Difficulties in Discussing Maternal Mental Health in South Asian Communities

Last week I attended the amazing #mumtakeover, a one day summit organised by the BBC to discuss maternal mental health in the UK.

I was incredibly impressed with all those who attended, especially the organisers and the panellists from Netmums, Maternal Mental Health Alliance and Better Start Blackpool who had all been chosen to give their expert opinions to mums and dads in the audience. They were helped by celebrity mums Stacey Solomon, Rochelle Humes, Giovanna Fletcher, DJ Neev Spencer and presenter Anna Foster who all kept the focus on mums and helping the fight against maternal mental health.

However, there were hardly any Asian mums in the audience. In fact, apart from the young mum of two sitting next to me, and Neev Spencer on the panel, I counted only another two Asian mums in the audience. So what does this mean? That Asian mums do not suffer from maternal mental illnesses? Or that maternal mental health matters are not an issue in the Asian communities?

Nothing could be further from the truth. It is because mental health is such a taboo subject, that hardly any mums tend to talk about it and therefore get the help they need until it is far too late both for them and their families.

I would know a little about maternal mental health myself, having been first diagnosed with post-natal depression (PND) soon after the birth of my child, who is now 14 years old.  Back then, I remember feeling so relieved to finally have a name to the feelings of low mood, weepiness and a general sense of low self-esteem and unworthiness. However, trying to convince my family was an altogether different and more difficult matter. I felt the most resistance from family members who wouldn’t take me seriously or tried to explain away my symptoms using excuses such as ‘over tiredness’, ‘too emotional’ and even ‘attention seeking’. Looking back now, it was definitely the start of a decade-long battle with mental health which only recently I have decided to speak out about.

Because my PND was not acknowledged or treated quickly at the time, it became a much longer, more clinical illness that I have just come to terms with having now. Some days are good, some days are dark but on the whole, I am not fighting it anymore. I see my mental illness as a familiar companion, some days we don’t get along and others we mooch along amiably, happy and relaxed. Because symptoms of depression can vary, from feeling lethargic and weepy to out and out psychotic episodes and hallucinations, there is no one-diagnosis-that-fits-all. Each and every mum will experience PND differently. Because mental health services in the UK rely mainly upon self-referrals rather than medically sanctioned sectioning, members of the South Asian communities are often unaware of their mental illness.

Looking back now, I don’t even blame those family members anymore because of the deep-rooted fear and lack of understanding when it comes to mental health and illness, especially amongst the older generation. I remember, speaking to a relative about feeling weepy and emotional soon after my child was born. I was told that I should be more grateful that God has blessed me with a beautiful, healthy baby and was made to feel deeply selfish and self-centred. Another family member wouldn’t accept the doctor’s diagnosis of PND, and kept telling me to stop being a ‘drama queen’. This is shared by blogger and writer Fatima Farah, who wrote in her excellent blog titled ‘Postnatal Stigma in British Asians’  ‘due to the cultural expectations of women in these communities to be maternal, (mums are expected) to ‘power through’, as they are not encouraged to talk about issues of emotional distress’.

The first year of my baby’s life was spent trying to deal with severe eczema, and I spent every waking moment worried and stressed about the best diet, sleep patterns and the daily skin routine. I felt I was at fault for the skin condition, and felt under constant pressure to ensure my baby was creamed and oiled with an array of skin lotions and potions, none of which worked much. It meant that I could not address my own needs and if I did try to discuss anything, I felt I was being a bad parent

So why didn’t I kick up a fuss back then and demand immediate medical attention? Women, especially when we are little girls, are taught from an early age not to make a fuss or draw any attention to ourselves. We are taught to smile, bow our heads and get on with the household chores or whatever it is that needs to be done. So when, later in life, we find ourselves feeling unwell or suffering a condition, we tend to just pretend it’s not happening. This is further compounded by the fact that mental illness is an invisible illness that isn’t always apparent immediately or without diagnosis by a professional. Add to the fact that the arrival of a healthy child is seen as a joyful, happy occasion in many cultures and communities while feeling down, emotional and weepy are associated with sad occasions. This further alienates a new mum from those around her, who don’t understand that she is suffering a real illness although with little or no symptoms. In 2015, Rima Lamba published her thesis on ‘Exploring Migrant Pakistani- Muslim Women’s Lived Experiences and Understanding of Postnatal Depression’ in which she discussed various cultural, religious and psychosocial factors that contribute to PND. It is incredibly insightful in how family dynamics play a critical part in whether the mum is made to feel isolated or involved in the family following the birth of her child.

In South Asian families, extended families are encouraged and provide a readily available network for the new mum to access support, advice and help with her new addition. However, over the past few decades, Asian communities in the UK are eschewing a traditional extended family arrangement which means fewer family members to turn to for help and support leading to more isolation for mums.

Mental illness can also strike at any time; it doesn’t have to be immediately after the birth of your first baby. Nilufa Dahlia, (@nillydahlia) a Bengali mum who blogs and vlogs about being a mother to two little children, told me that she did not experience any mental illness after her first child was born but after her second she was diagnosed with severe PND which she initially put down to ‘winter blues’.

Many Asian mums also feel that they will be tarred with a label that they can never escape from if they are diagnosed with a mental illness; once you’re seen as mentally unwell, you are seen as unstable and unbalanced for life. Many mums and their families will do anything to avoid that happening to them so they either deny or reject their symptoms and/or medical opinion.

Treatment for mental illness can also vary from each community; ‘black magic’ and ‘possession by demons’ is often used to describe severe psychotic episodes while anti-depressants and counselling is often rejected in favour of more unorthodox treatments such as using talisman and exorcisms. Community and religious leaders often tell their followers to turn to God and pray for good health or forgiveness without actually addressing the physical manifestations of mental illness; this is both counter-productive and dangerous- and can lead to long-term mental illnesses as was the case with me.

During the live summit on maternal mental health, many mums acknowledged that they were afraid that their ‘babies would be taken away’ if they told anyone about their mental illness. There is a deep-rooted fear of authority in some communities; especially of social services and the police, so for many, the possibility of this happening is entirely viable.

How can we tackle this sensitive and at times, taboo subject? Midwives and health professionals are doing a great job but at times they too can make mistakes and miss obvious symptoms of mental illness. In some cases, due to language barriers, or if the new mum is a recent arrival in the UK, family members often accompany mum to medical/ health appointments, leading to a fear of information being shared amongst family or community members. Although this is now being addressed with health professionals ensuring the use of independent interpreters, there is a still long way to go, especially when it comes to reaching out to those mums deemed the hardest to reach. I am so very glad that the BBC’s #mumtakeover started the conversation, now it is up to the rest of us to keep it going.

Below are some links that may help Asian Mums seeking advice on maternal mental health:

Websites

 

Helplines:

  • Samaritans: 08457 90 90 90
  • SANEline: 0845 767 8000
  • NHS Direct: 111

Author: Asian Mums Network Blogger

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About the author: AMN