Mental issue may lead to extreme, tragic outcomes if left untreated, says psychologist

PETALING JAYA: When an 18-month-old toddler was killed after having his throat slit, allegedly by his 32-year-old mother in Johor on March 17, it sent shockwaves among those dealing with postpartum depression (PPD).

This was especially so after Johor police chief Comm M. Kumar revealed preliminary investigations showed the mother had also sent a photo of the child covered in blood to her husband via WhatsApp.

While police are investigating the alleged assailant under Section 302 of the Penal Code for murder, clinical psychologist Dr Ainul Azreen Johari said the authorities should also consider PPD as a possible cause for the mother’s actions.

She added that PPD is a prevalent, yet often misunderstood condition affecting new mothers and remains inadequately addressed in Malaysia.

“PPD involves the mental health challenges faced by some new mothers who suffer anxiety and are unable to cope with newfound motherhood.

“While we are sure the police will thoroughly probe the matter, it is also crucial to consider all aspects, including PPD as a possible cause.”

Ainul Azreen said if left untreated, PPD can lead to extreme and tragic outcomes such as what happened in the Johor case and stressed the need for greater awareness and support for new mothers.

A specialist in maternal mental health, she said PPD is not just “baby blues” that will dissipate over time.

It is a serious mental health issue that can have lasting effects on the mother and her child if left unaddressed.

Rubithra Paramesivan, 29, who is a mother to a seven-month-old baby girl, said she used to love spending time with her newborn.

“But now it’s like a chore. I feel guilty for not feeling the overwhelming joy that everyone says I should have. Some days, I just want to lock myself in a room and cry.

“I can’t seem to shake this feeling of emptiness no matter how much love and support I receive from my family. It feels like I am trapped in my mind and unable to escape.”

Her husband, structural engineer Kabilash Sundaram, 31, said: “My wife has been more withdrawn of late, but we all thought it was the anxiety of being a new mother.

“We believed we were being supportive by offering to take care of the baby so she could get some rest. We also took her out for some hair therapy and massage sessions so she could relax.

“But one day I saw her almost losing her temper while feeding our baby who was just four months old then.”

Ainul Azreen said PPD presents a significant public health concern, impacting anywhere from 4% to 63.9% of new mothers.

She said it is closely linked to hormonal fluctuations, particularly reductions in oestrogen and progesterone, as well as epigenetic and neuroendocrine alterations that contribute to neuroinflammation.

Diagnosing PPD involves assessing the presence of at least five out of nine specific symptoms that persist for a minimum of two weeks.

“The symptoms encompass feelings of depression, loss of interest, fatigue, sleep disturbances, difficulty concentrating, indecisiveness, changes in appetite or weight, lethargy, suicidal thoughts or attempts, and feelings of worthlessness or guilt,” she said.