The bundle of joy – that’s how they refer to your precious baby that you've cared for and done so much to bring safely into this world. As you hold your crying baby in your arms, why does it feel so overwhelming trying to keep your own tears from falling? Where is that elusive feeling of joy and happiness?
Perhaps you did not see this coming. After all, as you looked forward to the arrival of your baby, you busied yourself with the preparations - for your baby, for the next phase in life as a mum.
Motherhood seems like a wonderful reality to prepare for, but beyond those Instagram-worthy moments, many soon-to-be mothers find themselves overwhelmed post-delivery. Between care giving and battling fatigue, they struggle to handle challenges of managing motherhood and their fragile emotional state and mental distress.
For some, they suffer severe mental distress in a form of a medical condition called Post-Partum Depression (PPD).
The National Institute of Mental Health (NIMH) defines Postpartum Depression as a mood disorder that may affect women after childbirth. Mothers with PPD find it difficult to carry out daily activities because of feelings of extreme anxiety, exhaustion, and sadness. PPD may occur shortly before or any time after childbirth, but commonly starts between a week and a month after delivery.
In Singapore, depression affects about 10-15 percent of women after childbirth. A few days after delivery, mothers may experience mild postnatal blues. If it lasts beyond two weeks, mums should seek medical advice immediately as 3-5 percent of women experiencing a moderate-to-severe depression require medical attention.
Yet, many don’t seek help and treatment.
The usual suspects – fear and lack of awareness – continue to permeate our society as mothers internalise their struggles, for fear of being judged or labelled as a less-than-competent mother.
Hence, being aware and prepared for the possibility of postpartum depression (PPD) should be part of your pregnancy preparations. Knowing the warning signs of PPD will allow you to seek medical help as early as possible. Likewise, there are things you can do to prepare for the consequences PPD may bring.
Beyond the damaging perception of new mums being overdramatic and emotional, postpartum depression is real.
With added responsibilities to take care of a newborn, it’s not surprising that new mums feel exhausted, overwhelmed and anxious all at once. It can be hard to tell whether the tears running down your cheeks while breastfeeding your baby is caused by baby blues or PPD.
How exactly do you draw the line between typical baby blues and PPD? According to the NIMH, baby blues, which affects up to 80 percent of mothers, are mild feelings of worry, fatigue and unhappiness that last a week or two, and go away on their own. On the other hand, PPD causes a mother to have extreme feelings of sadness and anxiety that interfere with her ability to care for her family and herself. The condition usually requires treatment.
Postpartum depression can rob a woman of motherhood joys. Despite having a healthy baby, a woman with PPD can feel down, losing interest in many aspects of her life. This could be early signs of Major Depressive Disorder (MDD) with Peripartum Onset. As per the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, 3–6 percent of women with PPD may begin to experience depressive episodes during pregnancy or in the weeks or months following childbirth.
Mums may cry out of extreme sadness, hopelessness, or emptiness for no apparent reason. Other mums suddenly lose interest in activities that they typically enjoy - no amount of leisure activities can take away their inner pain. Some mums lose their appetite and eat too little, while others either can’t sleep or oversleep.
The National Alliance on Mental Illness points out several risk factors for Major Depressive Disorder such as previous depressive episodes, a family history of depression, lack of social support, anxiety, marriage or money problems, stress, and substance abuse. Furthermore, being a stay-at-home mother and having an unwanted pregnancy are said to be associated to the risk of developing symptoms of depression.
Some mums suffer from PPD in the form of anger and irritability. For no apparent reason, they may experience rage that they can’t control, feel irritable and moody. What’s worse, they can encounter thoughts of harming themselves or their baby.
In some cases, mums literally lose their minds by having trouble concentrating, remembering details, and making decisions. PPD may also cause them to persistently doubt their ability to care for their baby and family. Likewise, mums with PPD also have problems connecting with their family, friends and their newborn. They usually try to avoid social gatherings and want to be in isolation.
The other face of PPD comes in the form of uncontrollable anxiety. Perinatal Generalized Anxiety Disorder (GAD) has a high prevalence of 8.5%–10.5% during pregnancy and 4.4%–10.8% postpartum. GAD is characterised by excessive, uncontrollable worry that can cause functional impairment. Women with GAD worry about foetal wellbeing, maternal wellness, illness in the partner, and parental mortality. Though these causes of concerns seem normal for a new parent to have, these worry symptoms that persist for an extended period of time may cause functional impairment in every aspect of the mother's life.
Should you experience any of the symptoms of PPD, it is best to consult a health care professional. You may be asked to undergo a depression screening that involves a questionnaire. Doctors may also recommend blood tests to determine other possible factors that may contribute to your symptoms.
The good thing about PPD is it can be treated. Seeking the help of a mental health professional as soon as possible is the key to receiving immediate treatment. According to NIHM, the treatment methods for PPD, which can be used alone or together, are counselling or talk therapy and medication. If left untreated, mums may suffer from PPD for months or years.
While there is no sure way to prevent it, there are things you can incorporate in your pregnancy journey that can help you prepare for postpartum depression. Don’t let PPD get the best of your experience as a new mum by including the following in your pregnancy preparations:
1. Stay physically healthy
Eat right. Sleep right. Do your prenatal workout. Being physically fit will help you cope well with the stress and fatigue as a new mum.
2. Take care of your mental health
As stress is a risk factor for PPD, it is important for mums to prioritise their mental wellbeing. Boost your mental health by engaging in meditative practices like Yoga, walking meditation, relaxation techniques, and Taichi.
3. Be financially prepared
Postpartum depression may hinder new mums from focusing at work. Not being able to work may affect your finances. Likewise, therapies and medical consultations will add to your long list of expenses as a parent. As no one can tell whether you will have PPD or not, it is best to be prepared financially. Aside from saving money, availing insurance products that cover mental health-related conditions financially will give you the security you need.
Postpartum depression may be the least of what you want to think about during the joyous days of pregnancy. However, equipping yourself with knowledge of PPD can help you prepare for the possible consequences of this postpartum condition.
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