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From pregnant mum to Psycho: A story on postpartum psychosis

Dr. Akin-Onitolo A.

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“Maimuna killed the baby.” Rabia’s words were thick with conviction. She sat, cross-legged on the mat near the door and leaned forward with her hands clasped as if she held the proof of her claim therein. The village elders looked on with keen interest. It was highly unusual for a twenty-one day old to be crushed by a stone. For that matter, the stone had been used to hold the roof of Mallam Usman’s room in place when a strong wind had supposedly forced it down and lifted the metal roofing sheet with an uproar.
“Since Mallam Usman brought that strange girl here, it has been one problem after another. She would not do chores because she is too lazy to wake before morning prayers, and very disrespectful.”
Rabia paused to adjust her scarf. “She does not even feed the baby, may her soul rest in peace, I am the one who would carry and feed her when the crying becomes too much. Have you seen the room Mallam Usman built for her?”
“But she said the stone fell off the roof, where were you when it happened?”
Rabia wiped the corner of her eye with the edge of her scarf. “Wallahi, the girl is possessed. I saw what happened because I had just returned from Tuesday’s market. The beans and pumpkin I was carrying poured away as I rushed to stop her but I was too late.
“Maimuna took the stone by herself and hit it on baby Amina’s head several times, may her soul rest in peace. I don’t know why a mother would kill her own baby.” Then she begun wailing and was sent out of the room. Their assertion that it was not an ordinary incident was unified.
Mallam Usman cleared his throat deliberately. “Maimuna said the baby had evil eyes, is it not possible it is true?”
“Kai! You should not encourage a woman’s foolishness. How can a baby that is barely three weeks old be possessed?” the chief of the elders rapidly countered. The words were barely out of his mouth when Mallam Usman’s first son rushed in to announce that Maimuna had tried to kill herself by hanging on the acacia tree behind the house.
Postpartum psychosis, affecting one in a thousand women and Maimuna in this story, is a mental condition that can affect new mothers anytime from shortly after to one year after delivery. Though not very common, it could get bad enough to cause a mother to harm herself and/or her baby. It is not caused by anything the woman did or didn’t do. It could just happen. But women with a history of bipolar disorder (recurring episodes of extreme high (mania) and low (depression) moods or schizoaffective disorder {schizophrenia (having hallucinations and delusions) + mood disorder}stand a higher chance of having the disease as well as if a mother or sister has had postpartum psychosis.
Such women may have some of the following;
• Unusually high mood – racing thoughts, feeling superhuman, more productive; unusually low mood – loss of interest in normally pleasurable activities, poor appetite or markedly increased eating, crying often without appreciable reason,
• Irritable or anxious feelings, restless, confused, fearful, sharp mood swings,
• Unusual behaviour like talking a lot or keeping to self, not sleeping or may not feel the need to sleep, losing control of self, having compelling urges to take certain actions,
• Thinking that people around want to harm her or her baby, believing and acting on thoughts that are untrue like thinking that the baby has an evil spirit – delusions,
• Hearing voices telling her what to do or talking about her or running commentary on her actions, seeing, feeling or smelling things that are not actually there – hallucinations
Often, she does not realize she is ill so the responsibility of identifying the illness may fall on her family and friends. Treatment involves the use of drugs and hospital stay for a few days. It usually does not involve separating her from her child as mother-child bonding is necessary but there is a need for 24/7 watching to ensure they are both safe.
It is important to understand that postpartum psychosis is different from what many mothers experience, baby blues, which occurs after delivery and tends to go away within a short period of ten days. In some women though, it could be last for two weeks or longer with worsened symptoms of low mood known as postpartum depression. And in some others, anxiety disorders could develop.

 

Early identification and prompt treatment is needful to save mother and child. It is unfortunate that this is rarely discussed or even properly managed in our society. Many women keep quiet about it because of the stigma associated with mental illnesses. Instead of promoting this stigma, we ought to support such mothers and speak out when help is needed.
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Dr. Akin-onitolo A. is a graduate of the University of Lagos whose mission is to achieve the sustainable development goals (SDGs) using health promotion and improved health literacy. She is an MDCN (Medical and Dental Council of Nigeria) certified doctor who had her elective at King's College London. Hugely interested in travel, meeting people and generally being creative, reading and writing fiction are a few hobbies you could find her engaged in during her spare time. Catch up with her on Twitter @Akinonitolo and Instagram @t_onitolo