Charlize Theron stars as Marlo in Tully. The film examines a woman's mental wellbeing during pregnancy, before and after birth.Picture: Focus Features

New movie, Tully, refuses to glamorise motherhood. Instead, it sparks a conversation that is long overdue, writes Marchelle Abrahams.

Every mother can relate to the late night feeds; early morning wake-ups; crying; burping. And so much baby vomit. It’s like the smell is permanently settled into your clothes, your hair and your life.

Charlize Theron’s new movie Tully is a reality check for parents. It shows the funny and dark side of bringing a baby into the world.

It’s profound and sad at the same time, shining a light on post-partum depression and the depths of pain mothers go through, only to be told that there is light at the end of the tunnel.

For some, yes, but for others the darkness is never ending and the light is elusive.

Never before has a movie explored the subject matter so rationally, and without sugar-coating it.

Theron plays Marlo, a 40-something mother of two who decides to hire a night nanny, Tully, after the birth of her third child.

Written by Diablo Cody, the brains behind Juno, Tully has inadvertently opened the discussion on maternal mental wellbeing, and the lack of support surrounding it.

In an interview with the Washington Post, Cody admitted parts of the movie are semi-autobiographical and arose out of her personal experience. Written two-and-a-half years ago, Cody said she penned it during a “post-partum fog” after the birth of her third son.

READ: Tully and the paradox of parenting

Many mothers experience some form of depression, anxiety or other psychiatric disorder during pregnancy or in the 12 months after childbirth, according to Dr Lavinia Lumu, a specialist psychiatrist at Akeso Crescent Clinic in Randburg, Gauteng.

“About one in five new mothers worldwide, and up to one in three in South Africa, may experience symptoms without even realising it.

“Psychiatric disorders in the perinatal (immediately before or after birth) period, such as anxiety or depression are often missed or left untreated to the detriment of mother and baby.”

According to experts, there are five types of disorders that new and expecting mothers are prone to.

Perinatal depression

This is characterised by a low or depressed mood, lack of interest, drive and motivation.

“Feeling hopeless or overwhelmed, having thoughts of death or suicide, and losing interest in the baby or feeling like you can’t bond are also among the symptoms of perinatal depression,” says Dr Bavi Vythilingum, specialist psychiatrist.

Bipolar disorder

“Psychosis in mothers may manifest as either auditory or visual hallucinations, delusions, suicidal thoughts or thoughts of harming the baby, known as infanticide,” adds Vythilingum.

Bryce Dallas Howard spoke about her postpartum depression in Gwyneth Paltrow's newsletter GOOP, saying: “[My husband] would ask what he could do to help, but knowing there was nothing he could do, I screamed expletives at him, behavior he had never experienced in the seven years we had been together.” Picture: AP

“This is an emergency and women who experience these feelings should seek help immediately.”

Anxiety

During pregnancy, the excessive release of endogenous cortisol (stress hormone), due to severe anxiety, may interfere with the normal growth of the unborn foetus. Panic and anxiety attacks typically peak within a few minutes and resolve within 30 minutes to an hour.

“It’s important that common medical conditions which often have their onset during pregnancy, such as hyperthyroidism and asthma are excluded, so that the patient can be properly diagnosed,” comments Lumu.

Birth trauma

“International research is limited, but it is estimated that the percentage of women who experience delivery as traumatic is between 9% and 44%,” adds Lumu. She says about 9% to 15% of these women experience post-traumatic stress disorder (PTSD) after childbirth.

For the diagnosis of PTSD to be made, symptoms must be persistent at least for one month after childbirth.

Obsessive-compulsive disorder

OCD manifests as intrusive, unwanted thoughts that are distressing, accompanied by repeated behaviours or compulsions to decrease the anxiety of the intrusive thoughts.

“Common examples of obsessions include an intense fear that something is contaminated by germs or dirt,” Lumu says. “Women with perinatal OCD often worry that their baby will be harmed through contamination. The compulsions may include washing, cleaning or sterilising repetitively and excessively.”

Treatments available

Urgent screening and intervention is important when making a diagnosis.

“If a family member suspects that a new or expectant mother has a mental health problem, it is important to encourage her to seek help urgently from a healthcare professional,” Lumu suggests.

“Milder depressive conditions can be managed through psychotherapy, while more severe conditions require pharmacotherapy in the form of antidepressants for depression and anxiety.

“Many antidepressants have been well researched and have been shown to be relatively safe during pregnancy and breastfeeding.

"Mood-stabilisers are reserved for the treatment of bipolar disorder, and mothers with suspected bipolar disorder should be referred to a psychiatrist.”