Cindy Raghubar

Fam­i­ly and friends of a young moth­er were thrown in­to mourn­ing yes­ter­day af­ter she died at hos­pi­tal from in­juries she sus­tained in a 40-foot fall at her home three days ago.Abi­gail Rago­b­ar nev­er re­gained con­scious­ness af­ter she was ad­mit­ted to the Port-of-Spain Gen­er­al Hos­pi­tal and died just af­ter 2 pm yes­ter­day.

How­ev­er, in their time of grief, Rago­b­ar's fam­i­ly al­so reached out to so­ci­ety to high­light the ef­fects of post­par­tum syn­drome on moth­ers, since they be­lieve this ul­ti­mate­ly led to her trag­ic end.In a pub­lic post on Face­book yes­ter­day, Rago­b­ar's sis­ter, Char­lotte Young Sing, gave de­tails of the events which led up to Rago­b­ar's death.

At the time of the post, how­ev­er, Rago­b­ar was still alive and the post al­so paid trib­ute to her life and asked fam­i­ly and loved ones to pray for her. It was shared 2,000 times by Young Sing's Face­book friends.

Young Sing said Rago­b­ar, a moth­er of two, "lived for her chil­dren – Por­tia and new­born Raphael – and would nev­er do any­thing to hurt her­self or the ones she loves but her dis­il­lu­sioned state left her vul­ner­a­ble to dan­ger."She re­called the heart-wrench­ing mo­ment when she found her sis­ter on Mon­day morn­ing at 5.45 am.

"Words can­not de­scribe what it was like find­ing her body nes­tled in a lemon tree but af­ter say­ing the 'Our Fa­ther' out loud, God gave me the strength to pull her out. While her hus­band and my mom stood at my side hold­ing up the branch­es of thorns.

"Ab­by, as she is fond­ly called, is cur­rent­ly in crit­i­cal con­di­tion and fight­ing for her life...past the point of a co­ma med­ical­ly," Young Sing wrote.She not­ed that the loss of her grand­fa­ther-in-law and grand­fa­ther in the past few months had ini­tial­ly led the fam­i­ly to be­lieve that Rago­b­ar was in grief but lat­er on they re­alised it was some­thing else: Post­par­tum syn­drome.

"The perks of be­ing a mom is tan­gi­ble beau­ti­ful kids that love us un­con­di­tion­al­ly but what many peo­ple don't tell you is that post­par­tum de­pres­sion is re­al and its side ef­fects can be dev­as­tat­ing and its symp­toms can be eas­i­ly missed," Young Sing post­ed.

Young Sing not­ed that it was her hope that by post­ing their sto­ry, oth­ers may be more at­ten­tive to the sever­i­ty of post­par­tum de­pres­sion.

"We hope that by shar­ing this post that we are able to make oth­ers more aware of post­par­tum de­pres­sion and that aware­ness will save lives."

Since the post was made yes­ter­day morn­ing prayers and best wish­es poured in for Ab­by and her fam­i­ly.The fam­i­ly thanked all those who shared and wrote posts of sup­port, say­ing they were over­whelmed.

"To all pray­ing, we are deeply moved and over­whelmed with hu­mil­i­ty and thank­ful­ness for your prayers, they do not go un­no­ticed. God is good and life is full of sec­ond chances and we are pray­ing for a mir­a­cle," Young Sing wrote at the time.

Al­though Young Sing's post was a pub­lic one, she did not im­me­di­ate­ly re­spond to our at­tempts to con­tact her via a Face­book mes­sage yes­ter­day.

Cas­es on rise in T&T

Gy­nae­col­o­gist and ob­ste­tri­cian Dr Sherene Kalloo says there have been an in­creas­ing num­ber of post­par­tum de­pres­sion cas­es in Trinidad and To­ba­go.She told the T&T Guardian yes­ter­day that bout ten to 20 per cent of pa­tients in our so­ci­ety "show signs of vary­ing de­grees of sever­i­ty of the symp­toms of post­par­tum de­pres­sion."

There is no one cause and the symp­toms were not the same for each per­son, she said, but learn­ing to iden­ti­fy them was very im­por­tant as one of the most se­vere symp­toms was sui­ci­dal thoughts.

Kalloo ex­plained that post­par­tum de­pres­sion was de­fined as feel­ings of sad­ness or de­pres­sion af­ter giv­ing birth, soon af­ter de­liv­ery, or usu­al­ly with­in the first three months of de­liv­ery and could con­tin­ue for up to one year.

"Caus­es are not spe­cif­ic. It's been thought that a com­bi­na­tion of fac­tors will play a role. Hor­mon­al im­bal­ance, where a moth­er's oe­stro­gen, prog­es­terone and cor­ti­sol lev­els fall dra­mat­i­cal­ly af­ter de­liv­ery, which caus­es changes in emo­tion and mood sim­i­lar, or to a high­er de­gree of those ex­pe­ri­enced dur­ing pre-men­stru­a­tion, the PMS syn­drome," Kaloo said.

"Women who have a pre­vi­ous his­to­ry of de­pres­sion, or fam­i­ly his­to­ry of de­pres­sion, use of drugs and al­co­hol abuse, stress­ful life events, like mar­riage prob­lems, in­ad­e­quate fam­i­ly sup­port, if a part­ner is not shar­ing du­ties, fi­nan­cial prob­lems, or even the de­liv­ery of a still birth, are more sus­cep­ti­ble."

The symp­toms vary as much as the causal fac­tors... "feel­ing sad, feel­ings of hope­less­ness, rest­less­ness, dif­fi­cult­ly to fo­cus and mak­ing de­ci­sions, feel­ings of guilt and worth­less­ness, loss of in­ter­est in do­ing things that brought you plea­sure in the past, feel­ings of with­draw­al from friends and fam­i­ly, sleep­ing too lit­tle or too much, fa­tigue, tired­ness, ex­treme sui­ci­dal thoughts, ex­treme neg­a­tive thoughts of the ba­by."

