According to the World Health Organization, 73 million women around the globe suffer a major depressive episode each year. Of these, about 13 percent suffer from postnatal depression (PND). Chinese statistics estimate that between 10 and 20 percent of new mothers in mainland China are afflicted by the condition, the causes of which are myriad and may range from hormonal shifts to life crises to pre-existing depression. But the statistics don’t tell the whole story and they may also underplay the incidence of PND, because many mothers simply don’t come forward.
A Heavy Burden
Fengxue is one such mother. “My pregnancy was a disaster,” recalls the 32-year-old Beijinger, who suffered from morning sickness and daily vomiting late into her third trimester. She began feeling severely depressed when she returned to work after her six-month maternity leave ended. “I like my job and try to do excellent work,” she says of her career, which involves organizing overseas art exhibitions for the Chinese government. “However, because of my baby, I had to ask for leave whenever there was no one who could help care for him.” She was often absent from work and as a result was passed over for a promotion.
Fengxue’s son is now 14 months old, and her PND hasn’t abated. She is perpetually torn between her job and her child. “I question why I had a baby,” she says. But she is also worried about upsetting her son and tries to keep her struggle to herself. “I keep smiling,” she says. “I don’t talk to friends because they have different troubles with their kids, and I will never talk to my parents [about it]because they’re tied up helping to take care of my baby during my workdays.”
Fengxue is not alone in her choice to keep quiet. According to Ivy Makelin, a counselor at the Beijing chapter of La Leche League (LLL), an international breastfeeding support organization, this may be a common situation. “I’ve heard the statistic that at least one out of five mothers has [PND],” says Makelin, “but in my general contact with mothers, it doesn’t seem that high. I wonder, is that because the ones that are depressed aren’t coming out for help?”
“I do feel I need to see a doctor,” admits Fengxue. “But I don’t have time, and a child is costly. [My son] is a heavy burden.”
Mute of Love
Ruth Grady* knew something was wrong immediately. “The moment they threw him down beside me,” she says of her newborn, “my first reaction was: ‘Okay, who’s going to look after that?’”
The 32-year-old Canadian expat had been married for a decade when she found herself unexpectedly pregnant. In spite of the “whoopsie” factor, as she calls it, she was thrilled. “I loved [that]it was socially acceptable to be fat,” Grady says about her pregnancy. She relished showing off her belly and feeling the baby kick. But her husband, prone to high anxiety, stressed over their situation in Beijing. “Every time I went outside and it was a little bit polluted, he would be like, ‘Put on a mask! Don’t breathe!’” she recalls. And after a prenatal screening indicated a risk of Down syndrome, her husband “crawled into bed in a fetal position and sobbed.”
Grady gave birth by caesarian to a son who was completely healthy. But as she recovered from the procedure, her husband’s anxiety ballooned. Panicked at the sight of her bleeding nine hours after the C-section, he “went white as a ghost,” she says. “He thought I was dying. He had to be ushered out.” By the time they left the hospital days later, she says, “I knew my task of being a mother was going to be extended to my husband.”
Back home, Grady kept bleeding, waiting for her milk to come in. It was interminable.
“I crawled into bed and just laid there and cried,” she says. “I felt like I was about to fail. And failing in the eyes of [my husband]because of his anxiety. It was all these things piling up on top of each other.”
“[PND] is compounded by the lack of family support,” says Ivy Makelin. “I think partly [these mothers]are not aware that they have postnatal depression and partly because mental illness is so buried in China and not talked about.”
Grady cared for the baby in an almost mechanical fashion. “I knew exactly what I had to do – it was innate,” she says. But although her son was always fed, changed, and kept warm, Grady admits, “I could listen to him cry for 40 minutes and it wouldn’t bother me.”
“It’s extremely important to have a diagnosis,” says Dr. Stephen-Claude Hyatt, the head psychologist at Beijing International SOS Clinic. “There are cases where the mother leaves the child crying for the entire day and nobody knows what is happening.”
Over the next year, as her husband “obsessed over things like fingernails, hair growth and why teeth weren’t coming in at the right stages,” Grady drowned in feelings of failure and emptiness. “I felt completely emotionally disconnected,” she says. “I couldn’t even feel love anymore. I didn’t love [my husband], I didn’t love [my son], I was mute of love.”
