John Legend Talks about Chrissy Teigen's Postpartum Depression

Contributing Factors

Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself.

The stigma surrounding mental illness, including depression, remains a barrier to people seeking help throughout the world. Talking about depression is a vital component of recovery, whether talking with a family member, friend or medical professional; in larger groups, for example in schools, the workplace and social settings; or in the public domain, in the news media, blogs or on social media, helps break down this stigma, ultimately leading to more people seeking help.

Target Groups Most Affected By Depression

Adolescents and young adults
Women of childbearing age (particularly following childbirth)
Older adults (over 60s) are the target groups identified by the World Health Day campaign because they are disproportionally affected by depression

Prenatal and Postnatal/Postpartum Depression

In pregnancy, depression is one of the complications of chronic illnesses such as HIV, hypertension, and diabetes mellitus in pregnancy was a risk factor for antenatal depression, causing tremendous life changes and limiting mobility and independence. This can make pregnant women not do things they enjoy which can eat away self-confidence and sense of hope in the future. It comes as no surprise that they often feel despairs and feel sad (J. Goldberg, 2014).

Findings in a study showed that prevalence of antenatal depression in Abeokuta North LGA, Nigeria is high at 24.5%. It peaked in the first trimester and slightly decreased with increasing trimester.

Various risk factors and predictors of antenatal depression were determined, and these were attending antenatal care in public facilities, gender based abuse or violence, intake of alcohol in pregnancy, young age, premarital pregnancy, unplanned pregnancy, illiteracy, history of previous caesarian section, coexisting medical conditions, and large family size.

Symptoms of Postpartum Depression

Postnatal depression can affect women in different ways. It can start at any point in the first year after giving birth and may develop suddenly or gradually.

Many women feel a bit down, tearful or anxious in the first week after giving birth. This is often called the "baby blues" and is so common that it’s considered normal. The "baby blues" don’t last for more than two weeks after giving birth. If your symptoms last longer or start later, you could have postnatal depression.

Common Symptoms of Postpartum Depression

The main symptoms include:

a persistent feeling of sadness and low mood
loss of interest in the world around you and no longer enjoying things that used to give you pleasure
lack of energy and feeling tired all the time
trouble sleeping at night and feeling sleepy during the day
feeling that you're unable to look after your baby
problems concentrating and making decisions
loss of appetite or an increased appetite (comfort eating)
feeling agitated, irritable or very apathetic (you "can't be bothered")
feelings of guilt, hopelessness and self-blame
difficulty bonding with your baby with a feeling of indifference and no sense of enjoyment in his or her company
frightening thoughts – for example, about hurting your baby; these can be scary, but they're very rarely acted upon
thinking about suicide and self-harm

These symptoms can affect your day-to-day life and your relationships with your baby, family and friends. If you think you may be depressed, talk to your GP or mental health care expert as soon as possible so you can access the support you need. Do not struggle on alone and hope the problem will go away. It can continue for months or years if not addressed.

Fathers and partners can also become depressed after the birth of a baby. You should seek help if this is affecting you.

Chrissy Teigen's Post-natal Depression

Model and author Chrissy Teigen has opened up for the first time about her experiences with post-natal depression, after welcoming her daughter Luna last year.

In an essay for Glamour US, Chrissy admits that although her life with husband John Legend and baby Luna might have seemed perfect to her millions of followers on social media, in reality things were very different. ‘I had everything I needed to be happy,’ she writes, ‘And yet, for much of the last year, I felt unhappy. What basically everyone around me – but me – knew up until December was this: I have postpartum depression.’

Returning to her hosting duties on Lip Sync Battle after maternity leave, she experienced debilitating emotional and physical symptoms, writing that: ‘I was different than before. Getting out of bed to get to set on time was painful. My lower back throbbed; my shoulders – even my wrists – hurt. I would go two days without a bite of food, and you know how big of a deal food is for me.’

Chrissy with her 11-month-old daughter Luna (Instagram)

She goes on to explain how, outside of her and her husband’s work commitments, she would rarely leave the house. ‘Most days were spent on the exact same spot on the couch and rarely would I muster up the energy to make it upstairs for bed. John would sleep on the couch with me, sometimes four nights in a row,’ she tells Glamour.

At a doctor’s appointment before the Christmas holidays, Chrissy was diagnosed with post-natal depression and anxiety, ‘so exhausted but happy to know that we could finally get on the path of getting better.’

When it came to sharing the news with friends and family, the 31-year-old found that ‘it got easier and easier to say it aloud every time.’

She also notes that this condition is rarely discussed in public, despite impacting around 10 to 15 percent of new mothers. ‘Before this, I had never, ever – in my whole entire life – had one person say to me: “I have postpartum depression,’ she writes, before adding that her lifestyle – which, she admits, is a highly privileged one – made her question whether she could truly be suffering from post-natal depression. And despite being – by her own admission – a chronic over-sharer, it also made her more reticent to share her diagnosis with the public.

