Jatin and Priya’s world came crashing down. Priya was in shock. She just couldn’t accept that she had lost her baby; Jatin, though disappointed, pulled himself together to support his wife. Like Priya and Jatin, many couples lose their babies unexpectedly. And although they all respond differently to this unfortunate event—some might go in denial, others might get angry at the unfairness of the situation, and still others may blame themselves for not taking enough precaution.

But often each couple goes through all the three stages—denial, anger and guilt. It’s a cycle of grief. The fourth stage, in many cases, is that of depression and the transition towards mourning and acknowledging reality. Sophia a housewife who miscarried in her first pregnancy shared that, “I felt I had lost something precious, l felt empty and that nothing was worth but the baby”. Like Sophia most mothers experience crying spells, lack of appetite and energy, low concentration, excessive or lack of sleep and isolation.

The final stage is that of acceptance, where the women learn to accept that they have lost their baby and gain resilience to move forward. This doesn’t mean that they forget the pain—just that they learn to cope with it enough to prevent it from interfering with their lives. This stage is considered the first step towards recovery.

Miscarriage is hard not just on the mothers, but also on the expectant fathers. After all, it’s their flesh and blood too. And the stages of mourning remain the same for the men, but are more subtle. Jatin, for instance, though heartbroken, put up a strong face and pulled himself together to support his grieving wife. Sophia’s husband couldn’t utter a word. “He was just numb. Probably none of us realised that he was heartbroken as well,” she said.

The repercussions

Miscarriage profoundly impacts a marriage—often leading the couple to come closer. But the opposite too happens in the case of some couples. They often lose interest in sex, have flashbacks, blame each other for what has happened and withdraw in their shells. Such couples are prone to depression and anxiety disorders and find it difficult to plan a baby in the near future.

The situation becomes more difficult to handle in case family and friends are insensitive towards the situation. It is seen that families are able to cope better since they are not directly involved with the unborn baby. This sometimes makes it difficult for them to acknowledge the grief that the couple is going through, making the couple feel alone in their journey.

It’s possible to heal

• Allow yourself to experience the pain. There is no right or wrong way to grieve.
• Rest for at least a few days post miscarriage and take a break from work if you find it difficult to confront colleagues and friends. Going on a short vacation as a couple helps recover from the trauma.
• Take care of your health post miscarriage as it scars not just emotionally but also physically. Massages, aroma therapy and guided imagery help relax mind and body.
• Share your grief with your spouse or closed ones. Suppressed emotions lead to mental disorders and sharing your feelings, especially with spouse helps understand your spouse’s feelings, which will help you cope with this together. It is important for healing and recovery.
• Be assertive and learn to say so firmly if you are not comfortable around relatives or friends.
• Seek professional help to gain some direction in this time of confusion and stress, especially if you are finding it difficult to perform day-to-day activities, feel depressed after several weeks, experience mood swings or experience traumatic flashbacks.
• Talk to your doctor about miscarriage and conceiving again.
• Join a support group to understand that you are not alone in this journey. Learning the experiences of others helps you grow as a person.
• Find creative means to express your feelings such as writing a journal or creating something in the memory of loss, something which symbolises your attachment to your unborn child like sowing a seed or creating a scrap book or making a painting or writing a poem.
• Write a letter to the unborn child; it’s a cathartic outlet. You could write the things you wanted to tell the baby or the good times you had planned with it, how you felt about the loss and how you plan to cherish the memories of the time you shared with it.
• Read books related to miscarriage to help you cope. I Never Held You: Miscarriage, Grief, Healing and Recovery by Ellen M Dubois or Miscarriage: Women Sharing From the Heart by Marie Allen and Shelly Marks are two good books that could help.
• Maintain a thought diary to monitor your guilt and other emotions that tag along with it to keep your emotions in check. This will also help you identify the situation and negative thoughts that leads to negative emotions.
• Work on letting go of “if only” or “what if” questions. Catastrophising only worsens coping with the predicament. Forgiving yourself and any other thing you might be holding responsible for your fate makes letting go of guilt easier.
• Consider Cognitive Behavioural Therapy [CBT] as it helps restructure unhelpful thoughts and behaviours.

Although miscarriage is a difficult and stressful process, you still have opportunities to conceive in future and to have a healthy baby. So, keep the hope alive.

But don’t rush into it and give yourself enough time to recover from the experience, which you will in due time.

This was first published in the July 2012 issue of Complete Wellbeing.

The post When the crib remains empty appeared first on Complete Wellbeing.

