Early this year, a 32-year-old mother in Kelantan slashed her two-month-old daughter to death.

The police found her beside the baby with a bloodstained knife and many were quick to condemn her as a heartless murderer. There were reports of her hallucinating and hearing voices, typical of many local stories of horrific crimes that were incomprehensible.

But it was also reported that the soldier’s wife had been sent for psychiatric evaluation on suspicion that she could be suffering from postpartum psychosis, a severe end of the postpartum depression spectrum.

Postpartum depression

When new mothers are aware of the risks of postpartum depression, they are more likely to reach out for help. Photo: 123rf.com

Postpartum or postnatal psychosis is not a condition that is often recognised, although there have been other cases of new mothers’ extreme behaviours.

Last year, an accountant jumped to her death from her condominium in Kuala Lumpur, leaving behind her newborn child. She was said to have been depressed because she was having difficulties breastfeeding.

May is Postpartum Depresssion Awareness month, a time to call attention to the struggles some new mothers go through.

There are three levels of postpartum depression, said Penang Adventist Hospital consultant clinical psychologist Dr Lynne Yong.

They are: Postpartum blues, postpartum depression, and postpartum psychosis.

A woman who has just given birth might first experience postpartum blues. Postpartum blues include mood swings, crying spell, anxiety and difficulty sleeping, and it is very common. Postpartum blues typically begin within the first two to three days after delivery and may last for up to two weeks.

Postpartum depression, however, is more serious and patients may need medical help. With postpartum depression, feelings of sadness and anxiety can be extreme and might interfere with a woman’s ability to care for herself or her family.

Postpartum psychosis is a psychiatric emergency, as there is a real risk of the mother harming her baby and herself. It is a severe episode of mental illness which begins suddenly in the days or weeks after having a baby. Symptoms vary and can change rapidly. They can include high mood (mania), depression, confusion, hallucinations and delusions.

Close encounters

When Zeeda Aziz, 38, read about the Kelantanese mother’s breakdown, she was empathetic as she knew too well the darkness of postpartum depression.

“There were a few times I wanted to grab a pair of scissors. The urge to stab my baby was so strong. I had to keep praying and reciting verses to stop myself from doing the unthinkable. But those urges still kept coming,” wrote Zeeda, who was moved to share her postnatal struggles on Facebook.

Zeeda said no one had an inkling of her turmoil. To everyone else, she was a devoted mother who took such good care of her newborn son that he hardly cried.

She and her husband had eagerly prepared for their first-born; they had bought him all kinds of things and she had read pregnancy and parenting books.

Zeeda was frightened most of all because her experience of motherhood was so different from her expectations. She simply couldn’t see her baby as being cute.

“I struggled to establish a bond. I kept thinking ‘This isn’t my baby. This baby is evil’.

“You see the bond between a mother and a child captured everywhere. Before having my baby, I believed that was what motherhood was. Everyone told me how beautiful motherhood was, but no one told me about the fatigue. I had to take care of my baby, my body, and household chores. Doing all that without sleep was a huge effort. I thought the depression I was feeling was a sign that I was a bad mother because none of my friends shared their struggles,” said Zeeda.

Postpartum depression

Zeeda shared her dark experiences of postpartum depression after reading about the mother in Kelantan who slashed her baby’s throat. Photo: Zeeda Aziz

Taking control

Then one day, she watched actress Brooke Shields describe her experiences with postpartum depression on The Oprah Winfrey Show.

“It was the answer I was looking for. I felt better knowing I was not alone,” said Zeeda who was then motivated to take control of her situation.

She began to understand that her postpartum depression “was brought on by postpartum hormonal changes, swollen breasts and severe sleep deprivation. I had to feed my baby every two hours. I had minimal help as my husband was working outstation and was only home once a month. I was expected to stay awake all the time.

“Severe sleep deprivation caused me to be delusional, confused, and depressed. I felt rage, sadness and a sense of doom. I would often sit alone in my room, crying. Every time someone held my baby, I would get angry. In my head, I could hear myself asking ‘why are you holding my baby?’. It was very irrational.”

One of the first things Zeeda did was to unfollow her midwife’s confinement rules, such as not napping in the daytime and limiting her water intake.

“My confinement lady forbade me from drinking too much water and eating fibre or gravy. The sudden change in diet and lack of water caused dehydration and constipation.”

She started prioritising her well-being and discarded any rule that caused her discomfort, even though her family disapproved.

“When I wanted to eat nasi lemak, I ate nasi lemak,” said Zeeda who eventually found her equilibrium.

When she gave birth to her second and third child, Zeeda confidently did things her way. She believes it’s important to keep things between mother and child simple and comfortable because when the mother is calm, the child is healthy.

It can happen to any mum

Postpartum depression is not only unique to first time mothers, as S. Umadevi, a mother of three, discovered.

“My depression started when my youngest child was two months old and it reached its peak five months later.

“I was at the stage of my life when I was focusing on my personal development when I had my baby. So, the change in lifestyle troubled me. I was not able to do what I was doing and I had to put on hold what I wanted to do.

“It was a struggle between me and myself, not about my baby. I was miserable. I knew I had depression when I felt I was not myself anymore.”

Support from loved ones

Umadevi reached out for help.

She opened up about her struggles to her husband and friends so that they could support her.

Her husband understood her challenges and encouraged her to take time off, such as going out for breakfast on Saturday mornings.

The biggest recovery took place when she joined a healing class to help her to be calmer and focus on praying.

“Prayers and meditation helped me a lot,” said Umadevi.