumstances they have grown up under,” Dr K Sudha said. Postpartum depression may also sometimes lead to an extended suicide. Speaking of a case she had encountered, Dr Anita Rayirala, Superintendent, IMH, said, “We had come across a woman who had conceived a baby after six years, but was constantly under the impression that her husband and her in-laws were not happy with the girl child. Her family did not appear to be unhappy, but she believed they were. As this belief kept growing within her, she tried to kill the child and die by suicide herself. During her attempt, she was rescued, but her child had unfortunately died.” According to Dr Anita, a mother might get carried away with negativity or an underlying guilt of pregnancy that she would not be able to treat the baby with sensitivity or would not show willingness in nurturing it. One of the major reasons behind this behaviour can also be a painful pregnancy process. Unnatural delivery processes, which often come with a lot of restrictions and pain, might prevent the mother from looking at the bright side of the pregnancy, the experts said. Domestic violence intensifies the risk, Dr Anita said. “Women who are victims of domestic violence, or any sort of cruelty against them by in-laws, are more prone to slip into depression.” The only cure for this condition is to identify it, and reach out to a counsellor and take medication. Experts stress the importance of breaking the stigma surrounding mental health, especially postpartum conditions. “Pregnancy is an emotional rollercoaster,” said Dr Gullappalli. “Recognising the signs early and seeking professional help can be life-saving.” Postpartum depression is not a personal failure; it’s a medical condition that requires attention. Families, friends, and healthcare providers must foster an environment where new mothers feel supported, heard, and encouraged to seek help when needed. As Dr Rani concluded, “Mental health support for mothers isn’t just about the individual—it’s about protecting the entire family, especially the vulnerable newborns.”
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