- Postpartum depression and the reality of ‘pregnancy brain’
The human body and mind are programmed for survival and to ensure the continued survival of the species. It just comes down to that. A lot of ‘what we do, why we do and how we do’ are based on nature (our genetics) and nurture (our immediate environment).
With that context in mind, parenthood is undoubtedly one of the most significant changes that we, as living beings experience, and therefore, it is not surprising that our entire system undergoes massive upheaval, even without us knowing it.
We often hear the terms ‘pregnancy brain,’ ‘mom brain,’ and ‘postpartum depression,’ and more often than not, there is a certain level of stigma attached, but what do these terms really mean? Is there scientific evidence that supports individuals who experience these conditions and what can we do to be there for them?
To understand this better, Brunch spoke to Clinical Psychologist Maryam Refai (MPhil (Sri Lanka), BSc [Canada]).
The reality behind ‘pregnancy brain’
“The term pregnancy brain is casually used often, to identify certain characteristics like forgetfulness or heightened emotionality during pregnancy, and it reinforces certain stereotypes for that reason. However scientifically, there is a lot more to what pregnancy brain really is,” shared Refai, delving into the reality behind a term that we have often heard being used – at times as a somewhat underhanded remark.
The clinical psychologist explained further that during pregnancy and in the postpartum period, the brain of a mother undergoes a series of scientific changes that causes them to experience pregnancy brain. However, Refai also shared that these changes are not limited to just being forgetful or feeling more emotional than usual.
Refai shared that hormonal changes, which are essentially in place to prepare a woman for the new role of a mother, are major contributing factors that cause pregnancy brain.
“Published empirical literature supports the fact that various hormonal surges in the brain of an expecting or new mother can make them more susceptible to being emotional, which can cloud judgement and even cause sleep disturbances and impact memory,” shared Refai.
She added that most women and sometimes even fathers and surrogates could experience an overload of sorts and go through a preoccupancy with what it means to become a parent. The clinical psychologist elaborated that there was also scientific evidence to show that the brain also goes through a series of physical changes, such as a shrinking in the area of the brain that is associated with spatial memory (the area which helps you remember where you kept something, for instance), in order to make room for more of the neural pathways that would promote empathy and perform specific functions that support the wellbeing of a child.
The connection of ‘mom brain’ to fear and compulsion
Among many of the chemical, neurological, and other changes that the brain goes through during pregnancy and early parenthood, one aspect that can cause a significant impact is the state of heightened emotion catalysed by the amygdala, according to Refai.
Delving into this connection, the clinical psychologist expressed that apart from these aforementioned changes, there are also other changes such as the conflict of self-identity (‘who am I outside of being a parent?’), body image- and social life-related changes, and changes in the relationship one has towards food that fuels the expecting or new mother, to experience this heightened state of emotion.
“It’s like a double-edged sword, because while your brain is trying to prepare you to be a mother, it also makes you susceptible to mental illness. For example, around their third trimester, most women become hypervigilant and sensitive to environmental threats and so on,” shared Refai.
However, she explained that this very vigilance could make one overly cautious and almost paranoid, without them really intending to be that way, because the adaptive mechanism of the brain had now become an overload, edging them closer to mental illness.
“This is where the fear factor comes in. Women may become overly cautious about what they eat, what they do, and so on. On the other hand, they may also become prone to Obsessive Compulsive Disorder (OCD), where they feel compelled to wash their hands 50 times a day, or engage in any form of ritualistic behaviour, believing that it will ensure that nothing happens to their baby,” shared Refai.
Societal pressure, self-stigmatisation and postpartum depression
The support system that we have around us plays a vital role in ensuring how we feel in day-to-day life. The more secure and healthy our relationships are, the more secure and healthy we are as individuals.
Drawing parallels from this to postpartum depression, Refai shared that while all mothers or parents for that matter may experience the phenomena discussed above, those who lack a steadfast support system may be worse for wear in these instances.
“Our ideology of motherhood is one that is spotless and perfect. There is no room for error. A mother is expected to be in control of everything all at once. The child must not be crying for too long, she must be able to handle daily chores and the newborn without complaining, she must be able to stay up all night, give up her social life, and maintain herself too. Is it surprising that this pressurises new moms to breaking point?” asked Refai.
According to the psychologist, this inordinate societal pressure and the burden of expectations often push women to self-stigmatise, thinking that they are indeed lacking and are not good enough mothers. She also shared that this could sometimes be observed in new fathers as well as surrogate parents.
Refai also expressed that in her experience, environmental factors surpass the genetic factors when it comes to the clinical presentation of postpartum depression. “A lot of my clients say, ‘I didn’t know that motherhood would be like this, nobody told me,’ or they would say, ‘I don’t know why I am always so angry, and how to take on all this alone. I have zero support’. So, it’s increasingly clear that postpartum depression has a direct connection to the weight of expectations and the lack of a solid support system,” she shared.
Nurturing healthy parenthood through support and timely identification
Refai shared that reaching out for support could happen on many different levels. One of these would be for expecting or new parents to identify certain symptoms or indications within themselves.
“Not feeling like your regular self; for example, looking in the mirror and feeling a complete disconnect is a sign to be aware of. Feelings of numbness, depression, frustration, and being extremely overwhelmed, to the point where it impacts your daily functionality, is a definite sign to be alert about,” she shared.
She also added that noticing the duration for which one has been experiencing these symptoms is also helpful, especially if these symptoms continue even after six weeks of giving birth.
Another level of support, Refai shared, is one that the immediate family and loved ones of the parent or mother can be responsible for. “You can look out for signs of personality changes such as irritability for instance. It is important to know that anybody going through postpartum needs to be nurtured mentally and physically rather than have more pressure put on them. That is like backing somebody already breaking apart at the seams into a corner and expecting them to make a magical recovery. It won’t work,” Refai shared.
Addressing cases of child abuse associated with postpartum depression, Refai elaborated that most women whose depression escalates to this level experience it because they have somehow failed by their own expectations and standards and they reach the final boiling point without even knowing it, which is why it is important for those near and dear to them to stay vigilant.
“It is also important for the people around the new mother or father to offer help and also ask them questions that are not about the child. Often with the arrival of a new child, the actual parents and their wellbeing takes a complete backseat. This needs to be avoided,” Refai shared, adding that most women, especially, would put on an appearance of having everything under control. This is why, according to Refai, those in their life need to ask them questions that prompt answers directly related to how they are feeling.
“There are programmes run by midwives, nurses, and mental health assistance organisations that one can reach out to, if they feel that they need help or resources. Postpartum depression is nothing to be ashamed of. It is simply an overload of our very human system and can be managed,” Refai concluded.