Pakistan is a nation with immense respect for mothers. Not unconditional or definite, but respect nonetheless. Who doesn’t love an old, grey, and weak mother, who has slowed down in her later years, and sits waiting for her children to visit all day? This mother is just a mother. And we as a nation love a woman who is “just a mother”.
We love her because the foundation of her existence is self-sacrifice. She has, over her many years as a mother, strangled her very identity; compressed all of her dreams or desires, and has cut off any resemblance of a personal social life, like one would an infected limb. This mother deserves respect and praise for doing it all, without help or support, and on most days, without love.
So, what do we do when this mother wreaks havoc in her newly wedded son’s life, or when she sits around telling all her extended family and friends, or anyone who’d listen really, about the dysfunctions of her household, and the disobedience of her children? What do we do when she screams and cries, or maybe even throws things around, because no one listens? We respect her, because of everything she has done, or we call her crazy and move on. Neither of the two, a viable solution.
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What has happened to this woman? How did she get to this point?
In the early days of becoming a mother, a woman will most likely use all of her languages to try and communicate the intensity of what has happened to her. She will cry, and show her emotions, and let her guard down, until the day she is judged one too many times. She will be criticized for being ‘ungrateful’ in the face of a huge blessing from God. But this is a woman who has experienced a traumatic event, the effects of which will show up in her mental and physical health for months, if not for years to come. It is unreasonable, almost criminal, to expect her to be taking on all of the hardships of a new baby with a smile on her face.
A woman who has just given birth almost immediately loses huge amounts of the two hormones which had been signaling to her brain to feel calm and happy during pregnancy. Yet, we have frequently seen a new mom overjoyed, crying ugly tears when meeting her baby for the first time. This is because of another chemical which is released in the brain during intense pain and stress, which serves as a coping mechanism to help with pain management. The effects of all of these feel-good hormones slowly disappear over the next few weeks. The smog settles, and a colorful and cherished life slowly takes on a greyish appearance, the hues of which change frequently from dark to darker, and back. This woman lives only to serve the child now, pushing back these heavy clouds just long enough to get it all done; change the baby’s diaper, bathe the baby, feed the baby, put the baby to sleep, repeat, repeat, repeat, repeat, repeat…
New mothers will be told that what they are experiencing is completely normal, which is sometimes, unfortunately, true. These feelings are generally the norm because the body is going back to its pre-pregnancy hormonal levels at a very rapid rate, stirring a whirlwind of emotions cuing crying spells, anger outbursts, difficulty sleeping, anxiety, and other severe mood swings. This patch right after giving birth and experiencing these difficult moments is what doctors call the “baby blues”. Environmental factors which do not help this mix can include being awake all night with the baby, having little to no help or support, becoming the default parent in these early days, and not being able to take care of a healing body effectively. Baby blues are quite common, may affect up to 80% of all new mothers, and can last up to two weeks after giving birth. What is less common, more severe, and often debilitating is what is known as post-partum depression (PPD). Baby blues which last longer than two weeks, and appear to be getting worse or stronger, or feel like they are returning after weeks or months of being away, can actually be a missed diagnosis of PPD. The most significant differences between baby blues and post-partum depression are of severity and longevity. Post-partum depression can begin within a week after giving birth, or happen at any point within the first year of having a child. It can last months if left untreated and includes a severe version of the usual symptoms of baby blues, but can also include great guilt, tiredness or fatigue, irritability, and, most significantly, the inability to take care of self or child. PPD is reported in 15-20% of new mothers and therapeutic intervention is often recommended, sometimes alongside medication. The most severe of these mental birth complications is a disorder known as post-partum psychosis. This condition only affects about one in one thousand mothers and can be very extreme and often dangerous to both the mother and child. This condition includes severe confusion, anger and frustration, hopelessness, paranoia, rapid speech, delusions, hallucinations, and mania. There appears to be a correlation between post-partum psychosis and high blood pressure, which places the patient in a condition which they often do not remember later. These new mothers are at a very high risk of self-harm, harming the baby or committing suicide. As a means to help these mothers, hospitalization and medication are often essential, along with consistent psychotherapy.
Educating ourselves about these post-partum complications can help us be kinder to ourselves and to those around us. Although these conditions sound daunting and a stretch from reality, it wasn’t until I found myself in the midst of post-partum depression that I realized its true effects. It is one thing reading about it, and a completely separate thing being submerged fully in its quicksand. As a therapist, I knew the symptoms, and I knew how to reregulate myself and keep swimming until I got out the other end. But that is a feat that I cannot get across in words or writing. It was the loneliest, saddest, and most difficult time of my life, and twice that, when I had my second child. On one such night, I sat down and thought about how many women in my neighborhood, or in the next sector, or in my city, or in this whole country, may be sitting on the floor in their rooms, sobbing silently so as to not wake the baby, feeling exactly the way I felt in this moment. There was no way I was the only one. And so, I set out to find my village. And when I didn’t find a village ready to take me in, I set out to make my own.
Ammis for Mental Health is a product of my post-partum depression. After realizing that no one around me could possibly understand what I was going through, I found solace amidst other mothers, who were also failing to be understood. Together we built a community safe for us all, looking out for each other, and checking in on one another in our weekly sessions. The element of group catharsis is what fuels us for the week, and keeps bringing us back to the group. We now have three running support groups, namely: Talking Through Motherhood (for pregnant and new moms), All the Single Ammis (for single mothers), and Heaven Beneath Our Feet (for mothers needing a little push in their religious obligations and spiritual connection).
Finding my drive from this project, I began offering personal therapy sessions as well. I now have the honor of helping other people swim their way back up. My approach in therapy is integrated and client-centered, from a trauma-based lens. The perspective I follow is that everyone has been through significant moments of trauma in life, including that of childbirth, but may not have the knowledge to heal and come back from these in a healthy manner. Most human bodies have habit forming ways of dealing with unresolved trauma by protecting themselves from future harm. These habits can manifest as anger, anxiety, depression, or a number of other psychological discomforts. My job as a therapist is to clear out some of these by enabling my clients with tools to effectively reregulate in difficult times and take back control where they feel it lacks in their lives. It is a journey I am extremely fortunate to be on, and one in which I learn and grow every single day.