“Do you think he would cheat on her?”asked my friend. Before I could answer, she went on, “Sure they seem content now, but… in all my life I do not know of a single relationship where one of the partners has not strayed at some point, to some extent.” I did not ask whether she included her own marriage of 30 years in that analysis, letting her continue, “I wonder if my husband has ever had an affair. If he has, I would rather he never tell me. After all this time, it doesn’t matter. I hope Kalpana’s husband will be able to put her affair into perspective too.”

Kalpana is a common friend. She has been married for 18 years, of which the last two involved an affair with a family friend. The affair was what is termed an ‘emotional’ one. Long phone conversations, an occasional lunch rendezvous, holding hands under the table at a coffee shop… All the things Kalpana’s husband was always “too busy” for. He had recently discovered the affair after chancing upon her itemised mobile phone bill.

Infidelity is not restricted to sexual betrayals, whether real [one-night stands, long term affairs] or virtual [instant messaging, online pornography]. It can include acts that violate the emotional exclusivity of a committed relationship as well. However, the meaning of infidelity can only be defined by the individuals in a relationship, based on their mutual understanding of what is acceptable or tolerable and what is not.

Unfortunately, most people in a committed relationship do not discuss these boundaries. Complete fidelity is expected and is accepted as the norm. However, if we go by what surveys have to say, monogamy is human but humans are not monogamous. According to one survey, 52 per cent of Indians have cheated on their partner with an ex-girlfriend/boyfriend, 38 per cent with a neighbour, 16 per cent with a college friend and 13 per cent with a colleague.

Even if an affair does not involve physical intimacy, its discovery can be devastating. Research has shown that men are more disturbed by sexual infidelity whereas women by emotional infidelity [Harris, 2003]. Whatever the case may be, the experience is traumatic for both partners.

Kalpana felt guilty but also angry. Although they lived under the same roof, her husband had built a wall around himself. This happened all because he was emotionally unavailable, she reasoned. But her husband was too distraught to see the affair from her perspective. He was jealous; his self-esteem shattered. He contemplated separation from his wife for a prolonged period.

The effects experienced post-discovery of an affair are at times similar to that of Post-traumatic Stress Disorder [PTSD]—flashbacks, depression, emotional numbness, insomnia, irritability, loss of interest in regular activities and avoidance of places or people that evoke thoughts of the traumatic event.

For Kalpana and her husband, divorce was not an option because of the children. In India, most often a couple decides to give their relationship a second chance because of societal, family and cultural pressures. As per a survey conducted by a leading magazine in 2010, only 14 per cent Indians would end the marriage if they found out their spouse was unfaithful. These figures do not mean that the couples who choose to continue to live together do so happily.

Picking up the pieces and patching up a relationship takes time and effort. Psychologists suggest:

• Maintain healthy eating and sleeping patterns, exercise regularly, avoid excess caffeine, alcohol and any other addictive substances.
• Practise yoga or simple deep breathing exercises that can help calm your mind and relieve some of the tension in the body.
• Write your feelings down in a journal or as a letter to your partner. It is, however, not obligatory to share the same.
• Take a break if you find yourself in a heated argument, and only resume the discussion once a calmer state of mind has been achieved.
• Follow fair fighting rules like getting your thoughts organised before starting a conversation, listening to your partner, acknowledging feelings, not taking recourse to physical violence or name calling, respecting your partner, focusing only on the current issue and taking time out to relax.
• Introspect on the aspects of the relationship that could have led to the affair, and on the areas, communication for instance, that you and your partner need to work on for a healthier relationship.
• Understand what you and your partner expect from each other in terms of household chores, expression of love, parenting, sex or communication. Unmet expectations can lead to stagnation and frustration.
• Read books and articles on the subject that open your mind and introduce you to different perspectives. Share those thoughts with your partner so that you both are on the same page.

Visit a marital therapist if there is a need for an unbiased mediator

This was first published in the May 2012 issue of Complete Wellbeing.

The post An affair to forget appeared first on Complete Wellbeing.

If you’re a new mother or know one who has been experiencing these feelings, these may be signs of post partum depression [PPD].

Baby blues v/s PPD

Often, the symptoms of PPD get ignored as they are pushed under the umbrella of ‘baby blues’ or ‘mood swings’. If left undiagnosed and untreated, they can lead to morbid consequences. Hence, it’s important to differentiate between the two.

Baby blues are experienced by a majority of mothers post delivery. Baby blues include crying spells, irritability, anxiety and tiredness prevailing for a few days up to two weeks after delivery. These symptoms do not interfere with the daily functioning of the mother and usually fade away with proper rest, adequate nutrition and family and social support.

