Dear Counsellor:

Six months ago, my daughter gave birth to her first child. Since then, she has become withdrawn and quiet and is not taking good care of the baby. I have to be looking after the baby. She says she is depressed and lately she has been talking to herself. I took her to a private doctor who says she has post-partum depression with psychosis. I am afraid for her safety and the care of her baby.

- Enid

Dear Enid:

Mental illness in mothers who recently have babies is common and we need to be aware of this. Some mothers develop severe depression after childbirth and some also develop a schizophrenic-like illness. The exact cause is unknown but it is thought that hormonal changes and genetic predisposition will precipitate mental illness in susceptible individuals.

Every pregnant woman should be made aware that she can get depressed and that severe depression after delivery is a possibility. We need to be positive and help these women to take care of their mental health and build up their support systems. New mothers need help with a young child because they might not be getting enough sleep at night and become exhausted. Family and friends can take turns helping with the baby.

Post-partum depression with psychosis is treated with medication. If the condition is severe, she may need to be admitted to hospital for a few days. If the mother needs to be in hospital, the baby will have to be cared for.

Your daughter needs to take her medication and get as much rest as possible. You will need to take care of the baby and supervise both mother and child. Watch your daughter closely, and if she is expressing suicidal ideation, she should be admitted to hospital.

Dear Counsellor:

My son is 16 years old and has been diagnosed with schizophrenia. He started taking medication but he refuses to take it at times. He improves, then relapses. He smokes ganja and refuses to go school. He talks and laughs to himself and will sit and stare in space. He is not aggressive but can be unpredictable. I am worried about my son.

- Sonia

Dear Sonia:

Schizophrenia is treated with medication and support. The medication needs to be taken to keep symptoms under control. Many individuals don't like to take medication, either orally or by injection. To improve compliance, we usually prescribe an injection on a monthly basis. This injection contains substances that will improve brain functioning. Some individuals also need to take tablets as well. If individuals are non-compliant with these tablets, they may develop complications. Schizophrenia is controlled with the medication. Family support and education about the illness will help to keep patient well.

I know you will be feeling frustrated about the problem, but you need to have faith in God. Smoking ganja is not good for patients with schizophrenia. You will therefore have to take steps to discontinue the ganja smoking.

Many adolescents refuse to go to school when they are ill because other children may tease them or they find school stressful. We usually grant sick leave to adolescents with schizophrenia so that they improve quicker. Timeout from school usually varies, as this depend on the recovery of the adolescent. Your son can get better and resume his schooling. In the meantime, take him to the psychiatrist or health centre where he will be reviewed and injections given.

You need to get counselling to help you cope and provide you with parenting strategies that can help your son. Parenting strategies are important as you must nurture your son and help him over this challenging period. If he has siblings, they ought to be of assistance to their brother.