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‘It takes a village to raise a child – I was that very, very tired village’

The water is dark and I am staring to freak out, but I can’t freak out, I have to stay focused, I have to stay alive, keep my head up. There is no time to be scared, no space for emotions… keep your head up, Sara, stay relaxed.

But the water is dark, scary and deep.

Sara, block out those emotions; block them. Where is that survival button? Where is that auto pilot button? Where is the stop everything button?

Sound confusing? It’s just a monologue from my first days and months into motherhood. The ‘autopilot mode’ lasted for more than 9 months.

Two-years-and-a-half later, whenever I look back at those days I feel like I am looking at someone else’s life. There’s no way this was me.

Yes, I had postpartum depression. Yes, it took me a whole year and a half to label that feeling and move out of its shadow.  I was in trauma but I was not allowed to heal

I had a life-threatening labour and was rushed into ER after waking up in the middle of the night covered in blood. I was in trauma but I was not allowed to heal

- Sara Al Shurafa, Assistant Online Editor

Why does it happen? It’s a combination of factors, some physical, others emotional, and they are all intertwined. As a person suffering from PPD you feel hopelessness, an inability to untangle your issues, to sort them out.

Let’s go back to when these feeling creeped up on me. It all started on the first day.

I had a life-threatening labour and was rushed into ER after waking up in the middle of the night covered in blood.

In the operation room, doctors and nurses were being nice and calm, trying to keep me awake – I needed to stay conscious - I could hear them saying that it was a close call. That night, minutes made a difference, minutes were the line between life and death for myself or my baby.

But I was not given the time or space to even digest that experience, I was in trauma but I was not allowed to heal. I was in such pain that I still tear up thinking about it.

I was not allowed to process what happened to me that night because of a tiny little creature who was handed to me. I had become her life support.

This is what happened next…

If I mess up, I end a life.

I am the sole person responsible of the well-being of that weak baby; she depends on me; only me.

‘That soul is your responsibility’ are words that will keep tumbling through my thoughts for days and months to come.

Even when my daughter has started to crawl, I will be hovering above her scared she will put something in her mouth and choke on it. When she started to walk the fear of her falling and breaking her skull made my stress levels spike – it made me more alert; it made me more nervous.

I can’t sleep. Even when my baby is sleeping.

I was always afraid of the still baby syndrome, so I have been awake for a year and a half.

Two and a half years later, I have not slept through an entire night yet.

I suffer from insomnia.

I was a new mother and an expat. The saying “it takes a village to raise a child” made me giggle nervously; I was the village – the very, very drained village.

Exhaustion, stress and hormonal changes affect your brain first, and I began to start having difficulty remembering things, I couldn’t concentrate or make simple decisions, I was going in circles for the lamest of things.

My moods would change suddenly and without a warning. I was exhausted, I was irritable, anxious, and angry.

I had no interest in the things I used to enjoy, and preferred to isolate myself from friends and family, I didn’t have the energy to deal with anyone or anything anymore.

Which lead to more conflicts in my life.

No one around you understands or feels what you’re feeling. I only used to hear “you’ve changed”, and my internal voice would be screaming “[I] am not okay, am exhausted”.

Physical changes

No one tells you that your body will never be the same. The body you lived with for 32 years and were finally acquainted with – comfortable with – poof! that feeling is gone forever.

No one tells you that your hip doesn’t go back to its place; it stretched when you gave birth and will stay stretched. That your skin will sag because you may have displaced the fat, but you will never be able to re-tighten your skin. Or the ugly white lines, like a tattoo that went wrong all around your tummy and sides, are here to stay. Ditto, by the way, for that scar from the c-section.

Your hair starts falling, you see it go down in bundles whenever you shower. Honestly, it’s like a horror movie.

And in the middle of this mind-boggling change in yourself, you see social media’s tall claims. I hate those super mama bloggers, who shove at you exercise and diet plans to retain the old you and give you advice on how to be a happy mother.

Let me tell you the truth about motherhood.

I shower at 3am because that’s the only time I find myself free enough to do so. I don’t have time to eat a proper meal, because I can’t cook and no one around me is cooking. I live on digestive biscuits and whatever my hand finds in the fridge. If I order in, you can be sure it’s going to be a heavy, unhealthy – and deeply comforting meal - to compensate for the stress and lack of sleep.

What gym are you talking about when you have an extra organ hanging on all day.

Ohhh that’s another trigger. WHAT IS PERSONAL SPACE? Where is MY personal space? I laugh out loud at even the possibility of it.

So you look at yourself in the mirror and don’t recognise that body or that yellow face with black circles and dry skin that stares back at you.

You open your closet and you find yourself staring for an hour, then closing it and just wearing the same sweatpants – the only thing that really fit you.

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Social influence

Motherhood didn’t get easier with social networking. You find yourself in so many groups, breast feeding groups, sleep training groups, development groups.

You are given daily new information and new milestones and concepts, which leave you daily trying to manage your expectations of your baby that is developing on her own space and doesn’t need you to stress about it.

I had a friend at month six, telling me how her son (same age as my daughter) was sleep trained and sleeps from 7am to 7pm. That day I cried, my baby hadn’t for slept more than 4 hours since she was born. [Note: My daughter is an energetic kid; she’s still not a good sleeper.]

