It’s been said that the thoughts you have can be a deadly weapon. Thus, mental health awareness should be at its optimum. Postpartum depression is a mental illness that affects new mothers and is usually misunderstood.
Understanding postpartum depression
It is estimated that one out of every seven women suffers from postpartum depression (PPD), and it may be tough to find a light out during this darkest moment. But with a lot of support and encouragement, keep on believing that there is a way out, no matter how difficult it may be.
Melissa Kho, who shared her experience, recalled that it happened soon after she delivered her baby six years ago.
“My PPD started out mild but got worse over the course of two to three weeks. When I first got hold of my child, I thought something didn’t feel right. I didn’t ‘feel’ anything for him, but it didn’t bother me too much, so I just ignored it.”
The 34-year-old described her experience as postpartum anxiety rather than depression. As she took her baby home, her anxiety increased.
“I was anxious about a number of things, including my lack of feeling, other aspects of life after the birth, my relationship with the child, and what to do with the child. I was plagued by thoughts all the time,” she said.
Kho recalled that her first symptom began with just a worry about how she was doing as a first-time mother.
“I was worried about the baby’s sleep, feeding, and night-time waking. I was also thinking how I could develop love for this baby.”
Kho’s constant worrying and over thinking had driven her to obsessively search the internet for the many things she didn’t understand. This had caused her to lose sleep.
“Sleeping became a chore. It became something I was hyper-focused on — the need to go to bed early, sleep when the baby sleeps, and wake up when the baby wakes,” she said.
Everything eventually had an impact on her mental state. She soon became panic at the thought of being unable to sleep.
“I was awake all night long. That, I believe, is what caused the ultimate panic and anxiety attack 3.5 weeks after giving birth.”
Although it occurred half a decade ago, the mother of one can still clearly recall how every time she was carrying her child, she would experience intense dread and panic for no apparent reason. When she is about to fall asleep at night, a surge of adrenaline will rush through her body, causing her to bolt awake.
“Most nights, I battled it alone. On certain nights, I would wake my husband because I couldn’t bear being awake and alone.”
A cry for help
The PPD-related sleepless nights and never-ending emotional fights were what spurred Kho to seek emergency assistance. She made an appointment with the psychiatrist with the help of her sister.
“But I wish I could say that I recovered right away.”
Kho said that it was a long road to recovery. Despite years after postpartum, the journey continues to this day.
“It took many trials of different medications, prayer, and faith in God to get me to where I am now. PPD/PPA disappears completely for some people after seeking treatment, and they can eventually wean off their medication. For me, it’s different, though.”
She added that she has continued to struggle with insomnia and anxiety over the years. As a result, Kho had to keep taking her medication. Nonetheless, the strong-willed mother learnt not to compare her journey to that of others.
“My journey may differ from others, but that’s alright.”
Throughout her journey, she expressed gratitude to her immediate family members, including her husband, sisters, parents, and close friends.
“They did not give up on me; instead, they stood by me as I went from one doctor to the next, trying one medication after another.
“I found that talking to others was the most helpful thing. Even though they didn’t understand what I was going through, I was still benefited by being able to communicate with them and express my suffering,” she said, adding that she had reached out to and spoken with others who were in a similar situation to hers.
“I then understand that I am not alone. To know that I wasn’t alone after learning this news was helpful. I therefore urged anyone dealing with PPD/PPA or any other mental health issue to seek help, to keep trying, and to stop believing that they must live in misery forever. Help is available.”
Postpartum depression: What you need to know
Even though PPD is a common occurrence, little is known about it. Many people are unaware of the medical facts. Rather, PPD is often mistaken as the mother’s lack of spiritual belief or failure to conclude her confinement properly. However, PPD goes beyond that.
PPD, or peripartum depression, is the term used to describe depression that happens during pregnancy or within four weeks after giving birth.
Speaking on the subject, Dr Rosliwati Md Yusoff, Director and Consultant Psychiatrist at Hospital Sentosa, said that PPD can affect any woman. The diagnosis has nothing to do with a woman’s ability to be a good mother.
“It is the most common psychiatric complication associated with childbearing. It involves a complex mix of behavioural, emotional, and physical changes for some women. Women can be especially vulnerable during pregnancy and the time following delivery,” she said, adding that at this time, mothers often go through immense biological, emotional, financial, and social changes.
