Dr Manali Rao, Author at GOQii

January 29, 2017 By Dr Manali Rao Leave a Comment

Pregnancy and Depression

The most wonderful time in a woman’s life is during her pregnancy. It’s a miraculous time when a little prince or princess is growing within us and for the first time in our life we are unconditionally in love with this little unknown being. We cherish every pain that we go through during these 9months. It’s as if all your happiness, your desires revolve around the yet to be born baby.

It’s a magical time. Or so everyone says. But, is it so for every pregnant woman out there?? Everyone expects the expectant mother to always be happy all the time. Pregnant woman is also told how she is not supposed to be crying or throwing tantrums or thinking negative. Well, believe me, this is easier said than done. Yes, the mother is happy, nobody could possibly be as happy as her. She is the one carrying the baby for 9 Months in her womb remember! And, yes she’s happy that she has made the entire family happy by this great news.

But,most forget that to-be-mothers are also human!!! So what’s wrong if she’s a little anxious! What’s wrong if she doesn’t feel elated every single moment of the day! What’s wrong if she weeps for some silly reason! What’s wrong if she gets upset or fusses over little things! Just because she is pregnant, it doesn’t mean she’s not a normal human any more right??!!!

Most women end up feeling guilty for being sad or upset during pregnancy! Why so?? Well, thanks to the expectations of everyone around them. They get a sense of fear towards their unborn child. They become increasingly unsure of their parenting abilities.Nobody is a perfect parent. We all learn through mistakes. Why do people forget that? Fear of the unknown is obvious. But, the unknown isn’t always bad right??

These thoughts precisely has led me to write this blog on Pregnancy and depression.

Depression during pregnancy also known as antepartum depression, and depression after delivery known as postpartum depression is a mood disorder just like clinical depression. All women experience depression and anxiety at some point of their pregnancy. During pregnancy, a woman’s body goes through many changes be it physical/mental/emotional. Hormonal changes occur during pregnancy and all these lead to mood swings which are perfectly normal during pregnancy. So when do we actually worry and differentiate between the normal pregnancy symptoms or symptoms of actual depression.

Here are few symptoms to look out for:

Feeling sad and anxious all the time
Loss of interest in activities
Not pursuing hobbies anymore
Sleeping too little or too much
Feeling of hopelessness or worthlessness or guilt
Thoughts of death or suicidal tendencies
Inability to concentrate
Withdrawal from family and friends
Crying spells
Recurring nightmares

Risk factors:

Troubled family life
Lack of emotional support from the family especially spouse
Past history of clinicaldepression
Family history of clinicaldepression
Any persisting or past psychiatric illness
Miscarriage in the past
Conception post infertility treatment
Any medical condition Or past illness

Apart from antepartum depression a woman can also go through Postpartum depression (PPD).
Many new moms experience the “postpartum baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety, difficulty in sleeping, difficulty bonding with your baby, fear that you are not a good mother and even thoughts of harming yourself or your baby. Baby blues typically begin within the first two to three days after delivery, and may last for up to two weeks. It can affect both parents.

How does one overcome depression??

Family’s support, understanding, love and care can work wonders especially the attention of your spouse. Everyone should understand that a woman goes through so many changes duringpregnancyand that the symptoms vary from one person to another. Some women may have a hassle free pregnancy, while others may not and understanding this is most important. Nobody will fake any ailment. So if a woman says she has some trouble, be it a simple backache or a headache or excessive nausea vomiting, trust her that she does.
Indulgein hobbies: Indulge in activities that make you happy. If you are inclined to sketching, singing or any other hobby try pursuing these hobbies during your pregnancy and that can keep you calm and happy.
Do not hesitate to seek help. Many families still think seeking help means either you are weak or something is wrong with you. And most conclude you have either gone crazy or have lost your senses, it is certainly not so. Any person may experiencedepression. That does not make the woman crazy. It’s just a phase of life. Like every other problem women have to fight it and overcome the same.
Eathealthy. Nutritious diet is most important along with folic acid/iron/calcium supplements duringpregnancy.
Sightseeing – going out and getting some fresh air with your spouse even if its just for walks can always cheer you up.
Rest -Yes it is very important to be active to ensure normal delivery and lesser complications. But at the same time getting ample amount of rest is equally important.

Management:

Instead of jumping to drugs as the first line of treatment we must try CBT (Cognitive Behavioral Therapy) accompanied by support of the family, healthy diet, meditation and making sure the mother incorporates hobbies in her everyday routine.

