IN a country where motherhood is revered and celebrated, a growing number of women are grappling with a silent assassin postnatal depression (PND).
PND is a depression that occurs within 12 months of having a baby, usually during the first few weeks or months.
It can start slowly or suddenly and can range from very mild and transient, to severe and lingering.
For some women, it passes quickly, but others will need professional help.
This debilitating condition, often shrouded in secrecy and shame, leaves a trail of devastation in its wake, affecting not only new mothers, but also their families and communities.
The World Health Organisation (WHO) estimates that over 300 million people suffer from PND across the world, making it the leading cause of disability among women.
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PND affects women after giving birth.
It remains largely under-diagnosed, particularly in both developing and middle-income countries.
In Zimbabwe, about 30% of mothers suffer from PND, studies have revealed.
The studies show that high levels of stress after delivery, previous history of depression and high depression scores during pregnancy are predictors of PND.
These statistics, experts warn, are likely just the tip of the iceberg, as many cases go unreported due to societal stigma and lack of awareness.
Carol, a 32-year-old mother of two from Glen View high-density suburb in Harare, recalls the darkest days of her life.
“I thought I was going crazy. I would cry uncontrollably, feel like a failure and couldn’t bond with my baby,” Carol recalled.
“I was so ashamed, I didn’t know who to turn to.”
Her experience is far from isolation.
Fellow women like, Emelda (28), from Harare’s sprawling suburb of Epworth, have been driven to the brink of despair.
“I felt like I was losing myself. I would lash out at my husband and child and then feel guilty for it. It was a vicious cycle,” Emelda recollected.
Experts say the consequences of untreated PND can be far-reaching, affecting not only the mother, but also her child.
Women suffering from PND may struggle to bond with their babies, leading to feelings of guilt and shame.
This can have a negative impact on the child’s emotional development and well-being.
Additionally, untreated PND can increase the risk of child abuse and neglect.
Harare-based obstetrician and gynaecologist Tafadzwa Nhekate attributed the high prevalence of PND to several factors.
“We have a society that expects women to be strong, stoic and care for others without complaint,” said Nhekate.
“This unrealistic expectation, coupled with lack of support systems, economic strain and limited access to healthcare creates the perfect storm for PND.”
Psychologist Pardon Taodzera added: “PND is often masked by cultural norms that dictate that mothers should be grateful and happy.
“This silence perpetuates the myth that PND is a Western problem when, in fact, it affects women from all walks of life.”
Seke-based community leader Gogo Mirriam Kutyauripo said traditional ways of social fabric could help with PND.
“When mothers suffer, families suffer. PND affects not only the mother, but also the child’s development, the father’s well-being and the broader community’s social fabric,” she said.
“New mothers are encouraged to be with close family members like their mothers and aunts, that is why it is important to do the kusungira process.”
African Mental Health Research Initiative director Dixon Chibanda said most healthcare facilities in Africa did not have screening tools that enabled accurate diagnosis of women.
On top of this, cultural factors make it difficult for women to talk about the fact that they are feeling depressed.
“Research in Zimbabwe found factors that increased the odds of a woman developing PND, saying these include recent negative events such as death, domestic violence and HIV infection,” he said.
“Using non-professionals to help to treat depression has steadily gained recognition as an effective way of reducing the treatment gap for PND and other mental health issues.
“This is driven in part by a shortage of psychiatrists or psychologists. Non-professionals such as village and community health workers and other auxiliary health staff can be effectively trained to identify and provide therapy for postnatal depression.”
Chibanda is doing his best to help his community by training local grandmothers in evidence-based talktherapy.
Mothers with PND issues sit on what is known as “The Friendship Bench” and over six sessions, the trainees try to help with issues the community members have, using their real-life experiences as well as therapy training.
Since 2006, over 400 grandmothers have provided therapy in over 70 Zimbabwean communities and in the past year or so, the project has helped over 30 000 people.