“Other factors include the physical changes brought on by pregnancy, adjustments made in personal and professional relationships, anxiety about parenting, and sleep deprivation.”
According to Dr Rosliwati, one of the several instances that may occur if PPD is not identified early or is not treated is that a mother may hurt herself or the baby.
“PPD has the potential to negatively impact a mother’s health and quality of life, as well as the health of the baby, who may be born prematurely or with a low birth weight. Peripartum depression can also lead to difficulties bonding with the baby. It can also cause sleep and feeding difficulties for the baby.”
Seek help immediately
As with any other mental health condition, Dr Rosliwati advises mothers to get help as soon as symptoms appear.
“Peripartum depression, if left untreated, can be dangerous to new mothers and their children. Treatment is determined by the type of symptoms and their severity.”
PPD responds well to treatment, especially psychosocial treatment with an interpersonal focus, according to the psychiatrist. However, treatment plans differ from person to person and can include things like individual, family, or group psychotherapy, medications, a supportive environment, a change in lifestyle, or a mix of these.
“Discussion on the risk-benefit of medications is also taken into account,” she added.
The doctor said that with the right care, symptoms experienced by new mothers can be relieved.
“Women who are being treated for PPD should continue their treatment even if they are feeling better. Symptoms may return if medication is stopped too soon.”
But post-birth doesn’t just affect mothers. The psychiatrist added that fathers may feel the same way.
“According to a data, in the first year following the birth of their child, approximately 4 per cent of men report experiencing depression. Fathers who are younger, have a history of depression, or are struggling financially are more likely to experience depression,” Dr Rosliwati said.
With all these matters relating to covert societal issues, they are undeniably there and taking place all around us. It is easy to dismiss PPD as the mother’s fault, but it is too late once things have occurred.
Therefore, Dr Rosliwati advises those who are in need to seek assistance at the closest health facility centre.
“Help is accessible through health clinics, general practitioners, district and general hospitals, and mental health professionals.”
Symptoms of Peripartum Depression
Emotion:
• Feeling sad or having a depressed mood
• Feeling of guilt, anxiety and worthlessness
• Feelings of being a bad mother
• Fear of harming the baby or oneself
Thought:
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide
• Thoughts of hurting oneself or the infant
Behaviour:
• Extreme difficulty in day-to-day functioning
• Loss of interest or pleasure in life
• Changes in appetite
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (eg, inability to sit still, pacing, handwringing) or slowed movements or speech [these actions must be severe enough to be observable by others]
A woman suffering from peripartum depression will usually have several of these symptoms, and the severity of the symptoms will vary. Many women who suffer from peripartum depression also have anxiety symptoms.
Who is at risk?
1) Any new mother (or gestational carrier/surrogate) can experience symptoms of peripartum depression or other mood disorder.
2) Women are at risk of depression during or after pregnancy
a. if they have previously experienced (or have a family history of) depression or other mood disorders,
b. if they are experiencing particularly stressful life events (having a child with special needs, marital difficulties, financial constraints) in addition to the pregnancy, or
c. if they do not have the support of family and friends
d. if they have complication during pregnancy or problem with the unborn baby
e. unwanted pregnancy or ambivalence about pregnancy
How can you support a mother going through peripartum depression?
A: Support from spouses, family, and friends must be strong and reliable.
· Know the Signs. Learn to recognise the symptoms of depression and anxiety and if you see signs, urge her to see a health care provider.
· Listen to Her. Let her know you want to hear her concerns.
· Give Her Support. Tell her that you are here to support her and that she is not alone. Consider offering to watch the baby while she rests or visits friends, or to assist with home chores.
· Encourage her to get assistance if necessary. She might feel uneasy and resist getting help. Encourage her to consult a medical professional. Share some peripartum health information. Make an appointment for her to meet with someone.
How does a mother who has been diagnosed with peripartum depression get around the loophole?
A: Self-care and effective coping mechanisms.
· Family and friends’ support: Ask for help. Let people know how they can assist you.
· Good nutrition and exercise: Follow a healthy diet (avoid caffeine and alcohol), go for a walk, and leave the house occasionally.
· Keep in touch with family and friends: Don’t isolate yourself.
· Strengthen your bond with your spouse: Make time for each other.
· Be realistic in your expectations for the baby and for yourself.
· When your child is asleep, you should also rest.
· When you first arrive home, limit visitors.
· Expect both good and bad days.
· Take part in any available new mothers’ support groups.
