Pregnancy and Depression - A match made in Hell!

According to WHO, in India, around 56 million suffer from depression and about 38 million people are affected by various anxiety disorders. As we all know, India is one of the countries with diverse social and cultural practices. Two significant reasons are the lack of mental health professionals and the social stigma surrounding mental health issues. This social stigma is so high that whenever a person visits a psychiatrist, he is labelled a “mental person, " making the affected person more depressed and stressed.

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Though I am from a family of doctors, if I tell my parents I need a psychologist or psychiatrist counselling, they ask me not to go to them. They say, “It’s all in mind, have strong willpower, control it, overcome it”, and lots of philosophical lecturing. I am not saying they are wrong, but the problem lies with me. I should not expect my parents or anyone to empathise with me, the situation or the problems I face from my point of view. Nobody can do that. But since I knew I needed professional help, I could go to them, and I got better. Unfortunately, this awareness is what is lacking among Indian citizens. This is the main reason the suicide rates keep shooting up in our country. Not only suicides but this lack of awareness can lead to broken families, domestic violence, substance abuse and a fall in their quality of life. This will invariably affect their family members, and this vicious cycle will continue.

Pregnancy: Rather than going from childhood, we have to start from the moment of conception. The moment the woman learns she is pregnant, she is put through varied emotions. Her parents, -in-laws, her husband and everyone are thrilled. They celebrate and distribute sweets and all that. What about her? Happiness is the first emotion that comes to her mind. But, adding to that emotion, fear, anxiety, stress and all those mixed emotions occur. According to her husband or her family, pregnancy is a normal biological happening which happens to every woman in the universe. They are aware of the physical changes that occur to a woman during pregnancy, but little do they know about the emotional burden she will carry throughout her pregnancy.

So is pregnancy a burden to every woman? No! People must be aware of the hormonal changes, mood swings, and temper tantrums she throws at her husband and family. The pregnancy hormones, namely oestrogen and progesterone, fluctuate in their levels throughout the pregnancy, affecting the neurotransmitters in the brain, which could result in mood swings. You return from work, and one day you may find her like an angel taking care of you; the other day, you may find her arguing, fighting and even beating you. If you react emotionally to everything she says or does, you will put the mother and child under much stress.

How does it affect the baby? If the mother is stressed or depressed, it can invariably affect the baby's genes. In addition, it could affect the developing brain, which may put the child at a higher risk of developing emotional and behavioural problems in later childhood.

How to take care of a pregnant wife? The only person who controls a woman's emotional status is her husband. Usually, the woman will always expect more from her husband. The reasons are that: she is living with him in his house and, more importantly, they made the baby. Since India has varied cultural beliefs, various states have imposed some restrictions. For example, in some States, men are not allowed to do any household chores or help the wife cook. This can hurt both the physical and mental well-being of the pregnant woman. The pregnant woman may suddenly crave food items or dishes, expect her husband to be more affectionate towards her, or blasts him verbally for trivial issues. Since some emotional barriers are not adequately addressed before pregnancy, women may be reserved to approach their husbands for their needs. This is the first barrier that must be broken in every married couple’s life, at least during pregnancy. The reason is it gives a deeper level of understanding between the couple; both their physical and emotional needs will be met, and she will open up to her husband, believing that he will not disappoint or hurt her.

So how could this barrier be broken? Communication is the key. Just open yourself. Be it your mother, -in-laws or your husband. Just make sure you are heard. Tell them how you feel and what you would like to do or eat. The problem in our society is that she can confidently open up only to her parents. But they cannot do anything other than empathise with her as she is not with them. The only other person to whom she can open is her husband. Most of the men in our society just see the world from their point of view, like how they were taught and brought up with their own set of traditions, customs, and beliefs passed on from their parents. They firmly hold on to those. I will tell you some points to remember when caring for your pregnant wife to improve her physical and mental health.

1) All men must understand that not all women are the same. For example, your mother is different from your wife. So don’t dismiss your wife’s emotional issues and needs during pregnancy by comparing her with your mother.

2) Parents, especially mothers, will always be possessive of their sons. So don’t go guns blazing that your wife is correct and your mother is wrong. This may lead to misunderstanding, and you may hurt your parent’s feelings. So if what your wife says is against your mother?

