Related Case Studies
Postpartum Depression Case Study: How a New Mom Got Through Tough Times
Patient Information:
- Age: 30
- Gender: Female
- Background: Married, new mother, employed full-time as a marketing manager.
History or Cause:
Ananya, our patient, gave birth to a healthy baby girl, Emma, approximately three months ago. Ananya had an uncomplicated pregnancy; however, by the first few weeks postpartum, Ananya began to feel overwhelmed. Ananya initially chalked this up to a normal adjustment to having a newborn and a new life situation. But by week 6, her emotional well-being was rapidly deteriorating. By this point, Ananya was experiencing extreme sadness, fatigue, and irritability. More surprisingly, Ananya was having difficulties bonding with Emma, something she never expected.
Ananya's difficulties were complicated further by several issues. Ananya moved us out of the city for a family-oriented lifestyle, which happened to move her and her family away from her parents. Ananya had to go back to work much earlier than anticipated, and her husband worked long and often unpredictable hours. Ananya also had to contend with other pressures from "ideal mothering" presented on social media, where it seemed that all the other new mothers were managing motherhood without any complications.
The tipping point came when Ananya started feeling hopeless and started questioning her capacity to care for Emma. She felt disconnected from her regular life and was filled with tension, leading to anxiety attacks. She had started an erratic schedule of eating/sleeping; she didn't seem to find joy in things she used to. After talking about her feelings with a trusted friend, Ananya decided to schedule time with a professional.
Diagnosis:
Ananya had gone to her primary care physician, who referred her to a psychiatrist. After evaluation, Ananya was diagnosed with Postpartum Depression (PPD). The psychiatrist explained that PPD is a type of depression experienced by new mothers within the first year after birth. Symptoms include a persistently sad mood, anxiety, a change in appetite or sleep, feelings of worthlessness, and general disconnection from the baby.
Ananya was able to be diagnosed following a clinical interview and use of the Edinburgh Postnatal Depression Scale (EPDS), the most commonly used screening tool for detecting postpartum depression. Ananya scored above the clinical threshold and thus qualified for an intervention.
Treatment:
Approach:
Ananya's treatment plan was holistic, to deal with both her emotional and physical needs. Because postpartum depression may be a sensitive and daunting experience, a combination of medication, therapy, and lifestyle changes was recommended.
Program: The treatment plan was a multi-faceted one:
1. Medication:
Ananya was prescribed an SSRI (Selective Serotonin Reuptake Inhibitor), which is used to treat depression and anxiety, called sertraline. Ananya was prescribed sertraline after much consideration by the psychiatrist. The psychiatrist explained that the sertraline would also help the chemical imbalances in her brain because it was part of the reason why Ananya was experiencing depression during postpartum.
Ananya's doctor followed her medication, checked for side effects, and made dosage recommendations every two weeks.
2. Therapy:
Ananya engaged in Cognitive Behavioural Therapy (CBT), well-researched and effective at treating postpartum depression. CBT engaged Ananya to identify her negative thought patterns and replace them with more positive, realistic ones instead. Ananya also participated in group therapy with other new mothers and connected with others experiencing similar feelings. The group significantly helped normalise Ananya’s feelings, and she was reminded she was not alone in her struggles and fight.
In addition to CBT, Ananya's therapist encouraged her to implement mindfulness and relaxation techniques, including guided meditation and breathing techniques, to help manage her anxiety so she can help manage stress and stay as present as possible with her baby.
3. Lifestyle Changes:
Ananya’s psychiatrist engaged her to modify her daily routines for self-care purposes and to maintain a healthy work-life balance, which included getting enough sleep, moving her body, and having a solid social network. She found additional support, such as several online parenting communities and a local new-moms group.
Improvements/Recovery Timeline:
Week 1-2:
Ananya began taking sertraline and went to her first therapy session. At first, Ananya felt a little anxious about being on medication, but her therapist and psychiatrist assured her this was common and effective treatment for PPD. The first two weeks, she experienced a lot of emotional ups and downs as she adjusted to the medication. She had some minor side effects, which included tiredness, but these gradually faded as she adjusted.
Week 3-4:
By the 3rd week, Ananya noticed she was beginning to feel some relief from the sadness she had felt. She was feeling more like she had her appetite back, eating regularly, and she was starting to sleep normally. Therapy sessions were starting to help her challenge the negative thoughts, and she was beginning to feel a connection with her baby. The therapist also began to teach Ananya to relax and explore techniques to calm her mind. She was learning to sort out how important self-care was for her and began using meditation as a way to calm her racing mind.
Week 5-8:
By the time Ananya was 6 weeks into treatment, she was feeling "a little like herself again." The sessions paid off, and she was able to spend more time with Emma instead of feeling like a failure as a mother. There were still moments of doubt, but she was learning that these feelings were temporary, and she was developing some coping strategies. She had even started exercising again, pushing Emma in the stroller, and started to feel some extra energy.
Week 9-12:
At the three-month mark, Ananya had made a substantial improvement. The self-care demands of being a new mother with a full-time job were now part of her routine, and she could feel confident that she could continue to navigate motherhood, work, and self-care. Therapy continued with the goal of implementing long-term coping techniques for Ananya. The psychiatrist's follow-up appointments confirmed the progress of her mental health.
Our Success:
Impact on Patient’s Life:
Ananya’s recovery had been a gradual process; however, by the end of the 12-week treatment program, Ananya had become a different person. While Ananya continued to have periods of stress and feel overwhelmed (which is common for a new mother), she now felt competent enough in her skills to know she could tackle the stress and mental discomfort. She was able to tap into resources of support and be able to identify when she needed a break for her mental health. Her relationship with Emma blossomed. Ananya could feel herself being more emotionally present while bonding with Emma. Ananya had returned to work with a different level of self-confidence and a commitment to her balance of work and family.
Family and Community:
Ananya's recovery positively affected not only her but also her husband, as well as her larger community. She discussed her challenges with her husband directly, and they created and nurtured more thoughtful support for one another. Her husband was able to help out more at home, which helped relieve the time and emotional burden from Ananya. They set reasonable goals and planned times to honour family, which helped give them a sense of being part of a bigger family that belonged together.
Ananya shared her experience with family and friend groups, and many of her friends expressed their appreciation for her vulnerability, openness, and honesty, which sparked important conversations about mental health. Her recovery may have also encouraged others in the community to seek help for their mental health issues, taking substantive steps in addressing and breaking the stigma of postpartum depression.
Future Steps:
Ananya's treatment plan after six months (a good time to reassess phase two of treatment) included continued therapy for several more months so she could continue to reinforce the new coping mechanisms she had learnt to cope with her mental health. Her psychiatrist had recommended a slow taper of her medication after six months, depending on how well or otherwise Ananya was still feeling. Ananya was reminded to continue to engage in her ongoing self-care routine, to stay in contact with her support network, and to track her emotional state going forward.
Dr. Amar Shinde, founder of Jagruti Rehab, is a renowned psychiatrist in India with over two decades of experience in mental health, addiction recovery, and neuropsychiatry, dedicated to holistic, compassionate patient care.