PPD is a serious problem where the mother experiences multiple symptoms like exaggerated mood swings, loss of pleasure in day-to-day activities, negative feelings like guilt over inability to take care of the baby, anger towards the baby or the family members, fear of harming the baby and extreme lack of concern towards the baby. The mother also suffers from disturbed sleep, excessive crying, feeling of helplessness or hopelessness, fatigue, lack of concentration, emotional and physical numbness, hyperventilation, anxiety, loss of appetite and intrusive thoughts.

More serious symptoms include homicidal or suicidal ideas. These symptoms could start in the first four weeks or within a couple of months post delivery. The symptoms could put the mother, baby and the entire family through emotional and physical turmoil.

Risk factors

The cause for PPD differs from woman to woman. Most studies attribute genetic vulnerability, drastic hormonal [oestrogen and progesterone] changes and variations in serotonin and norepinephrine [neurotransmitters in the brain] as the main contributors to the disorder.

However, some risk factors play an equally important role in the onset of this disorder. These include:

• Family history of psychological disorders such as anxiety or depression in the mother.
• Lack of partner, family and social support.
• Marital discord, single motherhood, unwanted or unplanned pregnancy, death in the family, stressful life events and premenstrual syndrome.

Premature child birth or child born with mental or physical disability, difficult temperament of the new born baby, financial difficulties, high expectations from oneself, low self-esteem, feeling of unattractiveness and loss of identity are other contributing factors.

Are you experiencing PPD?

Have you delivered a baby recently and

• Feel low, hopeless or depressed?
• Feel absolute lack of interest in carrying out day-to-day activities?
• Experience fatigue or inability to take care of your child?

If you have answered yes to the above questions, you might be experiencing PPD; consult a mental health professional for diagnosis and support.

Overcoming PPD

• Once diagnosed with PPD, educate yourself about it. This will help you identify the symptoms and deal with unhelpful behaviours. Include bibliotherapy in your healing process. Read books about the disorder. American actress Brooke Shields has shared her experience with PPD in her book Down Came the Rain. Reading about the experiences of others will give you the feeling that you are not alone.
• Understand that having a baby is not the end of your identity. It is a new facet to your persona.
• Share your feelings and fears with your spouse, family and friends.
• Spend quality time with your partner and maintain a supportive circle of friends.
• Get a house help to assist you with household chores or taking care of the baby.
• Don’t try to be a super woman—share your responsibilities with others. Have realistic expectations and reasonable demands on yourself.
• Take up at least one pleasurable activity such as listening to music or reading a book every day.
• Don’t plan major transitions during pregnancy or post-delivery such as a new job or moving houses as it adds to the stress.
• If you have a history of depression or other mood disorders, consult a psychiatrist or psychologist before delivery to keep your mood in check and to take preventive measures like therapy.
• Get yourself treated for physiological problems like hormonal imbalance, thyroid, and vitamin deficiencies as they too could be responsible for making you feel down.
• Acknowledge and accept your feelings.
• Stay active. Go for pram-walking with other moms from your neighbourhood.
• Learn to relax. Deep breathing exercises and yoga soothe the mind.
• Take small naps while your baby is sleeping.
• Maintain a schedule to help you complete tasks. Life seems easier, once tasks are manageable.
• Engage in positive self-talk: say to yourself, “I can handle this, well!”
• Don’t blame yourself.
• Write your thoughts down; journaling can help you vent difficult feelings and thoughts.
• Do things that make you feel good about yourself. Pamper yourself with a pedicure or a massage.
• Contact your doctor immediately if you start getting suicidal thoughts or thoughts of harming your baby.
• Enlist the help of a professional. Therapy and medication together can work wonders and the sooner you get it the faster you’ll be out of this phase. Antidepressants help in PPD. However, talk to your doctor about the side-effects on you and your baby if you are breast feeding. A therapist can help you deal with the new role of a mother and the stress factors that come along with it. Therapies like cognitive behavioural therapy, interpersonal therapy, marital therapy, family therapy, group therapy, and support groups have proved to be helpful.
• Follow the instructions of your health care provider.

New mothers could also be affected by other mental disorders such as postpartum panic disorder and postpartum obsessive compulsive disorder. But the good news is that these are curable. In the words of Kahlil Gibran: “Out of suffering have emerged the strongest soul.” So don’t give up the fight until you triumph.

The post Delivered from depression appeared first on Complete Wellbeing.