She took only 12 weeks of maternity leave. She was happy at work; it gave her refuge from her new identity. “In China, culturally, they don’t even call you by your name anymore. You become ‘Jasper’s mama,’” she explains. “As sweet as it is, you [also]feel raped of your person.”
“As long as they are experiencing the symptoms of postpartum depression, [mothers]are not able to effectively bond with their child,” says Dr. Hyatt.
Grady has a pragmatic view of this impact. “I wonder,” she says, “if I had to be desensitized from the kid to balance my husband’s oversensitivity to [the baby].” They talked about divorce, she admits. “If you have a problem with your marriage, the child is a magnifying glass for that problem.”
Now, her son is almost 2 and she is feeling better, despite not seeking help. “My concern going to counseling was that they would want me to go on drugs, and having seen my husband on antidepressants, it dulls your personality,” says Grady, who believes her husband’s slow embrace of fatherhood finally brought her balance. “I was willing to [do it]if things didn’t get better. But things got better.”
A Horrible Feeling
Vilma Busquets was diagnosed with PND after the birth of her second child at age 38. Her pregnancy and delivery were problem-free but a couple of months after giving birth, she noticed that she “couldn’t stop crying and everything seemed horrible.” She was also lonely. Her Venezuelan family of four had just moved to the US and her husband was working nights.
Now 51 and living in Beijing, Busquets believes she suffered from depression from an early age, which spiraled out of control when her youngest child was born. “I believe that’s why I didn’t go to college,” she says about her condition. “There was a fear of life, a fear of starting things.” She had had two abortions before mustering up the courage to have her first baby at age 36.
“Usually women with a history of depression are more likely to develop [postnatal depression]after birth,” says Dr. Hyatt. “If they’ve had it before, it means they can have it again.”
Busquets’ husband suggested she see a doctor and it was then that she was diagnosed with PND. She was put on antidepressants, but took herself off the medication periodically, trading a feeling of numbness for panic attacks. In hindsight, she feels that the medicine helped because the alternative was anguish: “You want to sit in a chair, see life go by and hope it ends soon.” She fought with her husband and felt incapable of taking care of her children. “You see your child crying and it’s like, ‘Again?’ I knew I felt love, but it did feel like a burden.”
“There have been cases of [PND] that have led to marriages dissolving,” says Dr. Hyatt. “It puts a strain on the marriage; the spouse can’t understand or relate to what is happening.” With a diagnosis, he says, “at least you know what you’re dealing with and you can get the help you need.”
Ivy Makelin concurs. “If I am counseling a mother, I’ll let her know that postpartum depression is a common thing and it’s curable,” she says. “She should talk to a professional.”
Busquets recognizes that the diagnosis has helped her understand what was going on. “Before, I didn’t know why I was alive,” she says. Now she knits, paints, cooks – anything that involves using her hands – but she also talks about her depression. “I think I have even made friends talking about it,” she laughs. “It’s imperative that you talk.”
“If someone has [PND], it’s important that they get proper treatment and care if it’s available,” says Dr. Hyatt. While he supports antidepressants being prescribed in certain cases, particularly when a child is in danger, he feels that PND sufferers shouldn’t view medication as their first option. “It numbs you to the reality of what you’re going through,” he says, stressing that mothers should work their way through the condition in therapy, with or without medication.
“It’s important to feel the pain, it’s important to feel the sadness, but [also]to work through it,” he says. This way, “it’s less likely that it will happen again.”
*Name has been changed.
La Leche League
Offers information and support for breastfeeding mothers. Chinese-language meetings take place at Beijing United Family Hospital on the second Saturday of each month at 10.30am. English-language meetings take place at Beijing United Family Hospital on the fourth Friday of every month at 1.30pm.
(139 1015 4641, firstname.lastname@example.org) www.llli.org, http://muruhui.org
Beijing United Family Hospital
2 Jiangtai Lu, Chaoyang District (5927 7000) 北京和睦家医院,朝阳区将台路2号
Beijing International SOS Family Counseling Center
Counselors on staff offer both individual and couples therapy, along with support for family dynamics, parent-child relations, and stress management.
Suite 105, Bldg 1, Kunsha Building, 16 Xinyuanli, Chaoyang District (6462 0333) 朝阳区新源里16号琨莎中心一座105室
Mothers interested in starting a Beijing support group for women facing PND should contact Busquets at email@example.com.