Don’t ever think twice to seek help. Ignore the stigma that the society has shown towards depression during pregnancy. It’s no one’s fault. It can happen to anyone. What’s important is to recognize the symptoms, remain strong, face it and overcome the same.

December 1, 2016 By Dr Manali Rao Leave a Comment

Living Healthy with HIV – Reality or Myth

Have you seen the latest#CondomEmoji campaign by Durex, the Global Sexual-well-being brand depicting an “Umbrella with Raindrops”? This was the unofficial safe sex emoji launched ahead of World AIDS Day today. It was an interesting campaign to communicate ‘Safe Sex’ among the young adults. The campaign called for putting a safe sex emoji on every smartphone in order to help young people communicate about safe sex. The campaign has trended both on Twitter and Facebook with supporters from over 160 countries backing the movement.

The survey findings noted while more than 60 per cent of young people surveyed admitted to being uncomfortable discussing safe sex, 72 per cent of respondents admitted that they found it easier to express emotions using emojis and more than three quarters admitted that they use emojis to discuss sex and relationships.

Why is this discomfort about talking of sex or sex related diseases such as HIV/Aids even in the 21st Century?
One of my earliest memories of AIDS would be the movie PHILADELPHIA where Tom Hanks sues his Company for being fired from his workspace for being HIV positive.

Whenever we hear the word AIDS or HIV the word itself it creates a lot of fear and makes one judgmental. This is not the case only among the lay man but also is the case equal judgment, not only among general public but also within the medical fraternity. Unfortunately more than a the disease, AIDS is considered to be a social stigma and a taboo.
It’s become imperative to understand why this stigma is attached to HIV/AIDS?

AIDS (Acquired Immunodeficiency Syndrome) as we all know is a syndrome caused by the Human Immunodeficiency Virus (HIV) which directly attacks the immune system of the patient leaving the body vulnerable to a host of infections. Aids is the last stage of HIV infection where the disease progresses and the body can no longer defend itself leading to more severe infections, malignancies and eventually death (if left untreated).
Let me try to look into the ways one can get infected with this Virus which are considered some of the main reasons for fear and stigma.

1. Unprotected sex- with an individual who is infected with HIV is the biggest cause of new HIV cases be it vaginal or anal sex. Oral sex also predisposes one to HIV if there are any cuts, ulcers or sores in the mouth. Wearing a condom is the easiest way to protect yourself and your partner against the disease. Unprotected Sex is more prevalent among young adults.
2. Blood transfusion with infected blood. This is one of the most unfortunate ways to contract the disease as the recipient is unaware of the blood being infected. It is always a good idea to make sure that the blood has been screened for HIV infection.
3. HIV infected mother can pass on the virus to her baby during pregnancy lactation or even delivery. These mothers can now take treatment to protect their babies.
4. Sharing razors or needles with infected people also puts you at risk of contracting the virus like in the case of drug abuse or needle prick in hospital.
In short the virus can be transmitted through infected blood, semen and vaginal fluids. In fact, when the disease first came to light in India, it was the sex workers and their clients who had the maximum prevalence followed by truck drivers.

The latest ‘DIPPER’ at night campaign where the Condom is disguised as the dipper is a great way to create awareness among truck drivers in India to frequent sex workers often.
But, honestly it’s not so bad as it’s been made out to be over the years. Currently, experiments are being conducted to find a cure for this disease. The good news in India is that we are seeing an overall reduction in HIV infections among the adult population.

According to more recent National AIDS Control Organisation data, India has demonstrated an overall reduction of 57 percent in estimated annual new HIV infections (among adult population) from 0.274 million in 2000 to 0.116 million in 2011.

India has the third largest number of people living with HIV in the world, according WHO.

LIVING WITH HIV / AIDS:

It’s not as bad. One can live with HIV.

The diagnosis is confirmed by a blood test and depending on the extent of severity of the immune deficiency, anti-viral medication is started which improves the number of immune cells which help fight infections and restore near normal life.

The medicines though expensive are distributed free of cost to patients at Government and NGO run clinics.Psychological help for not getting overwhelmed after the diagnosis, is also readily available. Confiding in a trusted person who won’t be judgmental. Judgmental helps in calming your nerves.

One must realize and believe that they can live to their potential inspite of being HIV positive. Having social and emotional support is very essential, hence patients must not isolate themselves from their near and dear ones and f.amily and friends should also not ostracize the patient.

