A version of this article was also published on the Express Tribune Blogs here.
Earlier in the month of October, we learned that both Hayden Panettiere and Drew Barrymore — both famous Hollywood actresses — have been suffering from postpartum depression and that, due to their courage for opening up about their experiences with this acute illness, is why the world should start talking about this illness further. And I couldn’t agree more. I agree that the world should be talking about postpartum depression and the severity of this illness for a long time coming.
Postpartum depression is a mental illness that is experienced by women all over the world. According to the Center for Disease Control, 11 to 20% of women who give birth each year have postpartum depression symptoms, and while some are fortunate enough to live in places where this illness is recognized for its austerity and are hence provided the relevant medical attention and care to treat it, other women are not as fortunate. This is simply because the illness is either not recognized nor acknowledged as a ‘mental illness’ in the first place.
While I truly appreciate celebrities coming forward and shedding light on mental illnesses, such as postpartum depression, it is also time that we started having this conversation not only in the west but more importantly in the east; especially in Pakistan/Pakistani communities and among Pakistani folks, where much stigma is attached to understanding the concept of mental illness. This stigma hence has very unfavourable effects, especially on our women who are suffering from postpartum depression, because they are more than often not taken seriously.
In our society, women are expected to quickly adapt to their roles as mothers as soon as their child is born, without any “nakhrey” (meaning “fuss” in the Pashto language). Any woman that does complain or show signs of distress are automatically deemed as “pagal/lewanai,” which hence becomes a major deterrent in their ability to seek professional medical help. It is this negative societal attitude towards women suffering from postpartum depression which sets the stage for further suffering and agony, resulting in either self-harm or the harming of the baby.
In addition to societal barriers, there is also a cultural barrier with regards to the sharing of personal information with healthcare workers/professionals, which also persists as the majority of people generally do not discuss personal, physical or mental problems with anyone outside of the family. Often, shame and blame are used to enforce norms in the family leading to additional mental and emotional trauma.
A Pakistani woman whom I interviewed not too long ago for my research work on postpartum depression told me that one of the reasons she did not seek medical help was because she was not allowed to due to what people were going to say/think if they found out that she was seeking professional medical help. I am sharing part of her interview, with her permission, below:
I lived in a joint family, with my in-laws, as is the norm in Pakistan. When I had my son several years ago, I fell under severe postpartum depression; I couldn’t eat, sleep, or focus on anything. I literally wanted to die. I knew if I asked my mother-in-law to take me to the doctor to give me medication for my depression, she would say ‘no’. As would too my husband. They were both already constantly criticizing my abilities as a mother. So, I decided to sneak behind everyone’s back, with the help of a close friend, who drove me to the hospital and back. This went on for several months until a neighbour spotted me at the clinic one day and enquired both my husband and in-laws about my whereabouts and my ‘ill health’. After that, I was never allowed to set foot in that clinic again…
As a result, many women have no choice but to suffer in silence in order to avoid insult and ridicule; they’d rather drown in their miseries and depression, than to have either their families or society label them as being “too fussy/spoiled” or “crazy.” Because it is understood that a woman’s dishonour is equivalent to dishonouring the entire family. The requisite to protecting the honour (“izzat”) of the house is thus a crucial responsibility, and the burden of keeping that honour intact is excessively placed on the women. This also stops the women from flouting the rules of the house in order to seek professional medical help for their postpartum depression, as this would result in not only wounding their relationships with the family but also the family’s reputation in the society. Hence, the dishonour, exclusion and discrimination faced by these women, when reinforced through culture and communal norms, further devalues their personhood and curbs their voice to seek the necessary help they so desperately need.
So why the general stigma around mental illness? What gives?
The answer is both simple and complicated. For the longest time, mental illnesses in our society have been perceived in a negative light. And, those suffering from mental illnesses have been deemed both “dangerous” and “immoral.” Of course, this is not to imply that everyone suffering from mental illnesses are either perceived or treated in this way.
However, there are many who are rarely provided with the necessary support and medical help needed. And this extends to our women as well, who have already been disparaged on a plethora of fronts; a mental illness such as postpartum depression thus worsens their acceptability both inside and outside the home.
It is therefore imperative that we as a society start to recognize postpartum depression as a serious mental illness, rather than taking it lightly or simply brushing it aside as a woman’s ‘nakhrey’ or excuse to ‘avoid responsibility’ as a (new) mother. We need to overrule any and all societal and cultural stigmas attached to it, so that sufferers can finally feel comfortable seeking the necessary help and treatment they require.
It is further important to both accept and create awareness about mental health issues with regards to postpartum depression in our society, as this would in turn encourage women to accept their mental ill-health, and come forward without having to feel any shame or guilt.
It’s seriously about time we had this critical heart-to-heart conversation, for it is better now than never.
Note: I am currently conducting an academic-based research study on PPD among Pakistani women, both in rural and urban areas, and I am currently accepting first person accounts and experiences for my research, which is to be published in a prominent Canadian Health Journal in 2016.
If you are a Pakistani woman who is currently suffering, or has suffered from PPD in the past, and would like to be a part of this important study, please contact me at firstname.lastname@example.org. Your help and participation in this study is greatly appreciated! Also, please pass on this information as widely as possible.