Back then I thought I was doing something wrong, I was harming her growth if she doesn’t sleep well, but today I understand that each child is different.

Things have gotten better – the lake I am swimming in is still deep and scary, just not quite as dark.

What is postpartum depression?

When talking about the changes that occur post the introduction of a new member to the family, be it hormonal, rhythm-based - sleeping, waking, communication with others - or identity, it's often termed the cute 'baby blues'. However, that little dip in the way you feel when you've got a newborn is a quite different from a period of persistent sadness.

Depression is a disorder that can addle the mind and the body. WHO’s meta-analysis showed that about 20 per cent of mothers in developing countries experience clinical depression after childbirth.

“Postpartum depression is different from the common baby blues that many mother experiences after giving birth as sort of adjustment to the changes of their life, characterised mainly by mild mood swings, feeling overwhelmed and difficulty to sleep. Postpartum depression is a severe mental condition that can affect the mother, the baby and also the whole family significantly,” explains Dr Valeria Risoli, clinical Psychologist at Dubai Physiotherapy & Family Medicine Clinic.

Degrees of pain

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There are three types of postpartum depression, explains Dr Mrabet Jihene, Dr Mrabet Jihene, Assistant professor and Director of the Office of counselling and disability at the American University in Emirates.

Baby blues

What is it? Frequent thing that happens due to estrogen decrease.

Felt for: 2 weeks

Symptoms: Mood-swings, anxiety, sadness and irritability. Sometimes the mother is crying. Concentration, appetite and sleeping problem.

Treatment: Manageable with support and help with the baby.

Postpartum depression

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What is it? If the period of baby blues continues, it may well be that the new mum is facing postpartum depression.

Felt for: upto a year.

Symptoms: Depressed, extreme mood swings, excessive crying and intense irritability and anger, severe anxiety and inability to bond with the baby, insomnia or sleeping too much. She may have thoughts of harming herself or her baby – but these are just thoughts.

Postpartum psychosis

What is it? The most dangerous of depressions, which can cause a new mother to behave in an irrational way. She may at this point be a danger to herself or her baby.

Symptoms: Will show up in the first three months after the birth. Confusion, disorientation, depression, hallucinations, delusions, and here the attempt to harm herself and her baby.

If any of these symptoms sound like you...

Let’s talk about it: In a non-judgemental space, with people who care and want to help. Consider their points – take the help they offer.

Exercise: Pregnancy does not mean turning couch potato. Exercising increases serotonin levels and decreases cortisol (stress) levels. Keep a pair of comfortable shoes on hand, always.

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Acupuncture: A study published in the journal Obstetrics & Gynecology points to acupuncture being a feasible option when dealing with depression in pregnant women.

Rest: Changes in appetite, mental well-being, etc. may disrupt a person’s sleeping patterns, but regulating them will give you huge respite.

Medication: Speak to a doctor, the benefits may outweigh the risks in this case.

Spotted a sufferer? Here's where you come in

Understand she has a problem. “Many people think maybe she is overacting, or maybe she is overreacting or something like that. We have to understand that she really has a problem and do not underestimate the problem,” says Dr Jihene.

Reduce the stresses. If she finds herself in a stressful situation, help her calm down.

“Give her rest periods from baby care, because she will feel like she’s always obliged to take care of the child and she is obliged to do it the best way and the right way,” she adds. It is important to help her feel that she can take a break.

Also help with house work – “to give her time to look after herself and her baby”.

Nap times matter. “Whenever you can, have extra sleeping time as a new mum,” says Dr Jihene.

Creating bonds. “We can encourage her and show her that she can take care of her child like no other is. For example emphasize on the baby’s smile or sparkle in his/her eyes when she talks to him,” she adds.

No judgement, just conversations. “Invite her to speak about her difficulties without any judgement, because mum will always feel guilty about being perfect,” she says.

Dads, you've got a role to play too

A study published in the journal JAMA Psychiatry and co-authored by Professor Paul Ramchandani of the Faculty of Education, University of Cambridge last year found a link between fathers who suffer from postpartum depression and the low moods of their daughters when they grow up.

“Post-partum depression can have a significant effect on the relationship between mother and child through the disruption of attachment. Attachment is the emotional bond that develops between parents and children through interaction. It can be more difficult for an infant to develop a secure attachment with a parent who is experiencing postpartum depression as they may find it more difficult to meet a child's emotional needs," says Dr Harry Horgan, Clinical Psychologist at German Neuroscience Center.

The study, which included more than 3,000 families in Bristol, UK, found that a woman was more at risk of getting depressed when she reached adulthood when her father had suffered from post-natal depression.

Horgan adds: "The finding relating to fathers and daughters is an interesting one and father-infant relationships are typically under-studied in psychological research. One explanation may be in relation to the sooner development of interpersonal sensitivity in young girls. In a broad sense, girls tend to be more interested in people, whereas boys tend to be more interested in things. This difference might lead to girls having increased awareness of difficulties their father may be going through.

"Research also shows that girls are more likely to experience 'internalising' problems such as social withdrawal or low mood in response to difficult life events, whereas boys tend towards 'externalising' problems such as anger and aggression," he adds.