How Arti (Name Changed) overcame Postpartum Depression?
16 Mar 2015
What was Arti Going through?
Arti (name changed), a 26 year old marketing consultant found herself struggling with sleeplessness, periods of extreme sadness, feeling like a failure, being angry and having crying spells. All these symptoms came up after she gave birth to her first child. She also reported being very emotional and having lost interest in sex.
She had been married for two years and reported having a good married life except now things were difficult as she had mood swings and often shouted at her husband. During the session, she broke down saying she was unable to keep her husband happy and was not able to take care of her newborn son. She felt ashamed that she was shirking away from her responsibilities.
She reminisced the fact that she had been a topper all through her academic life and reached a high professional position in a short span of time given her hard work and dedication. During the two weeks she was home before her son’s birth and after the birth, she had been pondering where her life was going.
She felt like she had lost her purpose in life. She was re-evaluating herself as a person and found she had no self-worth anymore. It was only when she started having recurrent crying spells & low activity levels that she confided in her husband who suggested she come for therapy.
Our First Interaction with Arti
When Arti came to us, we got to know of certain other difficulties she faced in her childhood and present life. She was a single child. Her parents were strict disciplinarians. Studies and career were given the utmost importance, to the extent that any kind of hobbies or time spent with friends was deemed a waste. Arti gradually learned that the only way to gain their acceptance and appreciation was to gain good marks and have a prestigious career. She worked to that regard and made them proud. But in doing all this, she made no friends and had no social life to speak of. Her marriage was an arranged one and even though Arti didn’t feel attracted towards her husband initially, she gradually started liking him for the person he was.
After her marriage, Arti’s parents had shifted abroad where her father expanded his business. Her mother-in-law had expired before she got married while her father-in-law succumbed to a heart attack around a year after her marriage. Arti felt pressured to take care of her son. While proficient in the marketing knowledge, she knew nothing about children. This was a project she was not sure how to work on. Although her mother had offered she could come for some time, Arti didn’t want her father to be alone abroad as he couldn’t leave his business and stay for a long duration.
The First Session
Arti was asked to fill some basic questionnaires regarding her disorder which gave us more information about her illness that helped in formulating treatment. After drawing up a case formulation based on her history, the therapist introduced Arti to it. She was shown how certain childhood episodes and incidents have made her who she is and how she thinks. She was helped to see what brought about this disorder and the factors that were maintaining it. She was educated about her disorder (post-partum depression), its symptoms, prognosis and treatment. She was told the prevalence rate of the disorder and that many others undergo it. This helped to normalize it for her. She was told she had the option of undergoing psychotherapy. Her husband was requested to support in her daily activities & child rearing responsibilities.
The Treatment & Management Plan
A problem list was formulated with Arti. She reported getting angry was one of the most important problems because she was losing patience with her husband. Also, sadness, loss of interest in sex and being emotional were some of the problems she listed. After the problem list, we worked on the goals derived from that list.
She was told therapy takes time and not to expect miracles. She was psychoeducated about cognitive behavior therapy and that she would be assigned homework to do. Her motivation for the sessions and compliance to homework was ensured. She was told about distraction and various activities were described to her. Her thoughts about herself, others and the world were discussed. She was helped to self-monitor her thoughts as a homework assignment.
Over the next few sessions, Arti was helped to identify her cognitive distortions and modify them through cognitive restructuring. Her day was planned by activity scheduling. She was asked to engage in activities that she enjoyed doing. Her social support was increased by seeking her husband’s help in introducing her to some of his friends’ and colleagues’ wives. She was asked to keep in touch with her mother over phone and seek guidance for child-rearing. She was helped to see how having a child didn’t define her entire life and that she can always work from home or go back to work after some time. Her thoughts about losing self-worth if she wasn’t working were addressed as a rule that had been made for her as a child and that had still stuck by even when it didn’t apply. Her anger issues were taken care of by teaching her anger management.
On the Road to Recovery
After 10 sessions spanning over 2 months, there was seen to be a significant improvement in Arti. She not only smiled often but she looked and felt confident and happy. From the frowning, tired countenance to a happy, energetic one, it was as if Arti had transformed into a different person. She reported her married life was better than ever as her son had added more happy moments in their lives. She was a pro at child-rearing but was also learning each day and enjoying it to the hilt. She was also excited that for once in her life, she had friends. She enjoyed going out with them. She also planned on joining a dance class that she had always wanted to do but had always given in to work instead.
Her plans also included starting work from home soon and fulltime work within two months. And her husband was a great support in sharing the responsibilities :)
Although Arti’s illness was precipitated by her son’s birth, on exploring we found there were some major issues that needed to be tackled. Once they were addressed, she reported improvement in all areas of her life. The therapy not just helped Arti with her illness but assisted her in taking some life-altering actions that improved her overall quality of life.
Depression may come in different forms and at different life events but its common and treatable.Please do reach out!
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Tags: #PostpartumDepression #Depression #sadness #