SINGAPORE: The first few month following a baby’s birth will be one of the most challenging times a new mother has to face. It makes sense why many people refer to it as the 100 days of darkness.
Your body is reeling from shock from a severe lack of sleep; you are petrified that you’re now responsible for a new life, plus, your hormones are going wild. And this is just the tip of the iceberg!
Babies are a handful, but they are also a blessing. Mums and dads are full of joy when they bring home their little bundles. This is usually followed by several parties to celebrate the newest addition to the family and visits from friends and families who want to take a peek at the new arrival.
During a time when you’re supposed to be bursting with pride, some women may feel the opposite. This is known as baby blues and many mums go through it during the initial postpartum weeks.
“Baby blues occurs because of the huge hormonal change that happens in your body after giving birth, which is a huge change,” said counsellor Silvia Wetherell, who specialises in maternal mental health. “However, if those symptoms prolong for more than two weeks, then it’s probably postnatal depression.”
According to SingHealth, 10 to 15 per cent of women in Singapore get postnatal depression (PND) after childbirth. If it’s not detected early, PND can cause a woman to lose her sense of self, wreck her marriage and even harm her baby. This was indeed the case back in November 2016, when a 29-year-old Singaporean mum fell to her death with her newborn from the 12th floor of her Bukit Panjang flat.
Several factors contribute to a mother’s PND. To some extent, hormones play a part, but so do external factors such as breastfeeding struggles, existing problems in the marriage or lack of support. Very often, getting the wrong kind of support can also contribute to a woman’s mental health issues. This can be anything from having a hands-off husband or helicopter in-laws and parents.
Whatever the case, maternal mental health should be taken seriously as it’s not just a hormonal issue that will pass with time. Nor should a woman who has had the courage to talk about her depression be seen as weak and told to toughen up.
“You wouldn’t say that to someone who’s broken their leg. That they just need to get up and be strong and not complain about it,” said Wetherell. “The thing about mental health is that you can’t see it so you can’t take it seriously.”
Another reason why PND is hard to take seriously or even detect is that most mothers are so good at hiding it. One of the big differences between normal depression and PND is that a woman with the latter often looks like she’s coping fine.
“That’s why it’s (postnatal depression) sometimes called the smiling depression, because the mother looks like she’s coping well from the outside, and she has to because she has a baby to take care of and she’s getting on with her duties,” explained Wetherell. “It won’t look like a normal depression where you have this idea of a woman crying under the covers and not going to work.”
PND can be tricky to diagnose, but it’s not impossible to do so. A mother who is battling depression internally will demonstrate some outward signs and symptoms that can be picked up by anyone who is keeping an eye out for it.
It’s important that you look out for these six of the most common symptoms – because you could end up saving lives.
Mothers with PND will have difficulty bonding with their baby. This is quite often the case even when a mum is able to meet her newborn’s physical needs, such as feeding him, changing his diapers and putting him to bed.
“Look out for someone who doesn’t show interest in her baby and keeps passing the baby to someone else. Or they get busy with other things and avoid spending time with the baby,” said Wetherell. “They often do it because they have difficulty bonding and are feeling disconnected from the baby. Sometimes, it could also be because they are terrified of hurting the baby.”
Some mothers also withdraw contact with their friends and family because they don’t want others to see how much they are struggling with motherhood. Other times, a mother is forced to stay home alone with her newborn during the first few months, which can contribute to her PND as well.
“I’ve had women who come to my support group who never left the house for three or four months. Their first outing would have been to come to the support group and they would sit there and sob and sob and sob,” said Wetherell.
A mother who is feeling inadequate and emotionally overwhelmed can sometimes just “check out” mentally, which leads to numbness. While the mum may physically go about her daily baby-caring duties, she is not really present – mentally or emotionally – for her baby. “She feels like it’s all too much and she can’t take it anymore,” said Wetherell. “This is not the best thing, especially when you have a newborn and you have to be very present.” The downside of this is that the mum will be unable to meet her little one’s emotional needs, such as cuddling and cooing over him, which is important if you want to raise an emotionally stable child.
The first few weeks after the baby arrives are the hardest. So, if a woman is feeling tearful it could be because of exhaustion and feeling overwhelmed. It doesn’t automatically mean she is experiencing PND though. “If she’s crying for just a few days and it goes away on its own, then it’s probably hormonal. But if it persists for more than two weeks, then it could be postnatal depression and they should seek treatment,” advised Wetherell.
ANGER AND NEGATIVITY
Some women may be good at hiding their emotions, but their depression can be detected from the things they say. “I see a lot of very angry mums, they may just be overwhelmed but it comes out as anger and frustration,” noted Wetherell. Look out for a mum who is continuously saying negative things about the baby or motherhood. She can also look quite angry at the baby or whatever that’s happening around her. She could also yell at her newborn.
Of the 25 to 30 patients Wetherell sees every week, about 80 per cent have PND while the remaining 20 per cent are struggling with pregnancy, fertility or a pregnancy loss. “Within that 80 per cent, I think I see more postnatal anxiety than I do depression. For some women, quite a few, they have both,” said the counsellor. With postnatal anxiety, mums experience lots of intrusive thoughts about something bad happening to their baby. They also worry about something happening to themselves or their husbands. “This could lead them to check on baby 10 times a night to make sure he’s really alive and this anxiety can trickle into everything they do,” said Wetherell.
The most severe form of PND is postpartum psychosis (PPP), where the woman breaks away from reality. “They hear things, they see things, they complain that their baby is evil or there’s something seriously wrong with baby and that they are doing the baby a favour by killing it,” explained Wetherell. Interestingly enough PPP is also the most treatable form of depression, since the mum is instantly put on medication and sedatives, which will make her feel better at once.
In its not so severe form, PND can also make a mum feel that committing suicide might be the easiest way out. This is because she might feel that things will never get better and it makes more sense to just end it all. She may not talk about it often though, but during the rare times that she does broach the topic of suicide, it’s important that those around her take what she says seriously instead of labelling her as a drama queen. It could end up saving her life and that of her baby’s.
A version of this story first appeared in SmartParents