If one in 10 women is reported to get post-natal depression, what could be the rate of those who do not seek help?

‘€œIn the South African context, our statistics say one in every 10 does suffer from it. Whether all of them get treated is a contested area. However, I think those are very crude estimates because most women do not present themselves for treatment, especially in the rural areas. We find women express their depression in a different way because there are not enough facilities. So, I am sure the rates are much higher in the country, but we are not aware of it’€, said clinical psychologist, Dr Vinitha Jithoo, in response to the question.

Post-natal depression is a mental illness that occurs in women within the first two months of having had their baby. Some women who live very stressful lives or have had a traumatic incident in their life may present symptoms as early as during their pregnancy.

Dr Jithoo says access to proper health services, especially in under-developed areas, hinders many women from receiving the right treatment.

‘€œ People who are wealthy or those who have medical insurance have greater access to health facilities.  Our public health services are under-serviced in the rural areas, they suffer. Post-natal depression is not a priority in the greater range of mental health problems we are facing. In terms of access to services, the rural areas are not even serviced properly because all they have are primary healthcare clinics where they are helped predominantly by nurses’€, she says.

Dr Jithoo says there is also a perception that post-natal depression is not a real illness. This perception could add to the reasons why women do not present themselves.

‘€œNot too long ago we heard in the news about moms dumping new-born babies. I’€™m sure those moms had some form of post-natal depression and, obviously, that is telling us there is a perception that this is not a real problem. Mothers who attend ante-natal clinics have that support. They are told about what to expect, but others in the rural areas hardly go for check-ups’€, she says.

 Debbie Levine, head of the Post-Natal Depression Support Association in Gauteng, shares the same sentiment as Jithoo, that there is a perception that post-natal depression is not a real illness.

‘€œIf a person gets physically ill, everybody is around them helping them find the right cure. But with psychiatric illness, everyone is afraid… they try to steer clear or they judge you and tell you to pull yourself together or they do not understand what it’€™s all about. One of my clients was telling me that her family feels she has gone mad – a kind of madness they don’€™t understand’€, says Levine.

Rachel Tambo, from Johannesburg, is a mother of four. She suffered from post-natal depression after giving birth to one of her children. She says it lasted for about three weeks.

‘€œIf you wake up and suddenly burst into tears that is not normal’€¦ You suddenly feel you’€™re so tired, so stressed you haven’€™t had enough sleep’€¦ You think of everything under the sun. It was so refreshing and empowering to say:  ‘€˜This is not right. I do need help’€™. It was for about three weeks. After that, I felt okay’€, she says.

 Tambo now encourages other expectant and new mothers not to be ashamed, but to seek help if they notice changes in their behaviour.

‘€œThe most important thing is that you need someone to speak to.  And help is available, it’€™s just about asking for it. If you feel at some point you are not coping, you need to get help’€, she says.

Head of the Post-Natal Depression Support Association in Gauteng, Debbie Levine, explains how they help women.

‘€œWe refer them to the proper person in their area, but ask other organisations who give free sessions so we can refer moms who cannot pay there. We’€™re also training nurses in hospitals to run groups for new moms so that it works as a preventative measure so moms can have support. Through that, we’€™re hoping to give moms all the support they need so they don’€™t get ill’€.

Levine lists some of the symptoms of post-natal depression.

‘€œAnger, general depression, low mood, anxiety, panic attacks, agitation, a feeling of numbness and, sometimes, moms reject their babies. But the two big signs are loss of appetite and inability to sleep’€, she says.