There are phys­i­cal symp­toms as well, she point­ed out, in­clud­ing "anx­i­ety, pal­pi­ta­tions, dizzi­ness, headaches and chest pains."

Kalloo said there was al­so the mild "ba­by blues" that could last any­where be­tween three days to two weeks in a lot of moth­ers "but this isn't se­vere and does not need treat­ment. Fam­i­ly sup­port can help with this. The prob­lems are with those with sui­ci­dal thoughts and who may want to harm the ba­by. If left un­treat­ed, it can turn in­to dis­as­ter."

Most times a pa­tient may not want to talk about the de­pres­sion they were ex­pe­ri­enc­ing but Kalloo en­cour­aged rel­a­tives to look out for the signs and in­form doc­tors about the pos­si­bil­i­ty of post­par­tum de­pres­sion in moth­ers.

"Don't be afraid to do it be­cause of the con­se­quences that can oc­cur," she said.More­over, she said post­par­tum anx­i­ety did not dis­crim­i­nate who it af­fect­ed.

"It can be some­one who has been nor­mal, had a nor­mal preg­nan­cy. Two out of every 1,000 births that are nor­mal preg­nan­cies can end up hav­ing PPD to the ex­treme of moth­ers hav­ing thoughts of sui­cide."

How­ev­er, it did seem to af­fect the low­er so­cio-eco­nom­ic class at a greater rate, as they might be at a greater risk of hav­ing fi­nan­cial dif­fi­cul­ties, she said.

"But there is the per­cent­age of it hap­pen­ing to pre­vi­ous­ly hap­py peo­ple," she not­ed.

But post­par­tum de­pres­sion could al­so af­fect a fa­ther, she said.

"Re­searchers are find­ing that men are al­so af­fect­ed, not the hor­mon­al as­pect of it but the whole ad­just­ment. Some think it's a bur­den and can't lime with the boys again... and the fi­nan­cial bur­den, so they get de­pressed and with­drawn."

The new re­search has termed this oc­cur­rence as pa­ter­nal post­par­tum de­pres­sion.

"Some men can reach the point of anger and vi­o­lent be­hav­iour, ex­tra mar­i­tal re­la­tion­ships, de­creased li­bido, few have even been doc­u­ment­ed as reach­ing sui­ci­dal thoughts but it's all new re­search," she said.– Cindy Raghubar-Teek­ers­ingh

GET HELP FOR THESE SYMP­TOMS

Some of the more com­mon symp­toms of post­par­tum de­pres­sion in­clude:

�2 Feel­ing sad, hope­less, emp­ty or over­whelmed.

�2 Cry­ing more of­ten than usu­al or for no ap­par­ent rea­son.

�2 Wor­ry­ing or feel­ing over­ly anx­ious.

�2 Feel­ing moody, ir­ri­ta­ble or rest­less.

�2 Over­sleep­ing, or be­ing un­able to sleep even when her ba­by is asleep.

�2 Hav­ing trou­ble con­cen­trat­ing, re­mem­ber­ing de­tails and mak­ing de­ci­sions.

�2 Ex­pe­ri­enc­ing anger or rage.

�2 Los­ing in­ter­est in ac­tiv­i­ties that are usu­al­ly en­joy­able.

�2 Suf­fer­ing from phys­i­cal aches and pains, in­clud­ing fre­quent headaches, stom­ach prob­lems and mus­cle pain.

�2 Eat­ing too lit­tle or too much.

�2 With­draw­ing from or avoid­ing friends and fam­i­ly.

�2 Hav­ing trou­ble bond­ing or form­ing an emo­tion­al at­tach­ment with her ba­by.

�2 Per­sis­tent­ly doubt­ing her abil­i­ty to care for her ba­by.

�2 Think­ing about harm­ing her­self or her ba­by.

On­ly a health­care pro­fes­sion­al can di­ag­nose a woman with post­par­tum de­pres­sion. Be­cause symp­toms of this con­di­tion are broad and may vary be­tween women, a health­care provider can help a woman fig­ure out whether the symp­toms she is feel­ing are due to post­par­tum de­pres­sion or some­thing else. A woman who ex­pe­ri­ences any of these symp­toms should seek med­ical help right away.

Some women are at greater risk for de­vel­op­ing post­par­tum de­pres­sion be­cause they have one or more risk fac­tors, such as:

�2 Symp­toms of de­pres­sion dur­ing or af­ter a pre­vi­ous preg­nan­cy.

�2 Pre­vi­ous ex­pe­ri­ence with de­pres­sion or bipo­lar dis­or­der at an­oth­er time in her life.

�2 A fam­i­ly mem­ber who has been di­ag­nosed with de­pres­sion or oth­er men­tal ill­ness.

�2 A stress­ful life event dur­ing preg­nan­cy or short­ly af­ter giv­ing birth, such as job loss, death of a loved one, do­mes­tic vi­o­lence, or per­son­al ill­ness.

�2 Med­ical com­pli­ca­tions dur­ing child­birth, in­clud­ing pre­ma­ture de­liv­ery or hav­ing a ba­by with med­ical prob­lems.

�2 Mixed feel­ings about the preg­nan­cy, whether it was planned or un­planned

�2 A lack of strong emo­tion­al sup­port from her spouse, part­ner, fam­i­ly, or friends

�2 Al­co­hol or oth­er drug abuse prob­lems.

Post­par­tum de­pres­sion can af­fect any woman re­gard­less of age, race, eth­nic­i­ty, or eco­nom­ic sta­tus.