‘I also just didn’t think it could happen to me,’ she says. ‘I have a great life. I have all the help I could need: John, my mother (who lives with us), a nanny. But postpartum does not discriminate,’ she writes.

‘I’m speaking up now because I want people to know it can happen to anybody and I don’t want people who have it to feel embarrassed or to feel alone.’John Legend has spoken out about Chrissy Teigen's post-natal depression and admitted he "didn't see it coming".

The Grammy award-winning singer and model/social media queen welcomed their first child Luna last year, and last month Chrissy bravely opened up about her battle with postpartum depression in an emotional essay for Glamour magazine.

John Legend Opens Up About Chrissy Teigen's Post-Natal Depression

Now John Legend has revealed he was not ‘emotionally prepared’ for her battle.

In an interview with The Sun, the singer admitted that ‘he didn’t see it coming’.‘You're not emotionally prepared for someone that's going through a dark time as you're welcoming this new life,’ Legend said.

‘When you don't understand what's happening, it's a bit challenging to figure it out and you don't know if it's something you've done or some other reason why she's not feeling well.’

‘It’s a chemical thing that happens to a lot of people after giving birth and there are ways to treat it and deal with it. So many people go through this — they say one in nine but there’s probably more than that,’ Legend explained. "Once you understand what the reasons are then it makes perfect sense and you can adjust accordingly."

John added that Chrissy's writing the piece was beneficial in her ongoing recovery, continuing: "I think it was good for her to talk about it."She was already doing better when she was writing the piece. She was coming out of it and was able to see it more clearly with some perspective and I think it was helpful for her to be on her way out of it as she was writing.

"We want three or four children. We're still excited to have more kids and we're going to do it." In Chrissy's powerful open letter, the star admitted she was in constant physical pain, couldn't stop crying, and would go days without eating. She also thanked John for his unwavering support and patience.

"He's exactly as compassionate, patient, loving, and understanding as he seems,"she wrote. "I know he must look over at times and think: My God, get it together. But he has never made me feel that way.

"He wants me to be happy, silly, and energetic again, but he's not making me feel bad when I'm not in that place."John and Chrissy have been together for ten years, and married in 2013.

Spotting the signs in others

Postnatal depression can develop gradually and it can be hard to recognise. Some parents may avoid talking to family and friends about how they’re feeling because they worry they’ll be judged for not coping or not appearing happy.

Signs for partners, family and friends to look out for in new parents include:

frequently crying for no obvious reason
having difficulty bonding with their baby, looking after them only as a duty and not wanting to play with them
withdrawing from contact with other people
speaking negatively all the time and claiming that they're hopeless
neglecting themselves, such as not washing or changing their clothes
losing all sense of time, such as being unaware whether 10 minutes or two hours have passed
losing their sense of humour
constantly worrying that something is wrong with their baby, regardless of reassurance

If you think someone you know is depressed, encourage them to talk about their feelings to you, a friend, their GP or their mental health expert (source: NHS Choices)

Prevention

Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for the elderly can also be effective in depression prevention. Visit a Psychologist today.

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Diagnosis and Treatment

Nigeria is one of the middle income countries lacking there mental health researchers are in shortage considering the growing concerns of mental illnesses worldwide. Other low and middle income countries in Africa are not left out. The absence of locally/culturally adapted simple tools to measure depression which will enable mental health workers to distinguish depressive symptoms from clinical syndromes of depression is a major concern because management strategies are different.

There is a need to offer and/or design intervention programmes that involves family members and loved ones as part of support system during stress management so that stressful situations among adolescent and adults can be addressed before they affect emotional well-being. Mental health education for all stakeholders in the education sector must be scaled up to enhance early diagnosis and early interventions.

However, there are effective treatments for moderate and severe depression. Health-care providers may offer psychological treatments (such as behavioural activation, cognitive behavioural therapy [CBT], and interpersonal psychotherapy [IPT]) or antidepressant medication (such as selective serotonin reuptake inhibitors [SSRIs] and tricyclic antidepressants [TCAs]). Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Different psychological treatment formats for consideration include individual and/or group face-to-face psychological treatments delivered by professionals and supervised lay therapists.

Psychosocial treatments are also effective for mild depression. Antidepressants can be an effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild depression. They should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with caution.

WHO response

Depression is one of the priority conditions covered by WHO’s Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase services for people with mental, neurological and substance use disorders, through care provided by health workers who are not specialists in mental health. The Programme asserts that with proper care, psychosocial assistance and medication, tens of millions of people with mental disorders, including depression, could begin to lead normal lives – even where resources are scarce.

As much as the mhGAP is a laudable approach if low and middle income countries can prioritize mental health. Apart from general myths shrouding mental illness in most countries, especially in Africa, the issue of adequate resource allocation and shortage of professional mental health care practitioners are major barriers for countries like Nigeria to care and support for the mentally ill. I shall be discussing these issues in subsequent updates.

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