The Constitution of India prevents any discrimination against anyone having HIV and AIDS and neither is it a legal ground for dismissal from occupational services.

Patients living with HIV must maintain a healthy lifestyle just like diabetics or any other chronic disorders. Having a healthy diet and exercising regularly are a must to boost your immunity along with the medication. Till date HIV and AIDS has no cure but anti-retroviral therapy (ART medicines) are helping people live a healthy and happy life for almost 2 to 3 decades.

Currently, Art drugs have become ‘very good’ at controlling infection but patients need use the medication for life. If they stop the treatment, the virus rapidly replicates, eventually leading to the fatal AIDS disease.

Pregnant mothers have successfully delivered children without HIV with the help of anti-viral medication.
Lot of research by brilliant minds is being done around the globe to find more effective medicines and a cure.
HIV facts to know

• According to the WHO, more than 70 million people have been infected with HIV so far and about 35 million people have died of from the virus.

• In 2015, an estimated 36.7 million people were living with HIV and so far the infection remains incurable.

October 4, 2016 By Dr Manali Rao 1 Comment

What is contraception?? Birth control or fertility control

Why or how does it play such a major role in the betterment of a society? I have a little story to share. Like all women, my friend was also super excited about her wedding. It was the perfect match, the man was perfect with a well-paying job, loving family and most importantly he was a man with a heart of gold. Are you wondering how our discussion on contraception fits into the scheme of this here?

Let me explain. Here’s what happened! Couple of days before their big day, my friend’s to be husband made it very clear to her that he does not want to use any contraceptive. But, he did not want a child for a year at least. And, that he also did not want her to use a barrier method of contraception (female condoms) either! The other conditions laid down by her to be partner was also that she had to lose weight and remain slim for the rest of her life. This is kind of a heard story right? It does not come as a surprise.

Now, my friend was in atotal fix. There were so many terms and conditions and unfortunately she had no say in the matter. It was told to her and she had to follow it. She was not very keen on OCPs (Oral Contraceptive Pills) given their side effects like weight gain, nausea, sore or swollen breasts, lighter or heavy periods, mood changes, abdominal pain and headaches. So what other option was she left with?

IUCD (Intrauterine Contraceptive Device)-It is a small contraceptive device, often ‘T’-shaped, containing either copper or levonorgestrel, which is inserted into the uterus. They are one form of long-acting reversible contraception which are the most effective types of reversible birth control.

Was my friend aware that it is not advisable to use IUCDs unless you have conceived at least once? Nope! She wasn’t aware nor did she take any medical advice. So just to keep her husband happy, she opted for IUCD.

What happened next?!!

She started having adverse effects like excessive bleeding during menses, abdominal pain, and loss of weight and before we knew it, she looked under nourished.

What led to all this? Who was to be blamed? Was it the girl’s fault? Or was it her husband, who had the notion that using a barrier method reduces the pleasure or the basic psyche that the girl must to do all that pleases her husband irrespective of what the consequences could be. I would say all three and most importantly it’s the lack of knowledge about contraception.

I am saddened by the thought that some people still think contraception is unnecessary as it decreases libido and that it’s a taboo. Well, trust me folks it is not so. When one uses contraception, they can avoid unwanted pregnancies and space planned pregnancies to promote optimal birth outcomes.

When a pregnancy is planned, one can start prenatal care, including increasing their intake of folic acid; work with the gynecologists to address relevant medical conditions, as well as substance abuse; and take other steps that lead to healthier outcomes for both the mother and the infant.

Pregnancies that are unplanned are more likely to be affected by delayed prenatal care, maternal depression, low birth weight, poorer childhood physical and mental health, and other complications. Breastfeeding rates are also lower after unintended pregnancies. We should also remember that most of the unintended pregnancies end in abortion, which affects both the parents psychologically and affects the mother physically.

When you look at the facts, contraception is a smart public health policy.

Of course, for some women, birth control is essential for other health reasons, including acne, fibroids, and endometriosis and to reduce problems associated with irregular or very heavy periods.

There are several methods of contraception:

Natural Family Planning (NFP): Couples can use NFP techniques like the rhythm method, basal body temperature, or the cervical mucus method to try to pinpoint when a woman is ovulating (fertile). To prevent pregnancy, sexual intercourse is to be avoided around the time of ovulation.

Other methods include barrier method (condoms), OCPs, IUCDs.

Remember, contraception plays an important role in the well-being of the family and the society as a whole.

Finally, don’t forget to consult your gynecologist for advice on the right Contraceptive method for you.