Let us take an example. Your mother expects your wife to be awake by 7 AM. But your wife cannot wake up due to early morning sickness and fatigue. What will you do? Will you fight with your mother so that she will not wake up by 7 AM or scold your wife and encourage her that all is possible and wake her up by 7 AM? The best way to handle this situation is to sit and talk with your mother about how your wife is feeling and what she is undergoing. Any mother would understand if appropriately done, patiently and calmly. But if you go and shout at your mother, she will become insecure and start to believe that her son has begun to take sides with his wife. This can always lead to problems in the future. If you force your wife to wake up by 7 AM, she will undoubtedly wake up. But, she starts to distance herself from her husband, thinking and believing he won’t understand her emotional needs. This will, in turn, put her under a lot of stress. Remember this golden rule. "Do not degrade your parents in front of your wife, and do not degrade your wife in front of your parents."

3) Whenever you return from your workplace and feel stressed, please ensure you don't dump all your stress on your pregnant wife. Remember, she is more stressed than you can ever imagine.

4) Call her at least once from your workplace to check on her. Ask her if she is feeling well and if there is anything she wants. As a result, she will feel more secure and happy.

5) Take her out at least once a week to the place she wants to visit and the restaurant she wants to eat at. Before going out, have the habit of asking her, "Where do you want to go?, Where shall we have our dinner?" and let her decide.

6) All pregnant women would suddenly want to meet their parents. Make sure you arrange for that, irrespective of your workload and schedule. Call them over to your home, make them stay for a few days and take care of them, or you could even take your wife to their home and make her wait for as long as she wishes. This will, in turn, make her happy.

7) Before the pregnancy, she may have fallen for you for some reason. Let us take an example. Before pregnancy, her attitude towards you may be, “Look how cute he sleeps, look how childish he is, he is a mess, and I love it.” During pregnancy, her attitude may change, like, “I hate the way he sleeps, look how stupid he is, he is a mess, and I hate it”, and she may throw tantrums at you and fights with you for no reason. Please understand that the hormones do the damage, not your wife. So please don’t get angry, argue or fight with her. And if she tells you about any problem, no matter how insignificant it may look for you, please do not follow the attitude of "It is not my problem". Just hear her out, be flexible and caress her.

8) During her pregnancy, she may put on some weight, and her old dresses may not fit. As a result, she may feel unattractive and all that. Just make sure to let her know that she is always attractive to you, and your love will never change, no matter how she looks, because of her pregnancy.

9) It is a common belief in our country that the mother's parents must take care of the first pregnancy's financial burden. Destroy that notion. It is your wife, your child, and it is your responsibility. Accompany her on all of her visits to the doctor, get yourself educated about pregnancy, hormones and all that and be with her throughout the roller coaster ride of pregnancy.

10) One important truth is that pregnancy is an extreme relationship test. You must learn to compromise, adjust and communicate in a way never done before. You may have been lovebirds for the past ten years. Still, your relationship will be tested only in situations like pregnancy, where you must take responsibility and be more mature in handling things.

Even after the pregnancy, the points I listed above apply to every married couple to live a happy and harmonious life. Men should not be selfish to follow these steps only when their wife is pregnant for the sake of their child. The golden rules of any successful relationship are to compromise, adjust and communicate freely without inhibitions. In the case of arranged marriage, postpone the childbirth for a minimum of 6 months so that you can better understand their likes and dislikes. Do not follow the habit of tit for tat. If she hurts me, I will hurt her. It is not going to take you anywhere.

The significant determinants of how far the pregnancy hormones can have a substantial effect on the woman's psychological status will be how far she can manage her premenstrual syndrome, which in turn will depend upon how the girl was raised, how much her parents loved her, believed in her, family history of depression and how much emotional and physical trauma she has endured since childhood.

Always remember, "She has left her home in which she was brought up, left her parents, her siblings and come to live with you in your home to be part of your family and to raise a family with you. So there is nothing wrong in compromising certain things for your wife." Both are responsible for leading a life and raising a family based on mutual trust and understanding so their children can have an exemplary environment where they can grow, adapt, depend upon and lead a physically, mentally and socially productive life.